Revamping US healthcare

US politicians and insurance companies claim to offer the best healthcare services in the world. Recently, however, top US experts have admitted that the system is about to collapse. During the annual meeting of the American Association for the Advancement of Science, ways to revive the system were mostly discussed. The new concern stems from the fears of bioterrorism
Revamping US healthcare
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us politicians and insurance companies proclaim they offer the best healthcare services in the world. These are nothing more than tall claims. Recently, top us experts have admitted that the system is about to collapse. During the annual meeting of the American Association for the Advancement of Science -- the world's largest scientific society -- ways to revive the system were mostly discussed. The new concern stems from the fears of bioterrorism.

A World Health Organization (who) report underlines the plight of the country. Every us citizen spends us $4,178 on healthcare -- the highest in the world. But the country ranks 37th in overall healthcare system performance. The prime reason: its healthcare is unaffordable for most.

High cost can be attributed to a number of factors, ranging from the rising costs of medical technology and prescription drugs to high administrative costs resulting from the complex multiple payer system in the us. It has been estimated that between 19.3 to 24.1 per cent of the total us healthcare expenditure is spent on administrative costs.

The high proportion of people who are uninsured in the us (15.5 per cent in 1999) also make healthcare services inaccessible, as conditions that could be either prevented or treated inexpensively in the early stages reach crisis proportions. Today, approximately one-fifth of the total population is uninsured. Recent trends show an average rise of one million uninsured people each year.

The us is the only country in the developed world (except for South Africa) that fails to provide healthcare to all its citizens. Instead, it has a confusing private insurance coverage system based primarily on employment, along with public insurance coverage for the elderly (Medicare), the military, veterans, and for the poor and the disabled (Medicaid, which varies greatly in its implementation across states). Such a 'non-system' creates serious gaps in coverage. Moreover, finances of the public insurance system are fast shrinking. In 1997, the us congress slashed us $115 billion from the Medicare budget as part of its balanced budget act.

There are many different indicators of the overall health status, but the most popular is infant mortality rate. As of 1998, the infant mortality rate of the country was 7.2 infant deaths per 1,000 live births (identical to the rates of 1996 and 1997). This is the highest among oecd (Organisation for Economic Cooperation and Development) member countries. This is not all. The infant mortality rate of black children (14.3 per 1,000 live births) is more than twice that of white children (6.0 deaths per 1,000 live births).

The confused system also leads to lack of accountability. There is a vast gap between what medical technology offers and the kind of healthcare most us citizens receive. Estimates show that as many as 98,000 people die each year due to medical errors. Only 40 per cent of the us population is satisfied with the healthcare system. Reports about patients facing sexual assault, racial abuse and maltreatment are common.

Fortune magazine declared the pharmaceutical industry to be the most profitable in the us. Since us drug prices are the highest in the world, this is hardly surprising. A study by Boston University

reveals that if the drug costs were lowered to match international norms, the money saved would be enough to help every uninsured person.

The situation is expected to deteriorate rapidly after 2010, when the first wave of baby boomers reaches retirement age. Till yet, the search for solutions has not been clear. Policymakers often attempt to address the crisis through short-term, patchwork solutions, under the pressure of time and the constraints of political decision-making, rather than analysing the problem as a whole. To find a way out, the us government has to stop tinkering at the edges when what is really required is grassroot level reform.

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