The State of US Healthcare

Healthcare is in a hole.

Just a simple google search of “US healthcare” turns up numerous articles, with titles like “US Healthcare: Most Expensive and Worst Performing” and “The Pathetic State of US Healthcare.

That’s a bit concerning.

The Commonwealth Fund released a report comparing the performance of the US healthcare system to 11 other countries, including Australia, Canada, and the United Kingdom.

The study, which was released in 2014 (disclaimer: this is all before the ACA was implemented, but I think the overall outcomes remain relatively the same), ranks the USA as last in the 3 categories of efficiency, equity, and outcomes, 5th in quality care (divided into the categories of effective, safe, coordinated, and patient-centered), and 9th in care access (timeliness and cost-related access problems; the latter of which we ranked last in).

Efficiency is measured by an interesting set of criteria, ranging from “patient spent a lot of time on paperwork or disputes related to medical bills” and “doctors report time spent getting patients medication and care because of coverage restrictions is a big problem.”

The basic problem? We spend too much time on administrative issues, and not enough time on proper patient care. There are too many issues getting timely access to records, which leads to duplicate tests and re-hospitalization, all which increase cost (and reduce care quality) for the patient.

However, some people can’t even get access to care, however inefficient it might be. The US ranks last on access to care, especially among low-income adults. 1/3 of these adults said that in the past year, they had a medical problem, but went without care. So, unfortunately, not only is the system inefficient, but it is inequitable as well.

Finally, if patients are able to get access to care and get past the administrative red tape, their life, on the aggregate, is not much better off. The US ranks last on overall outcomes for its patients. We have the second lowest healthy life expectancy (living to 60 without a lot of health problems), the highest infant mortality rate, and the highest rate of mortality amenable to healthcare.

The solution to any problem that we face has always been to spend more money. Money fixes all, right? Not so true. The US spends 17.7% of GDP on healthcare, as shown by the graph below, far more than Australia’s 8.9%.

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Despite all that spending, 37% of patients say that they didn’t get recommended care, prescriptions, or visit a doctor due to the cost of healthcare. Despite that we spend more money than any developed country, the Commonwealth Fund reports “survey findings indicate that from the patient’s perspective, and based on outcome indicators, the performance of American health care is severely lacking.”

Despite the ACA’s best intentions, problems with cost and quality of healthcare still persist. The world of healthcare seems to be a place where the rules of the market don’t apply in prices are kept artificially high, despite the entrance of competitors and consumer complaints. No other industry can quite get away with under-serving the public at such a high cost.

Something must be done to remedy the system, or else America will go bankrupt. Faith will be lost in the basic idea of doctor + medicine = health. Beyond that, our citizens will get sicker and sicker. We have to have a proactive system, rather than reactive.We need to act immediately, push pass the bureaucratic walls and insurance providers, eradicate the ridiculous monopoly drug providers have, to provide quality and equal care to patients.

Disclaimer: These views are not investment advice, and should not be interpreted as such. These views are my own, and do not represent my employer. Trading has risk. Big risk. Make sure that you can balance your risk/reward, and trade small, and trade often.

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