An estimated 85 million Americans under the age of 65 were without health insurance in 2004. And while U.S. citizens pay more for healthcare than any other country, the U.S. is ranked 29th in the World Health Organization’s (WHO) healthy life expectancy ranking.
“Basically, you die earlier and spend more time disabled if you’re an American rather than a member of most other advanced countries,” says WHO’s Dr. Christopher Murray.
The high costs are a concern not only because of the less than stellar results. There is also increasing concern about healthcare costs being a drag on the economy. Healthcare spending was reported as 15% of the gross domestic product (GDP) for the U.S. in 2003, compared to 8.6% in other developed countries.
General Motors (GM), sometimes referred to as Generous Motors because of the company’s excellent employee benefit packages, has estimated that the manufacturing cost of each GM vehicle includes $1,500 to cover the cost of health benefits. That makes it difficult for GM to compete against foreign cars manufacturers.
“The U.S. does pay more for healthcare than any other country, and we have a large uninsured population which adds to that cost of care,” says Amy B. Arrington, vice president for government relations at the Mississippi Hospital Association. “But needed change is about more than costs and coverage. There is uneven coverage and unequal access to care across the state and across the nation. Just as GM tells us about how much they add to the price of a car for healthcare expenses, the regulatory morass that health care organizations face takes time away from patient care and adds greatly to the cost of care.”
For example, it is estimated that every hour of patient care in the emergency department leads to an hour of paperwork on that patient.
No going it alone?
Hospitals alone cannot contain the cost of healthcare.
“It is going to take everyone working together to fix this broken system,” Arrington said. “We have payment systems that don’t make sense. Many people who have insurance lack coverage for basic services like mental health, substance abuse and dental care. Medicare doesn’t cover long-term care. And coverage does not guarantee access. Thirty percent of physicians are not accepting new Medicaid patients. Managed care restricts choice and access. And increased cost-sharing requirements can provide barriers to care for the insured.”
Adding to the problem is the fact that private payers subsidize the cost of care for the publicly insured and the uninsured.
Hospitals are working on improving the quality of the patient care provided.
“We are working to reduce the medical errors that take place in hospitals each year, on both national and state levels,” Arrington said. “We are working on evidence-based practices to address variations in practice patterns and spending levels for care. For example, the length of stay for the same diagnosis can vary greatly from hospital to hospital.”
As bad as things are now, they are expected to get even worse as the Baby Boomer generation ages, entering the years when more healthcare is needed. There are concerns these problems could reach crisis proportions as the population continues to grow and age.
“We all need to work together to improve the current system,” Arrington said. “And Americans realize it is important. Nearly one in four Americans see healthcare as the most critical issue in America today. A close second is terrorism and national security.
“The Mississippi Hospital Association and our hospitals are leading a process to do one simple thing in the coming year: listen. If we start by listening to the public, to families, to workers, businesses, nurses, doctors, insurance companies, government entities and others, we hope to learn more about how people experience healthcare today in Mississippi, what’s good about it, what’s bad about it and what needs to be fixed.”
Contact MBJ contributing writer Becky Gillette at firstname.lastname@example.org.