Fixing Our Health Care

Posted Nov. 27, 2008, at 6:59 p.m.

Americans have had it drummed into them for generations that they have the world’s best health care system. Once again, we now are told by a widely respected organization that it’s not true. This time, we are in a position to do something about it.

With a new president and a new Congress, with a public outcry for reform, with the business community desperate over soaring health-benefit costs, and with a financial crisis that requires change and reform at all levels, it is clearly a time to devise what truly can be called the world’s best health care system.

The new survey was sponsored by the Commonwealth Fund, which has found repeatedly in earlier studies that the United States lags behind most other nations by such measures as longevity, infant mortality and obesity, while costing more than twice as much per capita.

This study of 7,000 chronically ill patients in Australia, Britain, Canada, France, Germany, the Netherlands, New Zealand and the U.S. covered patients suffering from at least one of seven chronic conditions: hypertension, heart disease, diabetes, arthritis, lung problems and depression.

It found that in all the countries a majority of patients saw room for improvement. But it went on: “Chronically ill U.S. adults were the most negative, with one-third calling for rebuilding the system and only one-fifth saying the system works well with minor changes.” Dutch patients were the most positive.

The survey found that American adults were the most likely to report medical errors, to avoid treatment because of cost and to report difficulties in getting medical records of test results.

Among the few areas where American health care was found to excel was access to specialists, where U.S., Dutch and German chronically ill adults reported the most rapid access. U.S. patients also fared better in getting instructions, written plans and follow-up arrangements at discharge from treatment.

Still, the overall verdict was that, “U.S. patients appear at particularly high risk as a result of coverage gaps and poorly organized care.” It said: “Among the eight countries, the United States stands out for having the most expensive system ($7,000 per capita compared to under $3,500 in the other countries as of 2006), for its gaps in coverage, and for high cost-sharing even for patients with insurance.”

Universal health care has broad popular support and should be considered. An even more bold step is possible. A group in the House of Representatives has long been pushing a bill for a single-payer plan like Canada’s. The seven other countries have a variety of plans that should be studied as possible models.

The need, the time and a new administration are coming together. They should put together an American system as good or better than those others, and at a reasonable price.

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