U.S. still on top for health care spending. Nobody really wants change! Will anyone tell Americans the truth?

I was reading the paper recently and noticed this article on per capita health care spending among developed countries.  Although it is no secret, seeing the U.S. still on top by a wide margin caught my eye.  Is health care and its cost in the U.S. an unsolvable problem or perhaps a better question is does anyone really want things to change?

This following article in the April 9, 2011 Wall Street Journal caught my eye:

Number of the Week: 141%

How much more the U.S. spends on health care, per person, than the average OECD nation

At a time when politicians in Washington are battling over—among other things—the future of the U.S. health-care system, it’s instructive to see just how well that system operates. According to the Organization for Economic Cooperation and Development, the U.S. spends far more on health care than any of the other 29 OECD nations, and gets less health for its money. Annual public and private health-care spending in the U.S. stands at $7,538 a person, 2.41 times the OECD average. Meanwhile, average U.S. life expectancy is 77.9 years, less than the OECD average of 79.4. The OECD estimates that if the U.S. reached the efficiency level of the best-performing countries, the government could save the equivalent of 2.7% of economic output every year. That’s enough to solve about a third of the U.S.’s budget-deficit problem.

—Mark Whitehouse

FYI, number two in spending is Norway, number three Canada, number four Germany and number five France, all more socialistic than the US.

What we spend on health care is not health insurance; it is the cost of health care services.  Changing the cost of services and the use of those services is the crux of the matter. In order to lower the spending per individual we must change the way health care is provided and paid for.  We must change the incentives now part of the system.  In short, that means that someone must meddle between the doctor and patient, between the doctor and hospitals, between hospitals and patients and so on.  It also means that there will be hard decisions on what is covered, how much is covered and when it is covered.  Those decisions have been avoided to date.

If by some miracle we accomplish all the changes needed in the health care system to get our efficiency level comparable with that of other modern countries we (and they) still must deal with annual health care inflation.  Getting the U. S. to the optimum efficiency level in the delivering of health care is easy compared with curbing future growth.  Both demographics and technology are against us.

Remember the messages you have been hearing, insurance companies need to do more to control costs and nobody should come between you and your doctor.  Ignore all the blather about insurance companies and focus on what you are willing to accept as real changes in the system.  Also, plan on paying more and more for health care be it premiums, out of pocket costs or taxes of various kinds.  Anyone who tells you differently is simply lying to you.

Aside from the obvious major changes that are needed within the system, what we really need to change is attitudes.  I was at a doctor’s office recently and he said to me as he gently ventured into discussion of his charges, “We submitted to Medicare, but your supplemental coverage paid nothing.”  “I know,” I said “I designed the plan.”  “What good is it?” he replied whereupon he offered to reduce the outstanding bill by 10% if I paid the balance that day.  I could pay the $500 so I did, someone else may not have been so fortunate.  However, the real misunderstanding is about the design of my plan.  It’s quite simple; before I was enrolled in Medicare my employer plan paid me 80% of eligible charges after a $750 deductible.  After being enrolled in Medicare my employer plan pays me 80% after a $750 deductible…you will note it is exactly the same.  Even though I receive no payment most of the time from my employer plan, I receive at least the same reimbursement under Medicare.  In fact, under Medicare my deductible is lower and since Medicare allows a lower fee my 20% is also lower.

But you see that is not good enough, conventional wisdom holds that my employer plan should be paying 80% or even 100% of the 20% Medicare coinsurance thereby increasing my total benefit after age 65…why?  If that were the case (as it is in some plans, including many state government plans), why in the world would I care anything about health care costs?  However this type of coverage is counter to the attitudes of many retirees, health professionals and politicians. As for my employer plan, it provides catastrophic coverage plus coverage for some items not covered by Medicare and for prescription drugs. 

Now that you know the truth consider the comments below from the President during the health care debate. Here we have the United States “reforming health care” and focusing not on the cost of health care, but on insurance which is only a payment mechanism, not the cause of our woes.  We also have the President of the United States stating clearly that no one should meddle in your health care and you should be able to have the plan you want to have. Do you hear the President asking why the treatment cost hundreds of thousands of dollars? No, all you hear is complaining why someone did not pay all of the hundreds of thousands of dollars.

Is there any wonder the U.S. can’t deal with the issue of health care and its cost?  The fact is that nobody wants anything to change except they want to pay little or nothing for what they have, attitudes, remember?

President Obama’s healthcare town hall in Colorado, Aug. 15, 2009

… Today we’re talking about people like Nathan and his family who have insurance but are still stuck with huge bills because they’ve hit a cap on their benefits or they’re charged exorbitant out-of-pocket fees…

…And we’re going to fix it when we pass health insurance reform this year.  (Applause.)…

…So insurance companies will no longer be able to place an arbitrary cap on the amount of coverage you can receive or charge outrageous out-of-pocket expenses on top of your premiums. That’s what happened to Nathan and his wife. Their son was diagnosed with hemophilia when he was born. The insurance company then raised the premiums for his family and for all his coworkers who were on the same policy.  The family was approaching their cap….

…I heard from a teenager in Indiana diagnosed with leukemia.  The chemotherapy and intensive care he received cost hundreds of thousands of dollars. His family hit their lifetime cap in less than a year…

…And this is part of a larger story, of folks with insurance, paying more and more out of pocket.  In the past few years, premiums have nearly doubled for the average American family.  Total out-of-pocket costs have increased by almost 50 percent — that’s more than $2,000 per person.  And nobody is holding these insurance companies accountable for these practices.  So we’re going to ban arbitrary caps on benefits.  We’ll place limits on how much you can be charged for out-of-pocket expenses.  No one in America should go broke because they get sick.  (Applause.)…

…Now, insurance companies will also be stopped from cancelling your coverage because you get sick or denying coverage because of your medical history.  (Applause.)… 

A recent report found that in the past few years, more than 12 million Americans were discriminated against by insurance companies because of a preexisting condition.  When we get health insurance reform, those days will be over.  And we will require insurance companies to cover routine checkups and preventive care, like mammograms and colonoscopies. That saves money; it saves lives. (Applause.)…

…I just want to be completely clear about this; I keep on saying this but somehow folks aren’t listening — if you like your health care plan, you keep your health care plan. Nobody is going to force you to leave your health care plan.  If you like your doctor, you keep seeing your doctor. I don’t want government bureaucrats meddling in your health care. But the point is, I don’t want insurance company bureaucrats meddling in your health care either. (Applause.)…

…Under the reform proposals that we’ve put out there, roughly 700,000 middle-class Coloradans will get a health care tax credit.  More than a million Coloradans will have access to a new marketplace where you can easily compare health insurance options; 87,000 small businesses in Colorado will be aided by new tax benefits, so when they’re doing the right thing for their employees, they’re not penalized for it. (Applause.)  And we will do all of this without adding to our deficit over the next decade, largely by cutting waste and ending sweetheart deals for insurance companies that don’t make anybody any healthier.  (Applause.)…