A recent report compared 11 advanced industrial countries in terms of health care efficiency and outcomes. The United States ranked last on issues involving cost of care, duplicate tests, avoidable emergency room visits. It also ranked last on indicators of healthy lives as measured by infant mortality, healthy life expectancy at age 60 and deaths that might have been avoided through medical care.
If you’re a health care provider in the United States you should be appalled – not because of the findings of the report but because you’re being compared for things outside of your control. The report paints the picture that US health care is not on par with other countries. Nothing could be farther from the truth. The difference is the US health care system allows people to avoid health care altogether.
Most other industrialized countries have government supplied health care. Anytime a service is provided as an entitlement program, with little or no charge to the patient, the patient is more likely to access the system. The more likely a patient is to access the system the more likely they are to receive both preventive and timely care and they are more likely to seek care before a condition worsens or becomes chronic.
The US subsidizes care for everyone through private insurance. Costs to provide care to the uninsured is passed on to those who have the ability to pay which raises the rates for everyone. Government programs such as Medicare and Medicaid often pay less than the cost of care and the difference is passed to private insurance as well.
In the US many people are forced to access care in the emergency setting which is more costly than the primary care setting but a visit to the ED is for some the only option. It’s the only option when you’re uninsured and don’t have access to care in other settings. When forced to seek care in the emergency setting many people wait until their condition is no longer tolerable and beyond an easy fix which makes care both more complicated and more expensive.
The US health care system is the most technologically advanced and most innovative in the world. It’s also the most unique. We are a free market society and that free market has shaped who and what we are as a nation. Until the United States addresses the uninsured population by providing some type of health coverage or makes coverage affordable for everyone we will continue to lag other countries in terms of health outcomes.
The State of Missouri has the option to apply the same logic to our state by expanding Medicaid. The expansion of Medicaid in Missouri would help more than 300,000 Missourians gain access to care and significantly improve their health outcomes.