Fixing health care

We pay more for health care than people in any other country in the world, but our health care ranks 37th of 191 countries (based on the most recent survey by the World Health Organization, done in 2000).

Newsweek did a less comprehensive survey in 2010 and ranked the U.S. 11th in quality of care, while still #1 in expense.

Whoa, now! We always hear that our health system is the best in the world. Our politicians say so! What gives?

Most countries guarantee medical care for their citizens, but America ranks dead last in “fairness”: many Americans aren’t covered by medical insurance. In other words, Americans who can afford it get decent health care, but poor Americans don’t. Even Americans with health insurance have difficulty getting medical care on nights or weekends, unless they go to emergency rooms. The quality of our health care varies: we get outstanding care for some illnesses such as breast cancer, but not so good for other conditions such as colorectal cancer. We have the second highest death rates for bronchitis, asthma, and emphysema. Our infant mortality is high, and we have a high rate of dying from diseases that are treatable. Many other countries provide better care for people with chronic illnesses. We score poorly in protecting safety of patients, and we don’t do well in meeting patients’ needs and preferences. We boast about the quality of our hospitals but (according to a report by Consumer Reports) infections, surgical mistakes, and other errors contribute to the deaths of 180,000 patients a year – “Medical harm is probably one of the three leading causes of death.” Finally, we’re behind many other countries in use of information technology – our medical records and communications systems are embarrassingly primitive and inefficient.

Politicians claim that Americans are happy with our health care.

Again, not true: we rank 14th of 17 nations polled for overall satisfaction with health care. One big reason is high cost (“we’re number one!”). One cause of this high cost is poor efficiency (for instance, poor people having to go to emergency rooms for care that should be taken care of through prevention and less expensive services). Another reason for high cost is that American medical insurance companies, drug companies, and – yes –some health care professionals continue to get rich even though our overall care doesn’t compare so well with other health care systems.

The Patient Protection and Affordable Care Act tries to address these problems. (Conservatives avoid facing these problems by calling this Act “Obamacare”).
You have a choice this fall. You can vote for conservatives who promise to repeal the Act, thus halting the effort to systematically fix our mediocre health care system. Or you can vote for moderates and progressives who support using the Act to improve access to health care, control costs, and address the problems summarized above.

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