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Heading for the emergency room
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The Economist cites the Dartmouth Atlas Project which shows differences in cost across the country for health outcomes and spending involving Medicare. It cost $5000 per person in Salem, Oregon in 2006, $8000 in San Francisco, and more than $16,000 in Miami, with outcomes for health tending to be better in places where the costs were lower. This is one of the statistics that Peter Orszag of the Congressional Budget Office uses to come up with his estimate of 30% waste in health care spending in the United States. Prof. Skinner at Dartmouth and Prof. Garber at Stanford point out that of most health systems around the world the American system is "uniquely inefficient" and wasteful. The Economist cites information that the American system is twice as costly per person for healthcare than the Swedish system, and that it costs twice as much in Minnesota as in Miami. A poll done for the Economist shows 52% of the people in the UA are dissatified with the quality of care, 40% think the system needs fundamental change, and 29% think that it should be fundamentally rebuilt. The lack of uniform coverage is also causing turmoil in the system. About 49 million are uninsured, and a quarter or more are able to buy insurance and do not buy it because it is so costly, has exclusions and coverage is inadequate. But these people also end up in the emergency rooms along with the indigent costing the whole system tens of billion of dollars for costly late interventions that could have been avoided with preventive care early on. With the economic crisis and rise in joblessness, the dire condition of state and local budgets, the situation has probably drastically worsened, and the system near breakdown.
Developing new solutions to the problem of escalating health care costs in the U.S.
01/31/2008
New solutions are being developed and new ideas being tried to bring down health care costs. In many case quality can improve at lower cost or the similiar results delivered for lower cost with some other advantages inpatient focussed healthcare that improve outcomes. Pricing of pharmaceutical products and healthcare services as the major unsolved problem in the U.S.
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The options to tax employer provided health insurance as income, to reduce tax breaks for mortgage deductions and charitable contributions for highend taxpayers, and to reduce Medicare payments, all have one common problem. Each group would like to preserve as much of the status quo as possible, and give up as least as possible.
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The French health care system and its costs, comparison with the American system of health care.
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The French Lesson in Health Care
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The risks of "cosmetic" reform in the Obama administration's efforts, and the unsustainability of the current system in the costs and results it provides.
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The health care models of countries in Europe.
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The German, French, Dutch and other models of health care. The health care system of France covers 99% of 64 million people at acost of 11% of GNP compared to 16% of GNP for the US and 50 million uninsures.
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Medicare Reform Efforts.
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Doctors Chafe As Medicare Cuts Loom
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Economist 10/15/2009
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