E-mail updates
Follow on Twitter
Subscribe to RSSIf banking were like health care, it would take days to get money out of an ATM because the records would be lost. If airlines were like health care, pilots would decide on their own which safety checks to make, if any. If shopping were like health care -- well, you get the picture.
It’s a mess, the Institute of Medicine says in a report released on Thursday. The U.S. health care system wasted $750 billion in 2009, about 30 percent of all health spending, on unnecessary services, excessive administrative costs, fraud, and other problems. As many as 75,000 people who died in 2005 would have lived if they got the kind of care provided in the states with the best medical systems, the Institute found.
The report, issued just as candidates for Congress and for president make health care reform a central part of the national debate, doesn’t pull any punches. The panel of experts assembled by the Institute, an independent body that is supposed to provide a non-partisan last word on important issues, leaves no doubt that U.S. health care now is anything but the best in the world.
"The threats to Americans' health and economic security are clear and compelling, and it's time to get all hands on deck," says Mark Smith, president and CEO of the California HealthCare Foundation in Oakland and chairman of the panel.
"Our health care system lags in its ability to adapt, affordably meet patients' needs, and consistently achieve better outcomes."
But there's hope. "We have the know-how and technology to make substantial improvement on costs and quality. Our report offers the vision and road map to create a learning health care system that will provide higher quality and greater value," Smith says.
“What I am seeing around the country is that people are absolutely committed to reform,” says James Conway of the Harvard School of Public Health and the Institute for Healthcare Improvement in Massachusetts, who served on the panel.
“Whether you look at the Republican platform or the Democratic platform, you find in pretty strong language the importance of developing a high quality health care system.”
One of the biggest problems is that health insurers, hospitals and health systems don’t learn from their mistakes, the report says. Half of all health care professionals still neglect to wash their hands properly before seeing patients, even though it’s one of the main causes of infections that kill tens of thousands of patients every year.
An organized system that finds out what went wrong and where, and then provides for the health system to correct those mistakes right away would save money and lives. It’s possible in a computerized world, but it’s not happening on a systematic basis. Hospitals that report every single infection and ruthlessly track down where it came from have found they can cut infection rates to zero, for instance.
Yet just this week the Centers for Disease Control and Prevention reported that a third of Americans have high blood pressure and only half of them have it under control. There are dozens of drugs to treat it, not to mention diet and exercise methods. It took 13 years for one of those drug types, the beta-blockers, to become the standard of care even after they had been clearly demonstrated to work, the report says.
What’s missing, the report says, is coordination. “What I see is people doing a little bit of this and a little bit of that. Everyone has their little initiative. And back at the ranch, the doctor, the individual provider, is drowning in the sea of initiatives,” Conway says. “What is missing is a much more systemic and collective response.”
The report points to two main problems. “One is the increasingly unmanageable complexity of the science of health care. During the past half-century, there has been an explosion of biomedical and clinical knowledge, with even more dazzling clinical capabilities just over the horizon,” the report says. But the current system doesn’t help providers learn this material and it doesn’t give them any incentive to apply it.
“Second is the ever-escalating cost of care, which is widely acknowledged to be wasteful and unsustainable. Unless ways are found to provide more efficient, lower-cost health care, more and more Americans will lose coverage of and access to care.”
Conway praises the Massachusetts health care system, which he says is organized with the patient in mind. The report also says government initiatives, such as the Patient-Centered Outcomes Research Institute (PCORI) and the Center for Medicare & Medicaid Services Innovation Center are good ways to test and apply proven treatments and methods for paying for health care.
“Until we organize the health care system around the people we are privileged to serve, we aren’t going to figure it out,” Conway said. “I don’t think we have done that before -- we haven’t organized it around the person with cancer. That would be a remarkable change.”
Some ways to get there? Let people see what various treatments cost up front. Employers, who cover the health care costs of 55 percent of Americans, can help, too, the report says. They can use their buying power to demand high-quality, high-value health care, and get their employees involved in wellness programs.
So what would happen if shopping were like U.S. health care? "Product prices would not be posted, and the price charged would vary widely within the same store, depending on the source of payment,” the report says.
