Saturday, May 19, 2007

We got the diagnosis; what is the Rx?

TomPaine.com - An F In Health Care
The New York-based Commonwealth Fund released a comprehensive cross-border study of health care systems in rich countries and, no surprise, ranks the U.S. as pretty much last. Except when it comes to cost, that is. We pay more overall and get less.

What everyone who cares to look knows is that there are two health care systems in America—one for those with money and for those without. The report spelled it out plainly:

The U.S. ranks a clear last on all measures of equity. Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick, not getting a recommended test, treatment or follow-up care, not filling a prescription or not seeing a dentist when needed because of costs.

Many people have enough money, or otherwise identify themselves with money, that they’re grateful for what they believe is class-A health care. Thank god, they say, we’re not plagued with bureaucratic stasis and long wait times as are people at public hospitals or in socialist countries like Britain or Germany. They’re wrong. We’re at the bottom in most everything and for everybody.

The Commonwealth Fund does, indeed, say that the poor are in bad shape when it comes to preventable illnesses and chronic conditions. But, even the insured do badly. For instance:

The U.S. and Canada rank lowest on the prompt accessibility of appointments with physicians, with patients more likely to report waiting six or more days for an appointment when needing care.

On the other hand, Canada achieves approximately the same level of waiting using less than half the amount of money as the U.S. What is even more striking is that American medicine, despite the huge amounts of money poured into it, is so poorly organized that much of what would be good care gets negated by the haphazard system. Specifically, the U.S. is technologically behind and organizationally backward.

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