So, you’re unhappy with the US healthcare system…

Chances are that you are part of the nearly 80% of people who are unsatisfied with the costs of healthcare in our country. And it’s justified! Articles come out almost daily talking about the trillions of dollars spent on healthcare in the United States each year and the stark difference between costs of care in the US versus countries such as Canada. Even when we look back at history, it seems as if nothing has changed. In the 1940s, during Truman’s presidency, 82% of Americans said that hospital care and physician fees were too high. In 1990, papers were published saying that 89% of Americans were in favor of fundamental changes to our healthcare system. So why, after nearly 100 years, can’t we get it right? Movies such as Sicko have come out to show the public that healthcare in the US should be “free” like it is in Canada and that our government is cheating us! In no way is our healthcare system perfect (it has a great amount of room for improvement), but it’s all about perspective. With such a personalized service such as healthcare, it’s important to look at the issue from numerous angles before jumping on the ‘socialized medicine’ bandwagon.

Socialized medical systems are monetarily cheaper. This is a fact. Regardless of what those on the right or left try to say, there is simply too much published evidence showing that administrative costs in the US healthcare system are far greater than any nation embracing a socialized system. However, these studies are only comparing costs in dollars spent, while in reality, there is a price for time and an incalculable value for life. A socialized medical system may cost less on a balance sheet, but it would be a disservice to the American people to base the future of our healthcare system on whether the expenses are higher on a balance sheet. Let’s talk about Canada as an example for what all this means. Canada has a single-payer healthcare system, meaning that medical coverage for all citizens is publicly funded. Those public funds come from Canadians’ tax dollars, so healthcare is not “free,” but rather everyone is paying for each other as a collective. This single-payer system does not incentivize physicians to see more patients or work longer hours because each physician is on a salary that stays the same whether they see five patients or twenty patients in a day. Because of this and numerous other factors, average wait times to see a family practice physician, see a specialist, or even visit the emergency room are considerably longer in Canada compared to the United States. Although sources vary, the average wait time to see a physician in the US is 3-4 weeks while in Canada, estimates of averages are as high as 18 weeks. These long wait times frequently result in physical and emotional stress for a patient, loss of work productivity, time, and money. Worse, thousands of patients have died simply waiting for care. All this begs the question: what are the real costs of socialized medicine?

There are numerous issues with our healthcare system that must be focused on instead of fundamental shifts that have a slim chance of passing in Congress. The real issues can be seen right here at home. Various hospitals, whose main goals are to maximize profits, call themselves non-profit hospitals in order to avoid paying taxes. Researchers have found that non-profit hospitals act incredibly similar to for-profit hospitals and the “community benefit” promised in exchange for their tax exemption is questionable. Another issue is that we have physicians who practice defensive medicine by ordering many unnecessary tests because they look at patients as potential litigants. Studies have shown that up to 90% of physicians practice defensive medicine due to fear of litigation, and this greatly increases the overall costs of our healthcare system while also failing to benefit the patient or the physician. Arguably the most important problem with our healthcare system is a near total lack of price transparency. If every hospital clearly laid out the fees associated with each medical procedure, market forces would come into play and drive down the price of healthcare for all of us. By keeping prices secret, which is supported by large hospital lobbying groups, hospitals gain while we as healthcare consumers pay an absurd amount for our care.

We all haven’t mined for coal or dealt first-hand with our debt crisis, but all of us have received healthcare from the United States healthcare system, and that’s what makes healthcare such a personal public policy issue. And it would be wrong for me to say that we are not happy with the quality of care provided. Physicians, nurses, and other medical staff in the United States provide excellent care that even attracts individuals from other countries when dire medical attention is needed. Americans highly rate the quality of care provided to them, but like most large-scale systems, improvements can always be made. It is important, however, to make and fight for those improvements with caution because the health of the American people and our nation are at stake.

Sources:

Blendon RJ, Benson JM. Americans’ Views On Health Policy: A Fifty-Year Historical Perspective. Health Affairs. 2001;20(2):33-46. doi:10.1377/hlthaff.20.2.33.

Woolhandler S, Himmelstein DU. The Deteriorating Administrative Efficiency of the U.S. Health Care System. New England Journal of Medicine. 1991;324(18):1253-1258. doi:10.1056/nejm199105023241805.

Health Aff (Millwood). 2014 Sep;33(9):1586-94. doi: 10.1377/hlthaff.2013.1327.

Sekhar MS, Vyas N. Defensive medicine: a bane to healthcare. Ann Med Health Sci Res. 2013;3(2):295–296. doi:10.4103/2141-9248.113688

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