Related stories:
- Romney attacks Obama over Medicare
- Americans hate health reform but like what it would do
- Countries with the most expensive healthcare
Leave a Comment:
we really need a reform on healthcare in US, but not a insurance reform like Obamacare.
the medical cost is the biggest problem, and there's so far no solution on that. unless we have a system to reduce the cost, many people cannot afford it, and Obamacare would do nothing for those people.
if we eliminate insurance on basic minimum care level so that all clinics/hospital/doctors can go with retail pricing system for treatment and service, then people can shop around and afford doctor visit and minor medical service by paying out of pocket. this way, at least at basic care level, all that admin cost/waste and 3rd party involvement will be gone, which will lower the cost.
Dump the 25 million plus illegal aliens out of the system. That will cure the issue. Obamacare provides the same care for the illegal/invaders that I receive paying for it. A matter of fact. I'll get fined for not having insurance and they get a free ride all over the place.
There is absolutely nothing wrong with out health care system, if you are a multi-millionaire that is. If you are not a multi-millionaire, then just don't get sick and you'll be okay. If you do get sick, then just hope you die quickly.
Vote Republican so that the rich can get richer!
The question of "health care" has been twisted and distorted to the point that most people believe that "health care" means that you be sick and give lots of money to doctors, big pharma, and insurance companies. These for-profit monsters are happy to see an ignorant and chronically sick customer base. Their worst nightmare would be that everyone would be healthy and they'd lose all of their paying customers (dupes). They don't care about your health, they just want money!
I don't believe we should live to serve the interests of these businesses by making bad diet and lifestyle choices. I admit that most people won't believe that "health care" actually means being responsible for your own health instead of surrendering your fate to those who profit by keeping you sick. Most will continue to walk out of the supermarket with a big box of beer and a sack of twinkies, too bad. I know I can't save anyone with rants. My point is Americans have it all wrong and are paying the ultimate price.
Medicare and Medicaid for every American citizen, that is the only answer. If you have to raise the taxes to do that, so be it.
The US likes to think of itself as the leading nation for the world, insisting that other countries model themselves after the US; however, the US is the only major country in the world to not have a national health care plan in place to protect its citizens. The reason is clear enough: pharm companies and insurance companies with their lobbies and the very deep pockets used to buy politicians; add to this politicians who have top of the line health care paid for by American workers taxes, nothing is going to change. According to the wealthy, poor people are expendable, when one falls there is always another to take their place and work for no benefits and low wages. Yeah, the rest of the world should model itself on this. Wake up Americans!
right, even Obama made deals with big pharms, hospitals and etc. in order to push through Obamacare which benefits most of pharms, insurance companies and whoever in the deal. Congress (with some major Dems/Reps) also blocked the bill to re-import cheaper drugs from Canada.
it is a sad country for healthcare, and don't expect we can see a better system, which has low medical cost and broader accessibility for people, any time soon.
Here a some ideas for healthcare, instead of compaining: 1. Nutritionist advisor 2. Vaccine updates 3. Use CD carried by patients from doctor to doctor and have patients keep them as they are responsible for their own healthcare. 4. 2nd and 3rd opinions are not optional but mandatory. 5. Patients do not diagnose yourself as you can do more harm than good. If you visit a doctor you do not like and will not look you in the eye or answer your questions, then visit another doctor. Elective surgery vs. emergency surgery will need a great deal of thoughts and consults. Be preprared, do your homework. Ask questions about prescriptions and write any side effects down and call your doctor immediately.
At the moment I am living in UK married to a Brit.
I was initially skeptical about their healthcare system but I was wrong! I am also a nurse who has worked in their healthcare system NHS in UK and you know what it works! It is not free because you pay taxes but you get healthcare when you 'need it'!
I just hope the USA can change to this type of system for it works. Other European countries are similar and they are doing well and the people are getting healthcare. The USA can do this we just need everyone to see that NHS does work!
An article a week or two ago stated that Irish hospitals are closing wards and sending patients home on the weekends. Either those patients are not receiving the care their taxes should have paid for, or they are in the hospital unnecessarily and are a burden on the taxpayers.
Well, like Wall street and the bankers its time to clean up Health care and it's fraud, which Obama set up to do but was blocked by Republicans because the Insurances and other crooks didn't want this or that. Health Care doesn't need to be paid by Medicare or Medicade, it's clear it needs accountability, stop the privatization and lobbying of cooperations Time we just make it simple, it's health care for everyone and everyone puts in, employers, employees, CEO's and it should be proportional to the income of the company. Wall Mart should be making sure it's employees p/t and full time get health care, good health care not the rinky dink fraudulant stuff that's some of them are. All this needs oversight and not for profit. health should not be a profit industry too many crooks get duped by the dollar sign, including doctorsk. One thing is to develop and put more money into preventive medicine. If you care for your self as best you can then that should be worth something. Of course there are accidents and catastrophes, but that can minimized if prevention is priority, not lets make up diagnosis so that we can create more drugs and make more money.
