Could You Possibly Invent A More Expensive, Less Effective Healthcare System Than What We Have In The US?

No. Which is what Robert Reich is telling Congress today.

By Robert Reich, Substack

For many years, my right ankle has been losing cartilage that keeps my ankle bones from scraping up against each other. The result: increasing inflammation and pain. An orthopedic surgeon suggested replacing the ankle with an artificial one, but the procedure is costly, takes months to heal, and requires lots of physical therapy. So I’ve taken a different route. I cut way back on sugar, began an exercise program aimed at strengthening the muscles around my ankle, and lost twenty pounds. Now, six months later, the ankle pain is almost gone.

I share this with you because I’m testifying today before a House committee that’s considering the future of healthcare in America.

The fact is, we have too many high-priced specialists who know how to do a few complicated and costly things such as replacing a bum ankle, and too few generalists who know enough about the whole body that they’re able to avoid the complicated and costly things. The big money is in the complicated things, so that’s where the talent goes and what hospitals aim for. And if you can pay for it, great. The complicated stuff is what America excels at.

But we’re terrible at the uncomplicated things — not just my cutting back on sugar, exercising, and keeping the weight down, but making sure everyone gets regular checkups from general practitioners who are trained to prevent serious illnesses. The terrible tolls of diabetes, heart disease, and some cancers, for example, are preventable if caught in time.

Even before the pandemic, the typical American family was spending more than $6,000 a year on health insurance premiums. Add in copayments and deductibles that doctors, hospitals, and drug companies also charge, and that sum rises to $6,400. Add in typical out-of-pocket expenses for pharmaceuticals, and it’s at least $6,800. That’s not all, because some of the taxes the typical family pays are for health insurance, too — for Medicare and Medicaid and the Affordable Care Act. Add them in, and the typical household pays $8,975 a year for health insurance. This number doesn’t include what typical workers’ employers spend on their health insurance – which might otherwise go to their wages.