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America’s health care system is a disaster

Any realistic review of health care in America quickly exposes failure at every turn. We are sicker than any other developed nation on the planet. Life expectancy, infant mortality, chronic disease, obesity – if it’s bad, we lead the world.

From high infant mortality to low life expectancy, from birth to death, you name it, healthwise America is a mess. Not for lack of resources; we spend more per-patient than other developed nations. And we use up more of our GDP than other nations by far.

We even sink more public funding into health care ($4,197 per capita) than other nations except Norway and the Netherlands, and we get less. Every single one of those other nations gets way more for its tax buck: single-payer, universal public coverage. More important, these nations get better care and better outcomes.

In the United States, about 34 percent of us were covered by public programs in 2013, including Medicare and Medicaid. In comparison, everyone in the United Kingdom is covered by the public system at $2,802 per capita, with far superior outcomes. Public spending on health care would be greater than $4,197 in the United States if you included the tax exclusion for employer-sponsored health insurance (about $250 billion a year).

In addition to single-payer, universal public coverage, every other developed nation takes a dramatically different approach to health care. Our greed-driven, treatment-based system is not only ineffective, it’s a killer. Overtreatment and overmedication kill thousands of Americans every year and harm thousands more. Just compare our medication levels with other nations, especially the UK. Big Pharma is really getting its money’s worth out of its lobbyists and shameful advertising.

And don’t let the pharmaceutical companies give you their “cost to develop new drugs” song and dance. First off, an examination of their costs shows that rather than the $1.2 billion number they flaunt as the cost of a new drug, it’s more like $100 million.

Worse, they are not focused on developing new drugs. Almost all of their efforts are directed to reformulating existing drugs approaching patent expirations. Then there are the Jolly Roger-flying outfits that just buy up small one-drug pharmas and push the cost of that one drug through the stratosphere.

To illustrate the ends Big Pharma resorts to, years ago its lobbyists pushed a bill through Congress that prevents Medicare from negotiating prices on drugs. So this huge market pays retail. Meanwhile, the same members of Congress bemoan the lower prices Canadians have negotiated for drugs. By the way, Medicare buys a lot more drugs in total than the Canadians. Guess who benefits? The doctors and Big Pharma. American patients? Just the opposite; they pay through the nose, often for drugs they don’t need. Overmedication is a killer.

Other developed nations use a prevention-based health care system, which produces far better outcomes and is dramatically less expensive. As it happens, we have a side-by-side comparison right here at home. The VA Healthcare System is a single-payer, prevention-based system. Its outcomes far exceed the national picture, and when you compare per-patient cost with Medicare, it comes in nearly 40 percent lower. That performance is even more dramatic when you look at the patient bases. The VA is dealing with a bunch of beat-up old folks and some horrifically beat-up young veterans, whereas Medicare has a relatively healthy patient base.

As long as the medical community’s income is based on how much treatment, and how many drugs and tests they order, Americans are trapped in this destructive and unscrupulous system. The way out is simple, single-payer, prevention-based universal coverage. Tragically, we are already paying for it. It’s time we got our money’s worth.

W.T. “Bill” McKibben is a Buffalo-based author. He was a Medicare Part B & health care insurer consultant for more than a quarter century.