We need to ban commercials on medications, to ask your doctor if you are suffering from then ask for this medication. We are becoming a country along with many doctors that show no respect for knowledge and profession. Their shouldn't be any any any profit in health care.
Our healthcare system is beyond horrible. Two weeks ago i took my dad to the emergency room for a badly swollen leg, the staff promised they would get to him in 2 hours......... SIX hours later they finally examined him, then TWO hours later completed the tests and you know the results of those tests? INCONCLUSIVE! These healthcare people are supposed to be "professionals" professionals my ass. They obliterated my and my dads entire day and night for absolutely no reason, and accomplished exactly nothing. I have and still continue to have horrible experiences with the healthcare system regarding my own health problems, i am so fed up that if i ever need surgery again i will demand that i have my recovery at home, i absolutely abhor our hospitals and their moronic nonsensical slower than a snails pace systems.
Has anyone thought about what "Health care" is, fundamentally? Is it caring for someone who just wakes up feeling poorly, has a ache or pain, a sniffle? People live with those daily, it's just a fact of life. Serious illnesses, like cancer is another matter. We already have universal health care; If you have an emergency health problem you go to a hospital, and you won't be put out on the sidewalk to die. You will be stabilized and if you can't pay you'll be transported to a tax supported hospital. Would the care be as good? Well, technologically yes, but you wouldn't get the same "Awww, poor thing" that you would get as a paying patient.
Umm health care is being able to get your health problems fixed. In america many people such as myself are unable to even get access to medical care for no other reason than not being rich enough to pay absurdly high premiums. I suffered an injury through no fault of my own and have been left with damage that for whatever reason my body wont heal on its own, but because i suffered the injury while not having health insurance, health insurance companies either refuse to cover me at all, or will cover me for 1k-1500 dollar premium a month but will provide no medical care for my health problem. Exactly who would agree to pay for a service they need while knowing ahead of time they wont get what they pay for, and why am i being treated as though im guilty of making some sort of decision that lead to my getting injured?
There are agencies, tax funded, that you can go too. There are doctors in all specialties who will treat you because treating patients who can't pay is part of the territory of being a doctor. There are pharmaceutical houses, lol, Big Pharma, that will provide medication free to those who qualify. Just be sure that you qualify for special consideration through no fault of your own, not because you just don't want to pay. I stated earlier in a post that personal experiences are not a factor but since folks do use them to promote their agenda; My wife had heart disease, died in 2000. She had two by-pass operations and one Stent put in. We didn't have insurance for some of them and she was cared for anyway. Two of them were covered by Catholic Charities at St. Thomas hospital in Nashville. One time she had chest pains and was taken to the county hospital, tax supported. After being stabilized she asked for a glass of water and the nurse assistant came out of the room saying that she wasn't doing sh!t for that White bitch, let her go to Vanderbilt with all the other White people. Well, I was standing there and told the Head Nurse that I was taking her out. Lol, man, you never saw such a flurry of activity, hospital administrators apologized, the nurse assistant apologized. No good, I demanded to have the necessary paperwork and waivers which I signed and I rolled her out in a wheelchair, took her to Vanderbilt, explained that we had no insurance. She was taken care of. Ok, that was a personal experience and it doesn't mean a damn thing, my point is; Medical care is available, even if it has to be at a tax supported facility.
I had to take my 3 year old to the ER two weeks ago and we couldn't get in. had to wait for a bed. when we did get in, the doctor on shift escorted out a drunk homeless man who was cursing at everyone around him. the doctor saw us, apologized and said, sorry, the police drop this guy off 2-3 times a day and they by law HAVE to treat him. He also said this happens with multiple people through the day. and who is paying for this drunk guy? we are. there has to be a better way. people who do not take care of themselves should be in the waiting room so that people who actually need the care can get in and have proper treatment. i don't know how to fix it, but it isn't working anymore....
