According to the World Health Organization, the per capita expenditure in 2005 for health in the United States was $6350 (World Health Organization, 2008). Canada’s expenditure was $3,419, France was $3,314, and the United Kingdom’s per capita expenditure was $2,597. Yet the U.S. still has a much higher mortality rate, even though the U.S. seems to spend nearly double on health care compared to other countries. If that wasn’t enough, the U.S. also has a high rate of medical errors and 17% of Americans aren’t even covered for their medical expenses. All this tells us one thing very loud and clear. America’s healthcare system is in dire need of reform.

Healthcare is not a new topic for the United States. To fully grasp the origin of healthcare, we have to mention the origin of health insurance. Health insurance became popular a few years before WWII. The original intent was to create a steady stream of income for medical professionals. Families across America could pay a low monthly rate and, in return, be covered for so many days at a hospital. At the time medical expenses were not as inflated as they are now, so you could get a good plan for much cheaper and it was thought of as a good opportunity. Health coverage was not too popular with the country just yet, not until after WWII. During WWII many soldiers who served our country were first introduced to the idea of their medical expenses being covered. When these soldiers returned home they sought out similar coverage, similar to what they had experienced in the military. This is when health care becomes a big topic. President Truman, being the amazing patriot and hero he is, at this time makes a statement that every U.S. citizen has a right to medical coverage; so starts the campaign for social medicine. However, being in the WWII setting, anything with the word “social” was looked at with extreme prejudice. This form of medicine was just not considered “American” enough. If we were to start a healthcare system then we had to do it the “American” way.

The problem with today’s healthcare is not just any one element. Instead, it is the collective of failed ideas. Medical care was seen as a great opportunity in a post WWII era. To make it greater, the government allowed for businesses to use it as a tax right off. So now, what was once something that families would pay for out of their own pocket, employers are now paying and writing off come tax season. Essential employees are getting healthcare for free. Not to mention the reduced paperwork involved with the whole process. From now on, doctors wouldn’t even have to bother patients about fees because they could go directly to the insurance company. The old saying goes, out of sight out of mind. When medical expenses left the consumer eye it presented an opportunity for unneeded inflation. Suddenly adding onto medical expenses here and there was not seen as a problem since the American people were no longer paying for it. What’s the problem when pretty soon everyone in America will be covered by health insurance?

After WWII, the introduction of healthcare, the “American” way, poured federal dollars into our health systems. Once a career where you were required to attend a 1 year unpaid internship, the path to becoming a doctor turned into residency programs. These residency programs were started to increase the amount of medical professionals in the country, which were needed at the time. The big difference between the internship and residency programs was about $50,000 of today’s U.S. dollars. Now “a large percentage of students knew well before matriculation exactly what they wanted: money” (Lundberg, G., 2000). This was the start of our decline in the quality of medical care. However, the rise in medical errors had not gone unnoticed. Instead it was acted upon by creating regulatory agencies, whose job was to make sure the medical professionals were doing what they should be doing. In the end this had a negative result. More concentration was put on “process” versus “performance” (Porter, M., 2006). Now doctors are overwhelmed with lists of “processes” which makes them unable to focus on properly diagnosing patients. Now with more medical errors, doctors have to find a way to protect themselves from things like malpractice suits. How? Through raising health costs.

Unfortunately, money its self is not going to fix our healthcare. But to start somewhere, remember that the U.S. is not some special exception country where prices should be higher. Other global economies have higher living costs, much higher than that of the average American. One way to start hacking at this problem is by creating some sort of price regulation on procedures. Some healthcare systems have already ranked “medical procedures based on their cost and impact on the patient’s life” (Goodnight, L., 1993). By following this idea, we can regulate the price of procedures based on global comparison. Regulating the price of procedures prevents our health costs from spinning out of control.

Medical errors are not fixed by adding more paperwork to the doctor’s desk so they can lose focus of what really matters, the patient. However, we still would need a way to improve the actual quality of care patients receive. The most effective way to do this is through competition. “The best American health care is world class” (Porter, M., 2006); by increasing the publicity of doctor results, without disrupting the patient privacy, people will be able to see how doctors measure up to others in their class. If a doctor isn’t producing the results they should be, the public is informed of their results. This effectively results in less business for that doctor, in turn pushing doctors to produce better results.

For a country that is considered to be the only hyper-power, it doesn’t make sense when its standards aren’t the example for the rest of the world. Medical costs continue to spiral out of control, far surpassing inflation, preventing the 17% of the population who do not have insurance to be deprived of their right as a citizen, of the world’s greatest economic power, to receive healthcare. It doesn’t make sense that a single citizen cannot receive healthcare. This ultimately shows us that our healthcare system is in need of reform and unfortunately that a federally assisted health insurance policy is not the answer.

For more inforamtion:

Lundberg, G. (2000). Severed Trust: Why American Medicine Hasn’t Been Fixed. New York, NY. Basic Books.

Porter, M., & Teisberg, E. (2006). Redefining Healthcare. Boston, MA. Harvard Business School Press.

Goodnight, L., & Check, T. (1993). A National Health Care Program. Lincolnwood, IL. NTC Publishing Group.

World Health Organization. (n.d.) Core Health Indicators. Retrieved June 2, 2008, from http://www.who.int/whosis/database/core/core_select.cfm