Health Care: We're Number 1! ... In Costs

If you wanted proof that our health care system is totally broken, well, here you go:

66 is exactly the score the U.S. health system received in the most comprehensive grading to date of areas such as access to care, quality, cost, and efficiency.

The score comes from the Commonwealth Fund, a nonpartisan health policy think tank in Washington.

The group evaluated more than three dozen different measures to come up with a composite score for American health care in relation to top-performing nations — or, in some cases, individual states.

The categories included areas such as long, healthy, and productive lives (the U.S. scored a 69 on this), quality (71), access (67), efficiency (51), and equity (71) [...]

But it's not for lack of money. The U.S. spends a far bigger chunk of its economy on health care than any other nation, but has less and less to show for it.

The U.S. now spends more than $6,000 per capita on medical care, compared with $2,000 to $3,000 spent by the U.K., Germany, Canada, and France.

Hey dday, why are you being critical, we're FIRST in cost! Do you hate America because we're winning?

In virtually every other statistic, the US is behind pretty much every industrialized nation, most of which provide universal health care to their citizens that is both cheaper and better. The Europe-bashers on the right will always chide those so-called welfare states an unable to compete in modern economies (even though Ezra Klein notes that European unemployment rates are exactly the same as they are in America). But it's important for those of us who believe that health care is a right and not a privilege to internalize these numbers. The US system denies quality care to a large majority of the population. Our system costs more and is both less efficient and less effective. Universal health care, to put it simply, WORKS BETTER.

Anyone who doubts that economies of scale and centralized structures can't drive down medical costs needs only to look at what Wal-Mart is doing:

Wal-Mart, the nation’s largest retailer, will test a program to sell generic prescription drugs to its workers and customers at sharply reduced prices, according to people briefed on the plans.

The giant discount chain, which has used its size to knock down the costs of toys, clothing and groceries, will sell generic versions of about 300 widely prescribed drugs for as low as $4 for a standard prescription, these people said, speaking on condition of anonymity because they were not authorized to disclose details of the new program. On average, generic drugs cost between $10 and $30 for a 30-day prescription.

This is essentially the same Wal-Mart strategy of undercutting the competition with low prices. But it's a teachable moment for the country on health care. There's a lot of bargaining power by buying it in bulk. Of course, the real problem with health care is that HMOs are quite honestly thieving bastards. Here's the fun stuff that my personal insurer is doing:

The actual facts in the report are basic: California state regulators are investigating Blue Cross for unlawful cancellations of policies. When you buy individual coverage, unlike when you buy into group coverage, insurers can reject you based on your health history or conditions. In order to protect against fraud -- say, someone being diagnosed with heart disease, then applying for insurance the next morning without mentioning it -- the law allows for insurers to cancel policies if the applicant engaged in "willful misrepresentation." What's clever is how the insurance industry has redefined the standard: If you had a condition you didn't know about, they'll seek to not only yank your policy, but dispatch debt collectors to recover what they've already paid out.

In practice, the scam works like this: Selah Shaeffer, age four, was found to have an aggressive, cancerous tumor in her jaw. The family had been with Blue Cross for about a year, and the bump was examined and biopsied after they'd bought their insurance. But because it was growing before, Blue Cross cut off reimbursement for surgeries it had already authorized, and is now trying to recover $20,000 from the Shaeffers. Or take the Nazertyans, who had premature twins. They were covered by Blue Shield all throughout the pregnancy, and disclosed all facets of the birth and operations. Blue Shield not only dropped them, but was trying to get back $98,000 they'd already paid under the rationale that the Nazertyans hadn't disclosed an earlier miscarriage. After the Los Angeles Times reported the story, Blue Shield called off the debt collectors.

HMOs want to insure you but have to keep down costs, so when you get sick they don't want to pay you. So they literally LOOK FOR WAYS TO CANCEL YOU if you send in any claims, asking insurers to... you know, insure you.

On every single level, the American health care system is a disaster, and it's being gamed by a proliferation of middle men - HMOs, pharmaceuticals - who are getting rich off of the sick. The system needs radical change, and the numbers are there to prove it. I think the American people actually understand this, but have no expectation that their political leaders will be bold enough to articulate the kind of change that's necessary.

We need leaders that will.