There is no debate.
Healthcare in the United States is busted.
No one argues that we produce the best doctors, drugs and outcomes on the planet. If I am deathly ill, I want to be at Johns Hopkins, the Mayo Clinic, UCLA or Stanford.
But what's so good about being the best if access to this level of care either is unreachable or too expensive for most Americans?
Keeping Americans healthy and giving them access to quality medical care should not be a question of pure economics, but rather one of logic and pragmatism.
Health care costs have been rising for several years. Expenditures in the United States on health care surpassed $2.2 trillion in 2007, more than three times the $714 billion spent in 1990, more than eight times the $253 billion spent in 1980.
To put it in perspective, in 2007, U.S. healthcare spending was about $7,421 per resident, accounting for 16.2 percent of the nation's Gross Domestic Product (GDP). This percentage of GDP for healthcare spending is among the highest of all industrialized countries.
Despite the fact that U.S. healthcare spending has increased exponentially over the past 30 years, everyone agrees that access to medical services has fallen. The only Americans truly happy with their healthcare are the members of Congress. They've got the best that money can buy.
Since 1999, employer-sponsored health coverage premiums have increased by 119 percent, placing increasing cost burdens on employers and workers. With wages growing at a much slower pace than medical costs, many American workers face difficulty affording out-of-pocket healthcare spending.
A recent study, commissioned by the consumer health advocacy group Families USA, found 86.7 million Americans were uninsured at one point during the past two years.
Among the key findings of the report:
• Nearly three out of four uninsured Americans were without health insurance for at least six months.
• Almost two-thirds were uninsured for nine months or more.
• Four out of five of the uninsured were in working families.
• People without health insurance are less likely to have a usual doctor and often go without screenings or preventative care.
Healthcare experts and economists agree that access to regular screenings and preventative care is one of the most critical aspects of reform.
Hospital care accounts for the largest share (31 percent) of health expenditures. Physician services are the next largest item, one-fifth of the national health spending. These same experts agree that both hospital and physician expenditures could be significantly reduced by providing all Americans with access to screenings and preventative care.
Consider the case of Grand Junction in Colorado, a city of 120,000 on the western edge of the Rocky Mountain state, hardly a bastion of socialist ideals. If the country could replicate the way this western Colorado town delivers health care, Congress could cut health costs by 30 percent, at a national savings of $700 billion a year.
Grand Junction starts by making sure everyone has a family doctor. The town offers all pregnant women prenatal care. It focuses on keeping people healthy and preventing disease. They work at keeping people with chronic disease in the best shape possible. Additionally, they make sure that healthcare pros collaborate and communicate.
The Result of Inaction
On the opposite end of the healthcare spectrum, consider McAllen, Texas. National studies have ranked healthcare in this south Texas town of 110,000 to be among the worst in the country with costs per capital that are the highest.
According to the Atlas of Healthcare published by Dartmouth University, Medicare spends just $5,873 per year on the average recipient in Grand Junction, compared to a national average of $8,304. That's less than half the $14,946 Medicare annually spends per capita in McAllen.
The cost of semi-annual doctor visits is about $750 per year. Some healthcare economists conclude that the cost could be as low as $500 annually.
While we can't mandate that Americans follow a healthier lifestyle, countless studies have shown that regular doctor visits have a terrific influence on diet, weight control and even the curtailment of smoking, all of which lead to chronic or acute illnesses that drive up the cost of healthcare.
Shame on the Resisters
Opponents of the President's healthcare proposal have dug in their doctrinal heels. They rail that the President's plan smacks of socialized medicine akin to Canada or worse, Britain.
In truth, as much as the Brits or Canadians may complain about the lumbering inefficiencies of their healthcare systems, most would never switch. Ask the man on the street in London or Toronto whether he would favor the American way of delivering healthcare. He will laugh in your face.
The American ideal is built on the notion of rugged individualism. Philosophically, we don't want to dictate how another lives his life.
As taxpayers, we also don't want to pay for inefficiencies in government or unnecessary expenses. But when millions of Americans lack access to basic and preventative treatment, all of us carry the financial burdens of their healthcare consequences.
We need to stop worrying about the politics and start focusing on the problem. I don't care if the President is half-baked or concerned that it will fail to solve all of our healthcare problems. No one said there was an easy fix. But doing something is better than continuing the healthcare road we're currently traveling.
Consider McAllen, Texas.
John Cohn is a senior partner in the Globe West Financial Group based in West Los Angeles. He may be contacted at www.globewestfinancial.com
