Aug 13, 2008
The Commonwealth Fund, “a private foundation that aims to promote a high performing health care system,” supports independent research on health care issues. They produce a biannual National Scorecard on U.S. health care, scoring our system on 37 indicators of performance that are summarized within six criteria: Healthy Lives, Quality, Access, Efficiency, Equity, and Overall Score. In 2006, our health care system scored a dismal Overall Score of 67 out of a possible 100 “when comparing national averages with benchmarks of best performance achieved internationally and within the United States.”

In 2008, we dropped two points.

Most worrisome was the nine-point drop (from 67 to 58) for access to health care, as 35 percent of adults aged 19 to 64 who were un- or underinsured in 2006 grew to 42 percent in 2008. At that rate, half our population, which pays twice what the rest of the industrialized world pays for demonstrably inferior medical care, will be without adequate access to inadequate care by the end of the decade.

“Why Not the Best?: Results from the National Scorecard on U.S. Health System Performance, 2008” asks a very good question. The answer is a simple one known to us all. We don’t have the best—or anything like the best— because in America health care is a business, and that means it is profit based, and that means it must be provided at the lowest possible expense and at the highest price it can command. And thus we get a meager product at a premium price. And until we take it out of the realm of business, it will continue to deliver less and less for more and more.

Some staggering numbers from the National Coalition of Health Care.¹

• We spend on health care 4.3 times what we spend on national defense (and we spend almost as much on national defense as all other countries of the world combined²).
• In 2005, we spent 16 percent of our gross domestic product on health care, a number expected to go up to 20 percent by 2016. That’s one dollar out of every five, with, today, 47 million people uninsured. Meanwhile, Canada spent 9.7 percent of its GDP on health care, and insured every man, woman, and child in the country.
• Since 2000, employment-based health insurance premiums have increased 100 percent, compared to cumulative inflation of 24 percent and cumulative wage growth of 21 percent. Notice we’ve lost three percent of our wages to inflation and a large chunk to skyrocketing co-pays and deductibles.
• Every 30 seconds in the U.S., someone files for bankruptcy in the aftermath of a serious medical problem.

It’s not healthy. And it can’t go on like this.
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¹See the NCHC site for sources. (Accessed August 4, 2008)
²Global Issues (Accessed August 4, 2008)
tags: Health

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