Depending on what you believe, the passage of the health care reform bill (see our top story of this issue) has fulfilled your greatest fears, your highest hopes or less than either.
On a per-capita basis, as of 1998, the U.S. was spending $4,178 per person per year for health care. The next highest nation was Switzerland at only $2,794 per year. The average for all of the European nations studied was $1,783. When updated data is released, it will likely show that these numbers have only gotten worse. What's more, the U.S. is spending 50 percent more on health care than the next highest country and 1.3 times the average.1
In case you want to believe that our health care spending is higher because the U.S. population has a higher standard of living, the same picture appears when comparing health care spending as a percentage of gross domestic product (GDP). Again, out of 30 developed countries, the U.S. spent a whopping 15.3 percent of GDP on health care in 2006. Switzerland again came in second at 11.3 percent, with most other high-income countries under 10 percent. This places the cost of U.S. health care (as a percentage of GDP) 35 percent higher than Switzerland and more than 50 percent higher than most other high-income countries.2
With a need to cut at least 35 percent of our health care expenditures, the obvious and frightening question is: what to cut? The answers should come from the data. There is more than sufficient research on most forms of care to make utilization decisions. The new U.S. health care system should be paying for what works and not for what doesn't. Spinal injections, for example, should no longer be covered. At best, all they do is relieve pain.
Consideration should be given for the cost of one drug or procedure versus another. Many of the "new" drugs are not more effective, just more expensive. There is no reason to cover the costs of more expensive drugs that have no more effect than their predecessors.
Surgery, one of the largest expenses, should come under a microscope. The cost of surgery, failed surgery and rehabilitation from surgery must be weighed against more conservative care like chiropractic. One round of spine surgery can pay for monthly chiropractic care for years, without the potential negative outcomes.
Putting seniors on numerous (sometimes 10 or more) simultaneous prescriptions is another practice that adds tremendous unnecessary costs to our system. It is not unusual to find an older person who is taking more than $10,000 per year in prescription drugs. "Prescriptions" should be written for exercise, weight loss and a healthy diet instead.
At the end of the day, I believe that chiropractic care will gain greater recognition and utilization under a health care system that considers research findings first and is willing to ignore the politics that have plagued our current system for so long. For well over a year now, the issues of health care reform have been evaluated and debated. The politicians have revised and reconsidered much in crafting a bill that Congress would approve and the president would sign. But what a tragedy it would be if our country ended up with a "reformed" health care system that continued to recklessly ignore the data and focus precious resources on drugs, surgery and therapies that bring little benefit, substantial potential side effects and unnecessary costs.
With all due respect, Mr. President, you have had your say. You have signed the health care bill you were so passionate about. It is time for the politicians to direct their debates on the many other issues we face as a nation. It is now time to let the data speak.
- "The U.S. Health Care System: Best in the World or Just the Most Expensive?" Bureau of Labor Education, University of Maine, Summer 2001.
- Health Care Spending as % of GDP. Wikipedia.com.
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