If we were truly about health, our health care system would stop the poisoning of our food supplies and legislate against large corporations from providing toxins to the general public on an everyday basis. Our bodies are organic organisms which do not know how to rid itself of man made chemical materials. The outragiously huge pharmaceutical industry is no better. Lets take simple antibiotics as an example. Many antibiotics only target at most 6-10 specific organisms to kill. There are other well known processes that will rid and clean our organic bodies of over 1000 organisms that all of us are unwillingly and unknowingly exposed to every day. One primary example is the poisoning of our water supply with the use of flouride. Flouride is not an element, it is a toxin orginally given to the public from a skewed and biased study that did not expose the entire truth. Our legislators and congress folks are ALL to blame, as well as large corporate greed. Money is everything in our society. There is no money for the cure of illnessnes to continue the path of large corporate growth. Therefore, we are stuck in a vicious cycle of trying to rid chemicals and diseases with more chemicals that support the profit systems of all types of industries. My take on all of this is until we change our laws governing what can and cannot be utilized in our basic food supply, we will never become a healthy and happy society. The food supply is not only restricted to us humans, but also to the entire global living environment from all plants, animals and insects. Your only choice, at this point in time, is to do your own research and refuse to subject yourselves to the common and everyday chemicals we are constantly bombarded with through advertisements, recommendations from our health care providers, pharmaceudical compaines, as well as our insurance companies. If you go to the doctor to find something wrong with you, you will probably find something wrong, and subsequently, a drug that you can pay for, that may or may not relieve your specific diagnosis.
The hastily rammed through Obamacare legislation obviously failed, Obama failed, he's done.
Do you mean the health-care that the 1993 Republicans initiated? Or the mandated health-care program that is being used in Massachusetts? I forget who started the Massachusetts program, but I think that guy was pretty ecstatic with his idea, back then.
The word Health Care is a serious and major spin on words! If 'health' was truly the case in this topic we would be first and foremost looking at nutrition... or lack thereof. This country's food is the worst and our government (US tax payers) subsides it which makes it the cheapest and worse 'food' on this planet. WTF
true.
America's supply of food is the "Best in the West," economically, quality and abundance. Granted, there are some foods that are suspect, but only in the minds of people who have been swayed by agenda promotion by the "Free range" and "Organically grown" bunch. Lol, I've been eating a long time and so far so good. I remember a guy who married a woman from the then "Eastern block." First time in America she went to a Kroger and damn near wept; "My poor people, such abundance here." Anyway, it's we, the consumers, who buy food and if we buy without considering nutritional value it's our own fault. A box of Twinkies and a Pepsi does not make a nutritional meal, but it's what folks want. Nobody can walk through a supermarket and claim that there's nothing nutritional to buy, that there's not enough, that the prices are out of reach of the average consumer. On that note, the issue of cost; When I got married and had our first kid, 1966, a weeks supply of groceries cost around $50. In 1974, after we had our fourth kid and were living in Tennessee, a weeks supply of groceries was only around $65. And, I was making more money. The high cost of food in America is a myth, unless, lol, you factor in the cost of six packs of beer and cigarettes bought at the grocery store. One time in a check-out lane a woman behind me was going on about how high food was. "Lady, food in America is a bargain, quality and price."
People from countries with universal health care cannot understand the American hysteria around the notion of public health care. Furthermore, we cannot understand why Americans would tolerate the reality that a serious illness could potentially bankrupt them. It doesn't have to be that way, and it shouldn't be. Health care costs in Canada are a lesser % of GDP than in the US; we spend a lesser % of GDP on health care with much better outcomes. Read the literature. My family pays roughly $1200 a year for health care in British Columbia, and in most provinces people pay $0 outside of their taxes. My husband (who is a dual US/Canadian citizen btw, and has lived in both countries) was diagnosed with cancer at 25. It was in his lungs and brain. He has been cancer free for 10 years now, and he can attest to the quality of health care he received in Canada. Americans need to find a way to accomplish something better than what they have had, and this starts with being open to a broad discussion on the matter. I have actually seen American's foam at the mouth about a public health care system, and they actually know very little about it.
Bruce, private insurance companies were so inefficient it took a law to limit them to 20% administrative costs.
At the same time, government-run insurance has administrative costs of 3%.
I know that arithmetic is not a strong point among Republicans (look at your budgets!), but take it from me, 3% is cheaper than 20%. I know, I know, you'll say that's just my opinion, and the mathematics isn't settled, but eventually reality has a way of making itself known.
don't believe everything you read. I could write a dissertation on how those numbers are inaccurate
I remember reading and hearing from various, similar, panels before the last reform of health care got into full swing that all sides were in agreement that something had to be done to fix our health care system. Then, after proposals were put out there, it became a political football, with the Republicans saying any change would ruin "the best health care system in the world." What's to keep that from happening again? I wish that both sides would sit down and honestly serve their constituencies. Let's not kid ourselves here: For the Democrats it's the middle class and poor. For the Republicans, it's business. From those two viewpoints, we should be able to reach a consensus on health care that keeps the middle class and poor healthy and out of bankruptcy, and that provides business with the healthy work force that it needs, with minimum impact to their bottom line. Personally, I think that recently the Democrats have done a better job of serving their constituency than the Republicans. --mark d.
