Why US Health Care Must Be Reformed

Source: "Reforming American health care: Heading for the emergency room," The Economist, June 25th 2009.

Evidence is mounting that spending more does not necessarily buy better health. On the contrary, it appears that many Americans are getting mixed or even downright dreadful health care. In a recent study economists at the OECD found that America does indeed do well on some measures, such as breast-cancer survival rates and cervical-cancer screening, compared with other rich countries. However, it does worse in other areas. American infant mortality was 6.7 per 1,000 births in 2007, against an OECD average (excluding Mexico and Turkey) of 4.0. The death rate after haemorrhagic strokes was 25.5% in American hospitals but only 19.8% in OECD countries as a group.

Comment: I am a retired Fed, and my wife is retired from county government in a rich and liberal county, so we both have subsidies. Since I worked as a health planner for the World Health Organization 35 years ago I have had an ideological preference for health maintenance organizations, and my family has decades old coverage via Kaiser Permanente, whose services seem to be getting better with time.

It seems to me that we need two major reforms. We need to be sure that health services are available and accessible to every one in this country, and we need to reform systems so that the key intermediaries do not have perverse incentives to increase health service costs. JAD