I have commented before about the striking discordance between the amount of money that we spend on health care in the United States and the health outcomes that we achieve with all of those dollars. At more than $2 trillion dollars per year, or more than $7,000 per citizen per year, the U.S. spends more on health care than virtually every other country in the world. One would, therefore, assume that all of those trillions of health care dollars would translate into a globally unsurpassed level of health and well being in America. However, one would actually be mistaken in this assumption, as the United States lags behind many other countries of the world, including a few relatively underdeveloped countries, in several very important public health benchmarks. As if this were not bad enough, the world’s richest nation has an estimated 47 million uninsured citizens, with millions more possessing utterly inadequate health insurance coverage (millions of us in this country are just one serious illness away from financial ruin).
Health care reform in the United States continues to be a political “third rail,” although virtually all stakeholders are in agreement that our healthcare system is dysfunctional and inefficient, and that it offers the American people very poor value for their money. However, there is considerable disagreement regarding the root causes that underlie the acknowledged deficiencies in our health care system, which means that there is also pervasive disagreement regarding the best interventions to undertake. Amidst the worst economic downturn since the Great Depression, and with no end in sight to the ongoing Not-Quite-As-Great-Depression, it is unclear whether or not the fledgling Obama Administration will be able to assemble the political capital and the will to wade into the treacherous waters of health care reform within the foreseeable future.
A new research study, just published in the American Journal of Public Health , provides a rather stark comparison between the health status of rich and poor adults in the United States and Europe. In this study, more than 17,000 adults between the ages of 50 and 74 years were interviewed from among 10 European countries. Nearly 7,000 Americans of similar age were also interviewed for this study. The researchers assessed these 24,000 middle-aged and elderly adults for 6 chronic illnesses that are commonly accepted as indicators of the overall health of a society.
In general, the American adults reported poorer overall health than their European counterparts. While the differences in health between the two groups of adults were, not surprisingly, more pronounced among poorer patients, even the wealthier Americans reported more problems with their health when compared to wealthy Europeans. At the same time, the gap in health status between rich and poor was much smaller among Europeans than was observed among the American patients who participated in this study. (As a striking example of the health disparities between Americans and Europeans, heart disease, the number one cause of death in most developed countries, was present in 18 percent of Americans, but in only 11 percent of Europeans, in this study.)
This study puts some important numbers on health trends that have become increasingly obvious over the past few decades. When comparing health outcomes between two populations of patients that live in similarly modern, industrialized, and western societies, the United States fares very poorly, indeed.
Our nation’s focus on disease prevention is haphazard and poorly executed, resulting in unacceptably high rates of preventable diseases and disease-related complications. Rather than investing our nation’s wealth in disease prevention and screening programs, we, instead, backload our inefficient and byzantine health care system with trillions of dollars, every year, to treat the complications of diseases that are, in many cases, almost entirely preventable. European countries spend, on average, only 50 to 60 percent as much on health care, per capita, as we do here in the United States, and yet their health outcomes frequently exceed ours in multiple critical areas of public health .
While we may not all agree on every detail, almost all of us agree that our health care system is fundamentally broken, and that we cannot go on with “business as usual” any longer. Despite the ongoing implosion of the economy, we must somehow find the will and the foresight to overhaul our current fractured and wasteful health care system, including a much greater emphasis on promoting healthful lifestyle habits, and improved disease prevention and screening programs. As the average age of our population continues to rise, our ongoing failure to step up to the plate and fix our dysfunctional health care system will, increasingly, cost our nation dearly.