Eugene Weekly : Coverstory : 8.27.2009

A Physician’s Perspective
We’re paying more and dying sooner
By Todd Huffman, MD

EDITOR’S NOTE: The following is condensed from a handout a local pediatrician prepared for his patients’ families.

OK, I know it’s not perfect, but isn’t the American health care system still the best in the world?

No. Not by a long shot. By almost every measure, America is much less healthy than a modern nation should be. Our system of health care is so dysfunctional and unjust that we spend more and get less than almost every other developed nation. We have the worst of both worlds: complexity, restrictions and skyrocketing cost increases, all without the redeeming benefit of health coverage for every American.

What do you mean, “less healthy”?

The U.S. is the only rich country that does not guarantee health care for all its citizens. In all other wealthy countries, health care is fairer and cheaper and, in most cases, produces better results. Though the U.S. has far and away the most expensive per person health care system in the world, we lag behind most developed, and some not so developed, countries on virtually every health statistic you can name.

We’re 67th in childhood immunization rates, right behind Botswana. We do worse than 32 countries in child mortality under age 5. Our infant mortality rate is more than twice as high as in Japan and Sweden, and worse than in Cyprus and Cuba. And black infant mortality in this country is still twice the white infant mortality rate.

We are well behind other developed countries on measures from cancer survival to diabetes care. Our citizens are the most likely among rich nations to delay or forego treatment because of cost. We’re seven times more likely, in fact, to report going without needed tests or prescriptions due to cost than our neighbors to the north, Canada.

We are so far down the list in medically preventable deaths that the U.S. is just 45th among world nations in life expectancy, down from 1st in 1945, and 17th in 1960. Bottom line: We’re paying more and dying more, or at least sooner. Craziness.

What do you mean, “paying more”?

Again, contrary to public myth, the U.S. does not have the world’s best care. It has the costliest. When it comes to health care, the U.S. is #1 in only the amount we shell out for health care as individuals and as a nation. If only it bought better care.

We spend more than $2.5 trillion annually as a nation, almost $7,000 per person per year for health care, the highest medical bill in the world. One dollar in every six generated by our economy is spent on health care, twice the average for rich countries. And yet one American in every six lacks medical coverage.

At 17 percent of our GDP, health care is the biggest sector of the economy; it’s a monster that is consuming a larger and larger proportion every year, and without reform could one day bankrupt the country. It’s a monster that has become the king of all budget busters, slowly but surely eating up state and local budgets.

And family budgets, too. Private insurance now costs more than $13,000 a year for the average family of four. Health insurance premiums are rising three times faster than wages. More for health insurance, less for everything else.

Even with health coverage, Americans are paying more and more out of pocket for health care. Americans are far and away the most likely citizens of any nation to spend more than $1,000 per person out of pocket on medical expenses over the course of a year.

And unanticipated medical costs are the leading cause of personal bankruptcies. Two of every three personal bankruptcies are a direct result of individuals and families being buried under a mountain of medical bills. And three of every four bankruptcy filers had private health insurance. Nuts.

What’s wrong with the status quo? I’m happy with my plan.

Here’s what the status quo means: 

• Health premiums will continue to soar, as will the numbers of employers deciding to drop coverage for their workers or going out of business, leading to more and more uninsured Americans.

• Medicare and Medicaid costs within 15 years will swamp the economy, skyrocket the deficit and break the federal budget.

• More and more Americans will be getting too little care, too late, and getting sicker and dying sooner. Think of 50 million people leaving nagging conditions untreated until they potentially explode into catastrophes and result in expensive hospitalization, the costs of which are passed on to you in the form of higher taxes and insurance premiums.

• More and more families will be suffering the double whammy of financial and health crises, and more people will be forced to go on disability.

• Private insurers, faced with rising health care costs, will continue to preserve profits by cutting benefits, raising premiums, co-pays and deductibles, and further restricting prescriptions, referrals and diagnostic tests.

• More and more people, faced with higher deductibles and co-pays, will delay care or go without. More regular physicals will be postponed, more screening tests will be canceled, more prescriptions left unfilled, more dental needs left unmet.

• It means no change to a system that prevents people from changing jobs for fear they’ll lose their health insurance or won’t get the benefits they do now. It means no change to a system that invites employers to game it by seeking young, healthy employees who pose low risks of ill-health, while rejecting older employees who are likely to have more costly health needs.

 • It means no end to Wall Street-run health care, and health insurance companies making more money by delivering less care. Private insurers maximize profit by authorizing as minimal care as they can get away with. Profit-run medicine is not, and cannot be, full care.

What do you think about health care reform, about Obama’s plan?

It’s no secret that our health care system in America is sick. The U.S. leaves the health of its citizens at the mercy of a crazy, hodgepodge system where some get great care while others get none at all. Many millions are uninsured, and millions more go without care because of cost.

The American health care system is expensive, inefficient, profit-driven and treacherous. It is a drag on business, on gov-ernment and on growth. Health care costs are already staggering, and unless something changes, they will only get worse.

Americans and American businesses deserve and want a better system, one that remains innovative, strives for the highest quality and becomes truly for all. The current system is not meeting our nation’s needs and is getting worse day by day. Neither our families nor our firms can prosper in an economy with so much uncertainty around health care.

The overwhelming majority of Americans support health care reform, making health care affordable and available to everyone. I believe that President Obama is committed to this goal, to reforming the health care system for the benefit of the American people, not private for-profit companies.

And while the reform legislation that we get in the end may not be perfect, even an imperfect reform plan beats the status quo.

So, please ignore the naysayers, the mythmakers, the defenders of the status quo that make private insurance companies billions in profit year in and year out by denying care to the sickest among us. Please support health care reform, and show your support by calling Congressman DeFazio, and Sens. Wyden and Merkley today.   


Todd Huffman, M.D. is in private practice at McKenzie Pediatrics in Springfield.