Public Must Understand Social Issues Behind Health Care

Article excerpt

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Many health care professionals were stunned by recent surveys which indicated that a significant number of Americans favor "junking" our present health care system in favor of a Canadian-like approach. What was particularly distressing to the health-care industry was the fact that few Americans (while supportive of a different system) had any conceptual idea of what that really meant. The implicit criticism, of course, was that anything would be better than what we currently have.

It is very common in the media to see statistics which indicate that when the health of Americans is compared to other industrialized nations, we simply do not measure up in several critical areas. These shortcomings when compared to our costs would indicate, according to the critics, a need for some significant changes.

We know, for instance, that the United States does spend a higher percent of its Gross National Product on health care than other competitor nations. Currently, 12 percent of our total national output, or $650 billion, is spent on some form of health care. This equates to about $2,500 for every man, woman and child in the United States.

It also distresses us to recognize that our infant mortality rate is higher than in Japan, France, Germany or Canada, and our life expectancy is lower. The concern is that with higher expense and ostensibly worse results, do we need a complete rethinking of our health care system?

We accept the premise that our health-care system, like most of our systems, is a result of our history and unique American character. It then seems logical that before we jump off the precipice and suggest the adoption of a radically changed system, we should examine the consequences of that decision.

What are the factors that lie behind our less favorable statistics and what would be required to achieve some of the economies that other nations do? Could we in all cases live with those economies? A few facts might help in the analysis:

- It is interesting to note that while the expense of our hospitals is significantly greater than most other nations, our actual use of the hospital is less. Our physicians routinely admit to U.S. hospitals on a less frequent basis, and patients tend to stay for shorter lengths of time. However, once in the hospital, our costs are significantly higher. The reason is obvious - the application of high technology is greater here than in any other nation.

- Many analysts project that by the next century, our spending on health care could reach the $1.5 trillion to $2 trillion level. The extent of that figure depends on some factors external to the system, such as the aging of our population and the extent to which AIDS (Acquired Immunodeficiency Syndrome) impacts this nation.

- Much of our health-care cost is driven by the fact that this nation is in a desperate race for immortality. Americans are simply less accepting of death than other nations. We routinely spend exorbitant amounts of resources to maintain our elderly loved ones (often in suspended animation) simply because we have the technology to do so. Interestingly, while our life expectancy at birth does not compare well with other nations, by the time an American reaches age 70, we have much greater life expectancies than other countries.

- We must begin to understand how our social fabric affects our health characteristics and how that is ultimately reflected in statistics such as infant mortality and life expectancy. If we, for instance, have much higher rates of teen-age pregnancies, cocaine addiction and limited access for the poor into prenatal programs, is it not surprising that our infant mortality rates compare less favorably? …