Media Ignores Public’s Concerns About Health Care

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 “the availability and affordability of healthcare.� A total of 68% said they worried about this a “great deal.� Coming in second is the social security system at 51%. Following close behind that were “availability and affordability of energy,� drug use, crime and violence—and only then “the possibility of terrorist attacks in the U.S.� (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 week—from May 21st to 23rd in Rochester, Minnesota—and it reportedly “brought together more than 250 leaders from academia, business, government, health care, media and patient advocacy for a highly interactive exchange of ideas.� Dismayingly, there was virtually no major media coverage of this event. (The media apparently does not share the public’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 America’s ailing and failing health care system:

Editorial: A sobering checkup at the Mayo Clinic

Strolling through the rather imperial campus of the Mayo Clinic—a place revered for quality and efficiency—you would never guess that the U.S. medical system is itself in critical condition. Yet that’s exactly the message Mayo transmitted this week during a three-day symposium that brought some of the nation’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. “After studying health care in America, I feel I should apologize for all the jokes I used to make about Brezhnev,� 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.

That’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 nation’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.

5 thoughts on “Media Ignores Public’s Concerns About Health Care

  1. There is a really interesting (and scary?) article on the cover of the b5/29/06 BusinessWeek. The gist is that a certain MD has gone in for statistical analysis and has concluded that there is often no firm evidence that given–and popular–methods of treatment actually work.

    This MD speculates that things like angioplasty, bypass surgery, spinal fusions and other highly invasive (and expensive) surgeries may not produce better results than exercise, diet, and medication.

    Also, certain treatments tend to cluster geographically, which indicates a certain level of ‘faddishness’ may explain the prevalence of a certain treatment in a given area.

    This really, really helps explain how it is that we can spend way, way more (2.5 times?) on health care than everyone else and yet attain results that aren’t even mediocre. We tend to want the latest & greatest without ever asking if it really works.

    This MD also said that physicians too often have a vested interest in prescribing their special type of medicine. A surgeon, he says, gets paid when he operates, not when he doesn’t.

    However, one aspect of this is that insurance companies may not just be cold and heartless when they decline to pay for the latest technique. This decision may be justified. That aspect didn’t sit well with me, but if that’s the conclusion, then we have to accept. Otherwise, we end up as ideologues who don’t accept facts because they interfere with our world view. Like someone’s president and his gang.

    So those who argue that our health care (non)system is the greatest and would only be ruined by universal health care have just lost a big chunk of their argument.

  2. Health care has been in the hands of those who literally removed the notion of care and replaced it with health “greed” and they have mismanaged for many of us…. Having said that there is encoiuragement in your post to look around us to get back at the helm of our own health…. For instance there are amazing new facts about the human brain that would turn around lives and futures if we familarized ourselves…. I’d like to see much more education brought to people by those who are not benefitting from the greed that invaded the system…. Thanks for the ideas and insights here that may just help us to move in a new way… and take back our own health…

  3. Klaus, you raise a really good point. I don’t doubt that some medical “advancesâ€? are not as effective as touted. But the larger issue is the rate at which we are developing new treatments (with their varying degrees of effectiveness) is outpacing our ability to pay for these treatments. Consequently, at some point we are going to have to have a rational public discourse on that most dreaded of subjects – medical rationing. Of course medical rationing already exists. We just don’t talk about it.

    Taking a larger perspective, and I know this is cliche, but we are the richest country on this planet. Yet when compared to the top 20 wealthiest nations, we consistently rank near the bottom in terms of access to healthcare, quality of public education, family policy and addressing poverty. Some may argue that the economic inequities that underlie these issues are simply the tradeoff for a strong economy. But what exactly is the point of growing your economy if the majority of Americans don’t experience the benefits?

  4. There is one simple answer that would cover eveyone, control costs and medical inflation, reduce errors and equalize pay across the different specialites (especially for family docs)- and would end the criminal greed of the insurance and hospital company profiteers: National Health Insurance.

    Three good books to read on the need for a national, publicly financd health coverage system are:
    1 – Critical condition: How health care became big business and bad medicine, by Bartlett and Steele. A good look at the world of health care financing.
    2 – Health Care Meltdown by Dr. Robert Le Bow, former head of Physicians for a National Health Plan
    3 – The truth about the Drug Companies, self=explanatory title.

    Over the years, bills by Rep. John Conyers, and Rep. David Dingell, among others have been introduced to create a national health insurance plan, but have gone nowhere. I believe there may currently be a bill to amend the constitution to make access to affordable coverage a civil right (sponsored, I think, by Rep. Jesse Jackson Jr.).

    Perhaps we need real campaign finance reform before we get to national health care, since PHARMA and the insurance companies give so much money to politicians.

  5. A single payer national healthcare plan with shared responsibility of our citizens could be created by simply eliminating redundant administration and hyped profits for the pharma and insurance companies.

    Preventative care and the above would be as beneficial to municipal governments as they would be to taxpayers, large and small businesses.

    Seems like the only losers are those who want to keep the big profits and the lobbyists they pay off. Time to take off the gloves and take a lot closer look at the options.

    I’ve read almost 60% of all industry costs come from last few months of medical care to elderly. If so, what options are available?

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