The above graph is from a recent publication of the Institute of Medicine entitled “U.S. Health in International Perspective: Shorter Lives, Poorer Health (2013)”. The graph depicts the causes of death for males less than 50 years old. Compared to other wealthy countries the U.S. life-expectancy ranks 17th for men and 16th for women According to the report “The tragedy is not that the U.S. is losing a contest with other countries, but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary.” Several causes were cited including lack of insurance, lack of access to primary care, high poverty rate, poor diet, lack of exercise and use of firearms in acts of violence.
Although the report is blunt enough the bottom line is we have good doctors, good nurses, good medications, good equipment, good hospitals, and good clinics but we have poor management of our health care system. The equation is:
Good Providers + Bad Management = Bad Health Care
You may ask: what is health care management? In a word a “PLAN” or simply coordination of action — we truly do not have a health care system. We have a variety of types of insurance, government programs and fee for service (i.e. no money no service). Even the very wealthy get poor health care because of a lack of quality management. Some States do much better than others. If Minnesota was a country it would rank near the top. If Louisiana was a country it would be a third world country ranked near the bottom.
One of the big political concerns is cost. We pay more for health care than any other country. One third of our cost is attributed to waste (i.e. paperwork). When a system is poorly coordinated the cost is high. So, why would any country spend more money on such a system?
The above report is just another in a long series of bad reports on U.S. health care. Although the Affordable Care Act (Obama Care) is helpful it will never move life expectancy to the top of the list.
There are lots of solutions. But, they all require planning and system thinking. Trying to solve one problem at a time to evolve a better system will take about as long as human evolution. Perhaps in a million years we will have evolved beyond illness — yes, that’s the plan.