2.2 trillion reasons to reform health care
Post-Dispatch file photo
A new Congress convened in Washington this week with health reform among its top priorities. That means finding a way to cover the more than 46 million Americans who are uninsured — and helping millions of insured families who struggle to pay the cost of their own care.
Those are the easy parts of health care reform. Solving them requires only money and political will.
The really tricky part of health reform is illuminated in a new report that breaks down U.S. health care spending, which reached a staggering $2.2 trillion in 2007.
The good news, such as it is, is that spending on doctors, hospitals, nursing homes, drugs and medical research grew by the smallest amount in nearly a decade — 6.1 percent, or $128.5 billion. That’s more than twice the overall rate of inflation.
The bad news is that even with more than 46 million uninsured and lower average life expectancy than most other developed countries, we managed to spend about $7,421 for every man, woman and child in this country.
The situation isn’t hopeless. Health reform won’t reduce what we spend on health care, but in the long run, it could help slow the growth. More important, it can refocus spending on better care so we get more for the enormous outlays we make.
Roughly one of every six dollars in the U.S. economy is spent on health care, figures in the new report show. That includes public funds for Medicare and Medicaid and non-government money spent by businesses and families.
Spending on prescription drugs grew at a relatively modest 5 percent, compared to 8.6 percent in 2006 and as much as 12 percent in 2004. Economists who compiled the report, published this week in the journal Health Affairs, say that is why the rate of health spending growth slowed.
Helping to slow the growth of prescription drug spending was the appearance of generic versions of several blockbuster drugs, including the sleep aid Ambien and the antidepressant Zoloft, in 2007.
Consumers also were choosier about filling prescriptions in 2007, in part because of concerns about safety. The U.S. Food and Drug Administration issued about three times as many “black box warnings,” which caution about the potential for series side effects and death, as it did in 2003.
But spending on prescription drugs accounts for only about 10 percent of the nation’s overall medical bill. Spending on hospital care, doctors’ services and other components grew even faster.
As we’ve said before, reform efforts should be focused on what we get for the money we spend as much as on how much we spend. That hasn’t always been the case in years past.
It makes sense to pay doctors for keeping their patients healthy instead of for treating patients when they’re sick.
It makes sense to better coordinate care so there’s less waste and duplication and to encourage more medical school graduates to become family doctors instead of specialists.
The paradox of health spending is that more doesn’t necessarily equal better. The real health reform challenge is to improve quality. We’re already spending plenty for care.
And do not forget that it makes sense to put a cap trial lawyer lawsuits against doctors and drug companies. While you cheer when some doctor gets hit with a large malpractice suit, you cannot forget that the cost of that lawsuit, the cost of the malpractice insurance, and the cost of those lawyers all goes right to the consumer of the health care.
The way to make affordable medical care is to utilize the Nurse Practitioners more. They are well trained, with 7 years of education, and they are certified and licensed. They should perform triage to determine who needs to see physicians. The physicians should spend their valuable time on the critically ill and/or surgical patients. Prevention, health education, and minor illnesses, chronic conditions could be handled by the nurse. If we stay with the current system we will NEVER have enough money to fund it.
Here are some numbers to help put the cost of medical malpractice into perspective.
Total U.S. health care spending in 2006 — $2.1 trillion.
Total spending on hospital care, 2006 — $649.3 billion.
Total spending on physicians and clinical services, 2006 — $449.7 billion.
Total spending on prescription drugs, 2006 — $216.8 billion.
Total health insurance company overhead, 2006 — $150.4 billion.
Growth in U.S. health spending, 2005 to 2006 — $132.1 billion.
Total malpractice insurance premiums collected by all U.S. underwriters from doctors, other professionals, hospitals and nursing homes, 2006 — $10.4 billion.
Please correct me if I am worng, but is it not true that 12 million of your 46 are Illegal Aliens? Do you plan to provide health care for them also? Also according to the Census report, there are 8.3 million uninsured people who make between $50,000 and $74,999 per year and 8.74 million who make more than $75,000 a year. That’s roughly 17 million people who ought to be able to “afford” health insurance because they make substantially more than the median household income of $46,326. That cuts your number in half and still begs the question… How many people choose not to spend money on Health Insurance willing to gamble they don’twon’t need it. The real issue for me is DO YOU REALLY WANT THE GOVT. INVOLVED RUNNING YOUR HEALTH CARE???.
That’s very well, Mr. Carlton, but you are leaving out something important: Our liability system also forces doctors to practice “CYA” medicine, which drives up costs without improving outcome. And it also causes other bad things. I once knew a woman who had a debilitating case of early onset arthritis which could only be helped by Celebrex - alternative drugs did her no good at all. I see that Celebrex is now back on the market. But how much money was sucked up by this one situation, and how many similar situations are out there?
Waaah… Nanny, the bad old private sector is picking on me again. Come make them go away! While you’re here, I haven’t had a snack in over an hour. And could you change the TV channel for me? By the way, I’ve been wearing these old shoes ever since I turned thirty-five last year. Why haven’t you given me a new pair yet? Uh-oh. I’ve drooled on my chin. Didn’t you bring a hanky with you?
I read in the newspaper that you aren’t taking very good care of me. Do you need another assistant?
SoCoBoy,
You’re wrong.
1) The number of uninsured non-citizens in 2007 was 9.7 million, according to the U.S. Census Bureau.
2) The number uninsured people living in households earning between $50K and $74K is about 8.4 million. The number in households earning more than $75K is about 9.1 million.
But remember, that’s HOUSEHOLD income. Two other factors play a big role in figuring health insurance affordability: Household SIZE and COST OF LIVING. $75,000 or more is plenty of money for three or four people living in Missouri, but not in New Jersey where the cost of living is much, much higher.
Even in Missouri, a family consisting of six kids and two parents would qualify for the SCHIP childrens’ health insurance program on a household income of $75,000. That income, for that many people, puts them at a little over twice the poverty level.
Nick, Celebrex was never taken off the market. The drug that was removed over safety concerns was Vioxx. Like Celebrex, it’s a Cox Two inhibitor. But Vioxx had a different safety profile.
Reforming health care won’t help. IT’S THE ECONOMY STUPID! Look at Norway. The only reason their system works is because they have closed borders. Would you want to wait five years to get a transplant. Why do you think Canadians come to the U.S. for treatment? They can get it NOW. That’s why. If the U.S. passes these stupid laws, it will be screwed. When you see Americans going to Mexico for immediate treatment, you’ll know how screwed the U.S. is.
Bush will prove to have been a better president than Barack Obama.
We didn’t have this problem when we WEREN’T driving around in all these foreign cars. Remember, back when were making our own shoes, tv’s, toasters, coffee pots, car parts, non exploding tires and valve stems, HHMMMMM.