As Congress
presses forward
with landmark
legislation to
revamp the
nation's
health-care
system,
lawmakers are
grappling with a
troubling
question:
Are Americans
dying too soon?
The answer is
yes. When it
comes to
"preventable
deaths" -- an
array of
illnesses and
injuries that
should not kill
at an early age
-- the United
States trails
other
industrialized
nations and has
been falling
further behind
over the past
decade.
Although the
United States
now spends $2.4
trillion a year
on medical care
-- vastly more
per capita than
comparable
countries -- the
nation ranks
near the bottom
on premature
deaths caused by
illnesses such
as diabetes,
epilepsy,
stroke,
influenza,
ulcers and
pneumonia,
according to
research by the
nonpartisan
Commonwealth
Fund published
in the journal
Health Affairs.
During last
week's marathon
health-care
debate in the
Senate Finance
Committee,
Sen.
Kent Conrad
(D-N.D.)
bemoaned the
findings.
"All of these
countries have
much lower costs
than we do," he
said, pointing
to a giant blue
chart showing
the United
States in last
place. "And they
have higher
quality outcomes
than ours."
Some
lawmakers
theorized that
the rate could
be related to
trauma from guns
and automobiles.
Although gun
and auto
fatality rates
are higher here
than they are in
most wealthy
nations, the
statistics
underscore more
complex,
fundamental
challenges, say
physicians,
economists and
other experts
who track
health-care
systems across
the world.
"Chronic
illnesses are a
much bigger
driver of
health-care
costs" than
trauma cases
such as vehicle
crashes and
gunshots, said
Robert Shesser,
head of
emergency
medicine at
George
Washington
University.
"Because of our
wacky system,
some people are
bankrupted or
avoiding care
and some are
getting too much
care -- they're
hogging care."
The
performance of
the U.S. system
is a mix, at
best, said Mark
Pearson, head of
the health
division at the
Organization for
Economic
Cooperation and
Development,
which analyzes
data from dozens
of countries.
"Where it's
good, it's very,
very good, and
where it's bad,
it's horrid," he
said. The United
States, for
example, is the
international
leader in the
detection and
treatment of
most cancers, he
said. Americans
have earlier
access to new
medicine and
technology,
sometimes while
the clinical
trial is still
under way.
Europe, by
waiting, often
has more
information on
new products.
For people
with insurance,
"America
delivers care in
a timely
manner," Pearson
noted. That
stands in
contrast to the
situation his
own family faces
in England,
where relatives
have waited
weeks for tests
or elective
procedures.
But as many
as 80 million
Americans are
uninsured or
underinsured,
which means they
have little
access to a
regular
physician,
checkups,
preventive
services,
affordable
prescription
drugs, dental
care or
screening tests.
