Weaknesses in the U.S. Health Care System

Oct 31, 2007

By Thomas J. Donohue, President and CEO, U.S. Chamber of Commerce
November 27, 2007

Last week, in the first of three columns on U.S. health care, I examined some of the strengths of our system, including widespread coverage, excellent medical facilities, and tremendous new employment opportunities. Our health care system has achieved many outstanding results, including adding 30 years to Americans' life spans in the last century. Despite its accomplishments, it has many significant shortcomings.

Costs. We pay more for health care than any other modern society. Yet on a national basis, we fall short on some key indices such as infant mortality and life expectancy. Costs are escalating with no end in sight—for businesses, families, and the government. Unless solutions are found—and soon—these spiraling costs will bankrupt companies, force businesses and individuals to drop coverage, destroy the long-term viability of Medicare and Medicaid, and erode America's global competitiveness.

Medical Mistakes. Medical accidents are unacceptably high. An estimated 98,000 Americans die annually from preventable medical mistakes. According to the Institute of Medicine, medication errors harm at least 1.5 million people each year. In addition to the pain and heartbreak, these errors add incalculable costs to our health care system.

Medical Liability. Legal redress should be available for the victims of these mistakes, but that's no excuse for all the frivolous liability claims that are driving up prices and driving health care providers out of the profession.

Health IT. Most providers lack the IT systems necessary to coordinate a patient's care with other providers, share needed information, and monitor compliance with prevention and disease-management programs. This makes it impossible for doctors to provide the highest level of care and drives up costs by contributing to errors and redundant tests.

Consumer Responsibility. We need a far greater level of personal responsibility on the part of our citizens. Consumers need to understand the impact of their health care decisions and the cost of their treatments. And, they need to take better care of themselves.

The Uninsured. There are 47 million people in this country without health care coverage, but that's only part of the story. In fact, nearly half of the 47 million uninsured remain so on average for just four months. In addition, if you subtract noncitizens, those making more than $75,000 who choose not to purchase insurance, and those who are eligible for government-provided care but don't take it, the number of long-term uninsured Americans is probably in the range of 10 to 15 million. That's still an unacceptably high number, but it's nowhere near 47 million.

So how do we build on the positive aspects of our health care system while addressing its significant shortcomings, and without implementing an expensive, inefficient government-run program that would take us in the wrong direction? Stay tuned next week ...

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