Can we fix the healthcare system?
Thursday, December 11, 2008 9:23 AM EST

The costs keep rising, outpacing inflation, but are Americans getting any healthier?

In a few areas, our health index is getting stronger, but in other areas we are trailing the populations of many other industrialized countries.

In a Dec. 1 cover story, Time Magazine profiles the collective health of Americans, and points out where we've got a lot of work to do.

“Millions of Americans are at risk because they don't have insurance or easy access to a doctor,” Time says.

Time gives out a grade of B+ to the U.S. for (1) bringing the level of complete vaccinations to children ages 19-35 months up to nearly 80 percent; and (2) a declining rate of smoking by adults (19.8 percent).

Less impressive were the marks that went for weight control (D+): two-thirds of adults and 17 percent of children remain overweight, although numbers seemed to have stabilized; insurance (C-): more than 45 million Americans had no health insurance in 2007; and preventive care (D+): no more than half of all adults got blood pressure checks, cancer screens, immunizations and blood tests in 2005.

According to Time, Americans spent $2 trillion (that's right, trillion) on health care in 2005, which was the world's highest per-capita expenditure. The U.S. is spending more, but getting less, Time's analysis suggests.

The reason why is because we're spending for care “after the fact.”

“The reason we rank so poorly is that we don't provide a basic-wellness infrastructure,” says Dr. Mehmet Oz, director of the cardiovascular institute at Columbia University, as quoted by Time.

Unless there's some reform the index of America's health seems destined for further decline. As many types of bad health are preventable - heart disease, some cancers, pneumonia, diabetes, hypertension, stroke - more aggressive education should help. There is reason to believe that it has in the case of declining smoking and stabilized obesity rates. Start with the youngest - school children - as the prime target group, but don't neglect adults.

Expanded health insurance for children is a part of President-Elect Barack Obama's prescription for reforming health care.

Accessibility to health care for some populations is another hurdle in the way of improvement.

But what seems most daunting of all is the cost: as the price tag for medical care is soaring, so is the cost of insurance which is a shrinking candy bar. Everything is co-pay this, co-pay that; maybe your provider won't accept your insurance plan at all. And as the number of uninsured rises, the bill is falling on the insured.

Many are hoping for reform. 2009 won't be too soon. And good luck to those who will be honestly working on the problem! To those who aren't - get out of the way.

- Pete Lawson, Editor

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