America spends $30 billion a year fixing medical errors – the worst rate among advanced countries. Why? Among other reasons because we keep patient records on computers that can’t share the data. Patient records are continuously re-written on pieces of paper, and then re-entered into different computers. That spells error.
Meanwhile, administrative costs eat up 15 to 30 percent of all healthcare spending in the United States. That’s twice the rate of most other advanced nations. Where does this money go? Mainly into collecting money: Doctors collect from hospitals and insurers, hospitals collect from insurers, insurers collect from companies or from policy holders.
This rings so true to me. I saw a patient today and spent 3/4 of my time in such tasks as re-writing med lists with my quill and ink well and trying, through scrawled notes and talking to the patient, to figure out what he needed for home care. Next I get to call his insurance and wait on hold. I love being a nurse, I just wish I had gone to secretarial school first.
That’s part of the problem. Part of the solution is to open Medicare to all, enlarge the risk pool, cut administrative costs and also save lives and money by ensuring that a patient’s records are available to their doctors.
Reich mentions that home nursing helps prevent costly re-hospitalization, and that is my job. I spend more of my time filling out paperwork than I think is necessary for patient care, so I see some of the frustrating waste and inefficiency firsthand.
Another side of this that is not much mentioned is the terrible drain on our society by letting people get sick enough to go to the emergency room instead of helping them keep well with primary care. Well people who work and pay taxes are good, but if you talk about investing in health care it’s seen as charity for the unworthy and mindless sentimentality. Well, I’ve got news– there’s nothing pragmatic about letting people suffer– we pay more later.
This is from a recent research article from Open Medicine...
Canadian health care has many well-publicized limitations. Nevertheless, it produces health benefits similar, or perhaps superior, to those of the US health system, but at a much lower cost. Canada’s single-payer system for physician and hospital care yields large administrative efficiencies in comparison with the American multi-payer model.60 Not-for-profit hospital funding results in appreciably lower payments to third-party payers in comparison to for-profit hospitals61 while achieving lower mortality rates.62 Policy debates and decisions regarding the direction of health care in both Canada and the United States should consider the results of our systematic review: Canada’s single-payer system, which relies on not-for-profit delivery, achieves health outcomes that are at least equal to those in the United States at two-thirds the cost.
But let’s get down to the important issues. Americans are 10% more overweight than Canadians. This number takes into account the different ethnic makeup of the populations– with all the adjustments, Canadians can still fit into our old jeans.
Canada is a country where people consider a plate of french-fries sprinkled with cheese and smothered with gravy a light appetizer. Their main export is donuts. It’s freezing up there, and dark eight months of the year, so Canadians have no reason to go outside. Snow shoveling may burn some calories, but Canada is full of old people because their elderly just keep living and living. They just attach a snowblower to their scooter and ride to the Tim Hortons.
After careful analysis, I have to rule out diet and lifestyle
The only possible explanation is that a single payer health care system keeps people slim.
I’m getting some lunch at Panera Bread, bless their corporate heart– they’re here, they take my card and they have Wi-Fi. I’m a little sorry that a nice pizza place I was going to stop at has closed their doors– tough for small businesses.
Not to eat their bread and dis them– it’s nothing against Panera, but big chains don’t trickle customers down onto Mom and Pop’s Pizza. They take the customers. That’s what they’re supposed to do.
I’m listening to WRNI news that the Republicans will almost certainly succeed in extending tax cuts for the richest, as a condition of tax relief for the middle class. In their faith-based enthusiasm they assure us that the rich will trickle on us and bless us with golden showers of prosperity.
Robert Reich on Common Dreams gives us the two competing narratives on economic reform. I’m going back to work, so I’m going to just lift a lot of what he wrote, but follow the link for the whole post, it’s really good…
Quiz: What’s responsible for the lousy economy most Americans continue to wallow in?
A. Big government, bureaucrats, and the cultural and intellectual elites who back them.
B. Big business, Wall Street, and the powerful and privileged who represent them.
These are the two competing stories Americans are telling one another.
Yes, I know: It’s more complicated than this. In reality, the lousy economy is due to insufficient demand – the result of the nation’s almost unprecedented concentration of income at the top. The very rich don’t spend as much of their income as the middle. And since the housing bubble burst, the middle class hasn’t had the buying power to keep the economy going. That concentration of income, in turn, is due to globalization and technological change – along with unprecedented campaign contributions and lobbying designed to make the rich even richer and do nothing to help average Americans, insider trading, and political bribery.
So B is closer to the truth.
But A is the story Republicans and right-wingers tell. It’s a dangerous story because it deflects attention from the real problem and makes it harder for America to focus on the real solution – which is more widely shared prosperity.
Reich calls for a new WPA. That’s what the ‘stimulus’ should have been called, because it’s what people want. We want to work, we want to see everyone give their fair share. Someone has to find the words and get heard.