Readers of the New York Times were recently treated to Ezekiel Emanuel’s four-part series on how to rein in the cost of health care. I’m not an expert on health care; this post is not about his proposals. That said, the coming paragraphs are a crash course in Ezekielcare. If you read the series, feel free to skip ahead to the jump, or consider this a refresher.
In the first of four parts, Emanuel lays out the problem:
In 2010, the United States spent $2.6 trillion on health care, over $8,000 per American… our health care spending is the fifth largest economy in the world.
But he also recognizes that the issue is not the absolute dollar value spent on health care – it is the results those dollars buy. If we chose to spend exorbitant sums on health care, life expectancy skyrocketed, and disease disappeared, that cost would reflect a funding priority, a policy or market decision to exchange resources for a specific form of quality of life.
Instead, there is almost no correlation between the amount spent and health outcomes, relative to other developed countries. Simply put, Americans waste a lot of money at a time when they don’t have much to waste:
Almost no matter how we measure it — whether by life expectancy or by survival for specific diseases like asthma, heart disease or some cancers; by the rate of medical errors; or simply by satisfaction with health services — the United States is actually doing worse than a number of countries, like France and Germany, that spend considerably less.
In Part 2 of his series, Emanuel describes certain solutions – from tort reform to transforming health insurance companies into nonprofits – he says would do too little to solve the problem. Part 3 describes how 21st-century information systems could lower health care costs by $32 billion a year – a conservative estimate ‘just’ over the $26 billion threshold Emanuel believes useful solutions must cross. But most importantly, he closes his third installment with a promise:
Next week, I’ll write about broader, more systemic and bigger ways to save
For about one moment, I thought the author might deliver on his promise.
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