Right! And the store's prices would be much higher.
If you listen to the republicans, "we have the best health care in the world". Problem is only a small percentage of the population has it. For everyone else it is, indeed, a disaster, full of inefficiencies, exclusions and too many lacking coverage for the most basic needs, much less catastrophic coverage. What other country has people going bankrupt and into foreclosure because they had the misfortune of getting sick?
All said and done the fact remains that changes should be made in our health care system. What changes and where? Folks seem concerned about the high cost. Ok, the cost is high so what changes should be made? A government mandated price and wage schedule? A charge for a treatment can only be a set price, and, a care-giver can only be paid a set wage. What about availability of care? People complain about long waits in ER's. Ok, a system like the one we had in the army would work. "Sick call" in the morning and emergencies sent to the hospital. I was a Advanced Medical Specialist, MOS 911.20, and I held sick call every morning, treated minor cuts and bruises etc. Anything requiring more treatment I referred to the Special Warfare Center Surgeon. There's no real reason why something similar couldn't be adopted in civilian life, but, lol, there would be no frills to that. If we want the government to step in then we have to do it all the way; Establish a National Health Care Corps, draft doctors into it along with other care givers, declare hospitals to be Corps bases. No more seeing the doctor of your choice, if you live in a specific area then you are treated by the care-givers assigned to that area. Lol, if we want a well managed health care system that's the way to go. No high cost to the patient, no filling out insurance forms, if sick you report to the facility in your area, present a citizen ID card and you'll be cared for. No charges, no bills. Man, just what everyone wants, universal health care. So, who pays for all of it? Everyone working pays through taxes. If we can maintain a capable military force with taxes then we can maintain a capable health care system with taxes.
It's truly unfortunate that health care is not run by those who provide the care, but by insurance companies. Until they are removed from the decision making process our health care system will continue to decline.
Ok Scott, the insurance companies run the health care system, but, they also pay the costs, the wages and salaries of the care-givers, in most cases. So, eliminate the insurance companies, cool, now who's going to pay the costs? You say to remove them from the decision making process. Ok, so who's going to protect the interests of the insured? Insurance covers medical care that the insured pays premiums for, so if the care-givers expand the costs of giving the care above and beyond what the companies have agreed to pay who's left holding the bills? It seems to me that insurance companies already do a lot to hold down cost, by refusing to pay exorbitant costs generated by the care-givers. Don't insurance contracts have a dollar value per procedure? If so then that is what establishes the premium rate, so, lol, pay more in premiums if you want to be fully covered. Anyway, I'm not a insurance expert by any stretch of my imagination but I suspect that insurance companies are in business to make money, not generate losses. In the case of my wife I've been told; "Your insurance only covers so much, and we need to do more." Who's going to pay for "The more?" The insurance companies should do "What's right?" Lol, establish an answer to that question and we'll all be living in the perfect society.
When has adding a middle man (the insurance companies, in this case) EVER decreased the cost of anything? Price increases at every step until it reaches the consumer. And the insurance companies don't negotiate lower fees to protect patients - it's to protect their own bottom lines. Do you want an insurance company making your medical decisions, or you and your health care provider?
Healthcare and Health Insurance are crazy. I have an existing issue and need a thyroid pill a day. After I lost my job I applied for Health Insurance at a $164.00 rate and was denied...but they would give me the same coverage at a $647.00 a month rate for the same coverage. Obviously I cannot afford that since unemployment was just a bit more then that. Its a shame that criminals and murders in prison get the medical care they need without having to pay anything, but I go without coverage cause I cant afford the monthly premium. Its just crazy and I dont expect a free handout, but something needs to be done.
lol ! that's what I think of the state of our health care system in it's current form. Allow me to correct that , we have no health care system we have a highly controlled medical profession that's primary consideration is the bottom line. Our health care ( for lack of a better term ) is held hostage by HMO's, health insurers and pharmaceutical companies. Our doctors and hospitals have become little more than money generating stooges.