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Wednesday, October 18th 2006

In The News Arthur O. Sulzberger, Jr. Buys Huge Stake In Hospital Chain

Remember all those recent op/eds in the New York Times which have been saying that, despite the whines of GM and the likes, we don’t spend too much on health care? Well if not you really need to take a look at this post and this post and this post.

New York Presbyterian Times Hospital…
…Insurance Only

Because actually this is getting a little bit stunning, as The Health Care Blog links to yet another article praising the current condition of American health care. Okay, not praising but basically throwing up some excuses.

I’m not saying I don’t agree with some of the points the op/eds to date have made but this is an all out assault by the NYT to give the current system a little boost. A really surprising assault at that.

Here’s what the titled “A Lesson From Europe on Health Care,” has to say,

I wrote a column arguing that this country’s increased medical spending over the last half-century has, on the whole, been overwhelmingly worth it. Thanks to new treatments for everything from premature births to heart attacks, human life has continued to lengthen — defying expectations — even without major improvements in public health. Yet, strangely, we talk about medical spending as if it were nothing more than a drag on the economy, rather than an investment in the most important thing of all: our well-being.

I received about 500 e-mail responses from readers, and the most common reaction was a version of a simple question. “Why do Americans spend so much more than folks in most other developed countries while getting worse results?” as Sumati Eberstadt of East Greenwich, R.I., wrote.

One good way to understand the problem is to look at the share of health spending that the elderly account for in different countries. In the United States, people 65 and older have Medicare, which has administrative costs roughly as low as those of other countries’ universal plans. Younger Americans, by contrast, have private insurance, with all its inefficiencies. Yet elderly Americans’ share of national health spending is similar to that of the elderly in other countries, as Arnold Kling, an economist, has noted.

So something beside administrative costs is at work here, and it involves a basic cultural difference. Americans seem to be less willing to take no for an answer and more willing to try almost anything, no matter how expensive or how slim the odds, to prolong life.

There are enormous benefits to the American refusal to go gently into that good night. It has made us obsessed with medical advances and turned this country into the world’s research laboratory.

But much of it is simply wasteful. Expensive procedures — like some Alzheimer’s treatments, some knee surgeries and many body scans — are often no more effective than basic ones, according to research. Yet doctors can keep on getting reimbursed for the expensive ones. “Basically, anything that doesn’t kill patients is paid for by Medicare and insurance companies,” said Jonathan Skinner, a health care researcher at Dartmouth College.

My favorite line from the piece should be obvious however,

(The United States is also a fatter, more diverse country with wider income disparity, which gives our medical system a harder task.)

My pet peeve rises again. For those unaware, that would be questions like the one from the email published in the editorial. Questions which ignore one of the true relationships between spending and outcomes – namely that we spend more in small part because we live less healthy (and we have worse outcomes for the same reason).

Dr. Leonhardt addresses that with the little parenthetical on obesity he inserted.

As well I’ll agree with him as well that the socioeconomic gap and imbobility of class change in this country creates for further issues concerning health care. For instance, even in countries with universal coverage the poor consume less health care and are less healthy.

As the “lower” half continues to grow in this country it places a unique strain (in terms of magnitude) on the American health care system.