Insurance inefficiency

Insurance inefficiency

: Health care better become an issue in this campaign, for the state of things keeps getting worse as it gets more expensive and inconvenient. But it’s not just doctors and hospitals that need reforming; it’s insurance companies. They are adding more and more rules in its effort to save money by harrassment — if we make it really tough and expensive to get this prescription, maybe he won’t take it, goes the logic. But what this really does is add more work and thus more expense in doctors’ offices. It’s a vicious cycle and it’s not getting better.

In Todays’ NY Times, Jeff Madrick writes:

Americans spend some 14 percent of gross domestic product on health care, while other advanced nations spend an average of 8 percent. In the United States, the proportion may rise to 18 percent by 2013.

Yet in general, judging by life span and infant mortality, most developed nations are healthier than the United States….

What may surprise readers, and certainly surprised this writer, is that Americans, by paying so much more, do not have many more services. In fact, according to recent research, they typically have fewer. Consider the number of doctors. In 2001, the United States had 2.7 doctors per 1,000 people, compared with a median of 3.1 in the countries in the Organization for Economic Cooperation and Development. France, accused of having a doctor shortage in last summer’s heat wave, had 3.3 per 1,000.

Also, consider the number of hospital beds. The United States has only 2.9 hospital beds per 1,000 people, compared with the O.E.C.D. median of 3.9. Germany has 6.3. The United States is also behind in the actual days spent in a hospital and hospital admissions per capita. These are not necessarily bad in themselves, but the question is why we spend so much.

The reason for the high level of American spending, argue the researchers – Uwe E. Reinhardt of Princeton and Peter S. Hussey and Gerard F. Anderson of Johns Hopkins – is that American doctors and hospitals charge much more. Americans also usually pay significantly more for drugs, they say, and administration expenses are exorbitant.

Administration expenses are exorbitant.

I can’t wait until Hillary is president. We will get health care reform then. Just as Bush the younger finished Bush the older’s job in Iraq, I hope Clinton the Mrs. will finish Clinton the Mr.’s work — and her own work — in health care.