For anyone following my articles, I hope it has come across that I am extremely frustrated with our system. Much of that revolves around the incredibly high cost. But that’s only part of the story…
If we paid as much as we do and it resulted in a top-notch system, I think my frustration would be at levels that are more manageable. However, the World Health Organization ranked our system 37th, meaning we sit just below Costa Rica and barely above Slovenia! Largely based on outcomes, this report speaks to a system that doesn’t put the patient first, where the few quality providers are largely out of reach to the masses, and one in which we often wind up worse off after we receive care than we were before.
It is on this point that I get the most amount of pushback from the public. They ask me “Why do people travel from all over the world to get care in the U.S.?” This is a legitimate question. Let me give you a statistic. As of 2007, the nation with the second highest number of MRI machines per 1 million residents was Italy, with 1,097. France, the top-ranked health care system, had 350. The U.S.? We have 7,810 per 1 million residents. This is an insane number that requires mass volume of MRIs just to be financially viable. CT scanners are even worse. We had 10,535 per million versus France, with 659. So, why do people come to the U.S. for care? Because sometimes, faster access to mediocre care (at best) is better than waiting months for really good care.
This disproportionate amount of care exists in in all areas within the U.S. Outpatient facilities, hospital beds, labs, pharmacies… Therefore, we have a tremendous amount of not great care available to us at a price most of us cannot afford. Medical bills are now responsible for 67 percent of all bankruptcies in the U.S., and over half of those who file have health insurance! So even with insurance, we still cannot afford the cost nor the insane volume of care we receive.
When a car salesperson or real estate agent recommends a car or a house, don’t we hold the recommendations of even the most seasoned professional a little suspect? Don’t we verify what they tell us about cost, quality, warranty, school district, etc. before signing on the dotted line? Why do we not hold our doctors to the same standard? Do we not think that doctors’ advice is affected by their own life experience? Things like prior malpractice suits, or how they are paid and the extra income they sometimes receive by referring patients out for expensive tests and procedures?
Until we hold our doctors and hospitals to the same standards as we do those we sell us less important things, like our cars or appliances, until we force them to provide a low cost, high quality service, until we ask about what they are recommending, and how much they charge, and make sure we are getting value, our system will continue to rise in cost and decrease in quality. After all, don’t we have more on the line when getting care than when buying a new refrigerator? In that case, shouldn’t we ask more questions, not less?
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