Wednesday, August 10, 2011

US Bringing Up the Rear

Here is yet another study demonstrating how costly and inefficient the US health care system is. The full report, from Canada, is behind a paywall, but the abstract makes clear how "interacting with payers," what we would call paperwork or red tape, drives up costs dramatically in the US and how Canada is significantly less costly:
Physician practices, especially the small practices with just one or two physicians that are common in the United States, incur substantial costs in time and labor interacting with multiple insurance plans about claims, coverage, and billing for patient care and prescription drugs. We surveyed physicians and administrators in the province of Ontario, Canada, about time spent interacting with payers and compared the results with a national companion survey in the United States. We estimated physician practices in Ontario spent $22,205 per physician per year interacting with Canada’s single-payer agency—just 27 percent of the $82,975 per physician per year spent in the United States...
This kind of shit is at the heart of our embarrassingly poor health care system. Much of the red tape relates to insurance companies jerking health-care providers around because they, the insurers, have profit margins to protect. What we rarely heard in the mainstream media during last year's health care debate was any recognition that the high cost of health care in the US is precisely the opposite of free marketeers' claims that competition and profit motive always improve service and drive down cost.

And the other side of that ideological shibboleth is that any government-run, socialized, or nationalized program, and that would certainly include anything so massive and complex as national health care, cannot be efficiently run, and is absolutely a terrible choice for freedom-loving Americans (cue the fireworks).

Once again, conservative ideology needs to explain itself to empirical reality. The United Kingdom has fully-nationalized health care. As reported in The Guardian on August 7, the UK's National Health Service, or NHS, is among the developed world's most efficient health care systems.

The "surprising" findings show the NHS saving more lives for each pound spent as a proportion of national wealth than any other country apart from Ireland over 25 years. Among the 17 countries considered, the United States healthcare system was among the least efficient and effective.

Nothing surprising about it. The study merely confirms what other research has shown. Maybe they should have watched Michael Moore's Sicko. The irony to this is that Prime Minister David Cameron, of the Conservative Party, just came out and said that the NHS needs to foster more competition so it can be more competitive. You mean like the US?

Maybe Cameron is the one surprised; he should not have been. He should have read that report first.

The Guardian's story, with a link to the complete study (pdf), is here.


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