It's no secret that the American health care system is sick. So sick that we spend more, twice as much more per person, on health care as citizens of other advanced countries, yet we get less, and are less healthy besides.
The U.S. does not have the world's best care. It has the costliest.
Our health care system is so dysfunctional and unjust that one in six Americans, including some nine million children, go without health care twelve months out of the year. One in three Americans below age 65 lack private or public health insurance for all or part of the year. Six of ten of these uninsured adults even hold full-year, full-time jobs.
And, not surprisingly, since 2001 the number of Americans falling through the cracks of our broken health care system has been steadily rising.
Also not surprisingly, uninsured Americans receive about half the medical care of those with insurance. They receive too little care too late, get sicker, and die sooner. Roughly 18,000 excess deaths occur each year in this nation of plenty among uninsured adults age 25 to 64.
Put in contemporary terms, lack of health care is clearly killing many more Americans than terrorism. The real wolf at the door is not the one purportedly roaming the mountains of western Pakistan.
Being without health care means that when a child gets sick, the parents don't take them to the doctor. They wait, and hope their child will get better. People without health care don't treat their diabetes. They don't get a Pap smear, or a mammogram. They ignore the pain in their chest. All this adds up to a less healthy society.
Health and health care are vitally important in influencing life's chances. That so many people should be without medical coverage in the world's richest country is a disgrace. It blights the lives of the uninsured, who suffer by being unable to get access to affordable treatment at an early stage. And it casts a shadow of fear well beyond, to people in America's middle class, who worry about losing not just their jobs but also their health care benefits.
Having health care benefits does not necessarily guarantee peace of mind. Premiums are soaring, while benefits are shrinking. Millions upon millions of working Americans with health insurance have benefits so insufficient that they are not able to meet the financial consequences of major illness, which has become the nation's leading cause of personal bankruptcy.
As a full-time primary care physician practicing in a blue-collar community in Oregon, daily and nightly I listen as families tell the stories, the symptoms, of our sickly health care system.
I hear stories of friends and congregations holding garage sales and charity breakfasts to help a family with medical expenses; of uninsured families bartering skilled services for medical care; and of families with health insurance but living paycheck to paycheck, unable to fill prescriptions, complete recommended treatment, or even see a doctor when ill because their co-pays are too high.
All this in a community neither especially poor, nor without good jobs.
How can the U.S spend so much more and get so much less out of its health care system? With five percent of the world's population, the U.S. accounts for nearly fifty percent of the world's healthcare spending, while ranking just 29th in the WHO life expectancy ranking, and 37th in child mortality under age 5. We even rank near the bottom of countries with indoor plumbing when it comes to physicians, nurses, and hospital beds per person.
All this in a country neither especially poor, nor without good jobs.
And things are soon to get worse. Much worse. The combination of an aging society and fast-rising health care costs means that health care spending is slated to sop up much, much more of our future resources than Social Security.
Within a decade, an aging America will spend one of every five dollars on health care: the nation's total health care bill by 2015 will be more than $4 trillion. Consumers will foot half the bill, the government, and therefore taxpayers, the rest.