A couple of months back, the Gallup Organization conducted a poll to determine the top issues and concerns of Americans. As subsequently reported by Editor & Publisher and other media outlets, health care topped the list:
A new Gallup Poll released Tuesday reveals that the issue cited by most Americans as the one they worry about the most is â€œthe availability and affordability of healthcare.â€? A total of 68% said they worried about this a â€œgreat deal.â€? Coming in second is the social security system at 51%. Following close behind that were â€œavailability and affordability of energy,â€? drug use, crime and violenceâ€”and only then â€œthe possibility of terrorist attacks in the U.S.â€? (at 45%). In a sign of the times, Americans grew more worried in the past year, Gallup said, in 11 of the 12 top issues. Health care, energy and immigration had grown the most in concern since 2005. [full text]
Given the growing concerns about health care, one might expect that a National Symposium on Health Care Reform sponsored by the world-renowned Mayo Clinic might attract some attention in the press. Such a symposium was held earlier this weekâ€”from May 21st to 23rd in Rochester, Minnesotaâ€”and it reportedly â€œbrought together more than 250 leaders from academia, business, government, health care, media and patient advocacy for a highly interactive exchange of ideas.â€? Dismayingly, there was virtually no major media coverage of this event. (The media apparently does not share the publicâ€™s concerns or is pathetically out of touch with such.) I would not have known about it myself had not my colleague, Nancy Arons, a talented clinician who hails from Minnesota, pointed it out to me. She had read an editorial in the Minneapolis Star-Tribune (offered in full below), which did manage to offer some commentary and perspective on the topic of Americaâ€™s ailing and failing health care system:
Strolling through the rather imperial campus of the Mayo Clinicâ€”a place revered for quality and efficiencyâ€”you would never guess that the U.S. medical system is itself in critical condition. Yet thatâ€™s exactly the message Mayo transmitted this week during a three-day symposium that brought some of the nationâ€™s most eminent experts to Rochester and delivered one indictment after another of American health care.
Consider: Americans spend 50 percent more on medical care than their counterparts in nations such as Germany and Japan, yet a recent RAND Corporation study found they receive appropriate care only about 55 percent of the time. Meanwhile, the cost of health insurance doubles every eight to nine years, crushing major corporations such as Ford and General Motors and pushing the ranks of the uninsured ever higher. â€œAfter studying health care in America, I feel I should apologize for all the jokes I used to make about Brezhnev,â€? said Eugene Litvak of Boston University, who came to the United States in 1988 from the notoriously inefficient Soviet Union.
Mayo, which has traditionally shunned the spotlight on policy and politics, organized the forum out of frustration that no one in Washington has taken the issue seriously for a decade, and out of hope that the general public, confronted with the facts, might start demanding leadership.
Thatâ€™s good. This conversation needs to move outside the walls of clinics and universities into public discourse and onto the campaign trail.
If the symposium highlighted problems, however, it also offered intriguing solutions. Dr. John Wennberg of Dartmouth University said that Medicare, which pays about one-fifth of the nationâ€™s medical bills, could cut its outlays by some 30 percent if it required all hospitals to be as efficient as those in Salt Lake City (or some in Minnesota, for that matter). Roger Feldman of the University of Minnesota said hospitals would cut the number of medical errors sharply if insurance companies rewarded them for adopting well-known, simple safety protocols. Dr. Ezekiel Emanuel from the National Institutes of Health said the United States, using vouchers for every citizen, could provide universal health insurance without spending much more money than it spends today because it already treats the uninsured in such costly, inefficient settings.
Since the debacle known as Hillary-care in 1993, Washington has mostly shied away from fundamental reform. Congress did create the new Part D drug benefit for Medicare, which is a great subsidy for the elderly but hardly a model of efficiency; it also created Health Savings Accounts, a form of tax shelter which was generally panned by the experts in Rochester. Perhaps, like the guy who quits smoking only when the doctor insists, Washington will listen up now that Mayo has entered the consulting room. Voters should expect no less.