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Thinking about Health Care

Posted 4/4/2016

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  Like it or not, it behooves us all to think about the state of health care in the US and health care policy going forward. This is always important and even more important in a presidential election year. This is broader that the future of Obama Care and reflects the values that we hold as a nation. Of course it also reflects the budget that we have as a nation and our shared perspective that health care costs have to be better contained.

  Even if it is not your usual sphere of interest, try being a policy wonk for a few minutes and read this excellent essay from JAMA by David Blumenthal, MD. It is well worth your time and attention.

Better Health Care
A Way Forward
David Blumenthal, MD, MPP

Despite areas of excellence, the United States health care system could perform much better than it does. The key questions: what can realistically be expected, and how can the nation get there?

To set expectations, real-world examples are helpful. Cross-national comparisons show that if the US health care system performed like systems in other Western democracies, individuals would live longer lives and spend less, and the United States could provide universal access to care.1 As just one example, if health care costs in the United States had increased since 1980 at the rate of health care costs in Switzerland, where all citizens purchase private insurance from competing plans, an estimated $15.9 trillion dollars could have been saved2—nearly enough to retire the US national debt.

Given some Americans’ skepticism of foreign experience, home-grown examples may be more compelling. The Commonwealth Fund State Scorecard3 suggests that (1) if US health spending per person averaged the same nationally as among the 5 lowest-cost states (Utah, Arizona, Georgia, Idaho, and Nevada), an estimated $535 billion (approximately 20%) less would have been spent on personal health services in 2014; (2) if rates of health insurance coverage averaged the same nationally as among the 5 areas with the highest rates (Massachusetts; Vermont; Hawaii; Washington, DC; and Iowa), an estimated 20 million more Americans would have been insured in 2014; and (3) if the national levels of mortality amenable to health care averaged the same as among the 5 states with the lowest rates (Minnesota, Vermont, New Hampshire, Utah, and Colorado), an estimated 77 000 fewer deaths would have occurred in 2014.

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