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Best healthcare? No, but we have costliest

Coincidentally with the arrival of The Citizen in my driveway, there appeared an article in the New York Times about a very recent study by a well-respected independent group claiming the U.S. healthcare system contains $750 billions of waste per year.

Dr. Lawson claimed my most recent letter contained many “misleading statements and few facts,” which he quickly followed up with his own misleading statements and outright fabrications. Undoubtedly the doctor ... feels he has an economic interest in the status quo. That status quo is a healthcare industry which delivers excellent care in some cases and middling care in others when measured against the major industrialized countries of the world.

For my facts I read various articles, again easily obtainable online. The one I found most pertinent was an article entitled “Explaining High Health Care Spending in the United States: An International Comparison of Supply, Utilization, Prices and Quality” by Mr. David A Squires, writing for The Commonwealth Fund (www.commonwealthfund.org/).

Mr. Squires used data published by the Organization for Economic Cooperation and Development (OECD) and other sources to compare healthcare spending, supply, utilization, prices, and quality in 13 industrialized countries: Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States.

This is not some dry article with an overabundance of numbers and absence of purpose but a hard look at what we’re getting for our healthcare dollars, both public and private.

Mr. Squires’ conclusions, though, are inescapable. We pay a lot more than anyone else in the world. The service delivered is sometimes at or near the top (5-year survival rates for the cancers studied; breast, cervical and colorectal, top only in breast cancer survival rate) and often not near the top (practicing physicians per 1,000 population, physician consultations per capita, average length of stay for acute care, asthma mortality among ages 5-39, diabetes lower extremity amputations, acute myocardial infarction death rate, ischemic and hemorrhagic stroke death rate).

However, we always lead in costs by a huge margin. Dr. Lawson’s assertion that the cost numbers are misleading is flat out wrong. The numbers used in the study involve the total cost of healthcare in each country subdivided into public funds, insurance funds, and out of pocket funds. This is a total number and already takes into account the source.

The United States spent $7,960 per capita; Japan spent $2,878 per capita; Germany $4,218 per capita.

While holding their spending to slightly short of one-third of our costs, the Japanese system delivered more doctor’s visits per individual and better overall health statistics. If you want a hip replacement, go to Germany, where they perform 296 hip replacements per 100,000 people to our system which performs 166 hip replacements per 100,000.

Our drugs are more expensive. Our hospital stays are vastly more expensive and we seem to have a great deal of wasted expense which is pure profit for insurance companies and providers.

Dr. Lawson is correct stating that I should not have used the term “uninsured” when that number is far less than 50 million. Interestingly in his report, Mr. Squires writes:

“For many U.S. households, healthcare has become increasingly unaffordable. In 2010, four of 10 adults went without care because of costs and the number of either uninsured or ‘underinsured’ (i.e., people with health coverage that does not adequately protect them from high medical expenses) increased to more than 80 million. A 2007 survey in five states found that difficulty paying medical bills contributed to 62 percent of all bankruptcies, up 50 percent from 2001. For the average worker with employer-based health insurance, growth in premiums and cost-sharing has largely erased wage gains over the past decade.”

So the number of people who have insurance problems in this country is really 80 million, not 50. For those people Dr. Lawson suggests use of the emergency room.

Now this is a great use of our healthcare dollars: the most expensive and short-lived care you can get. And since the underinsured can’t pay much and the uninsured can’t pay anything, guess who gets stuck with the bill?

As for Medicaid it is certainly better than the alternative nothing. Notice also it is the thing Paul Ryan wants to denude of funding. And incidentally, if your parents need nursing home care, Medicaid will pay as long as their estate is depleted and they’ve signed over all but $66 per month and that is after a five-year look-back to ensure they haven’t transferred any funds or assets to you. Keep worrying about the billionaire’s passing on their national expenditure size estates to their worthless spawn.

Other fantasies in Dr. Lawson’s letter: There are no “entitlements” in the Constitution. He should read it sometime. The health panel’s recommendations on testing for certain cancers are based on survival rates both with, and without testing. It does not mean someone couldn’t pay for their own testing. In the end their statistical survival rate is not affected.

How about the $20 billion coming out of the Massachusetts healthcare system? Turns out that is the shortfall incurred by the largest 50 municipalities in Massachusetts for healthcare for retired employees. That shortfall was incurred over a long period including Mitt Romney’s term as governor and it is NOT coming out of the healthcare system. It is an obligation of the municipalities.

One Republican voted for the Affordable Care Act but that doesn’t mean no Republican had an input. George Mason, Elbridge Gerry, and Governor Randolph of Virginia refused to sign the Constitution, but they had a huge input forming that document.

And it was kind of Mr. Gilmer to give us some foam at the mouth Rush Limbaugh invective. Quite frankly if he has 100 million like-thinkers, he won’t need his civil war (unless he likes tanks driving through his living room).

And I’m not a socialist (like the guy in the parable I have too much stuff) and I’m not leaving, seeing as how I have to collect my military pension, military healthcare, and then rail about government spending.

Conclusion: We’re being sold a bill of goods. Most of us have good healthcare but it isn’t top notch by international standards.

We pay way too much and we have a lot of people who have an economic interest in seeing that we pay a lot more.

You can start off by getting the facts (not Lawson facts but real ones) and make your own decision, but don’t swallow this crap from the Republican leadership and others who are in bed with the healthcare pirates.

Timothy J. Parker

Peachtree City, Ga.

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