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Healthcare: Why is American healthcare so expensive?
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Dr. Arthur Garson, Jr, former Bush White House
Health Policy Advisor and former Dean of the
UVA Medical School talks about health care costs
and the prospects for reform this year.
American healthcare costs twice as much as in other rich, developed countries. Solutions to our collective medical dilemma are circling both the halls of Congress and the slightly wider orbits of former members of Congress now offering proposals from think tanks a mile or two down K St. from Capitol Hill.
As previously pointed out, the Congressional Budget Office (CBO) scoring of the various proposals does not address the overall cost of healthcare. Only costs and savings that directly affect the federal deficit are counted. Bringing down the overall cost of healthcare is not addressed.
One of the most convincing explanations of our cost overruns comes from Dr. Arthur Grayson, Jr. Dr. Grayson has just been promoted to Executive Vice President and Provost of the University of Virginia. Previously, he was Dean of the UVA Medical School, a member of President Bush’s Health Policy Council, and President of the American College of Cardiology.
Dr. Garson’s 2007 book “Health Care Half Truths” provides useful insights from just before the present health debate took off. He points out that health care and medical care is easily confused. A number of the frequently cited international metrics reflecting poorly on American Medicine have their basis in socio-economic status rather than medical capability.
According to Dr. Garson, a primary determiner is simply the existence of health insurance for everyone. Patients with no insurance tend to seek care at hospital emergency departments when their condition is at an advanced stage. The existence of Health Insurance for these patients would decrease their morbidity by 10 to 15 percent.
Dr. Garson states that physicians and hospitals in America are compensated at a rate three times higher than their colleagues in other developed countries and that pharmaceuticals sold in the U.S. are priced double because American prices are just plain higher. U.S. insurance companies are run as for profit businesses while their cousins in other countries are mostly not for profit. The labyrinth of administrative overhead today unnecessarily consumes one out of every four health care dollars.
Finally, Dr. Garson points to the frequently cited problem of malpractice lawsuits. Although litigation itself consumes only about one percent of health care costs, the fear of being sued encourages defensive medicine. Extra unneeded tests and procedures nationally are responsible for up to nine percent of the total national medical bill.
While his book was in composition, Dr. Garson thought reform was likely to be incremental over time, but in a Wednesday interview with Examiner.com, he said he has hopes that the Obama administration has avoided some of the strategic mistakes made by President Clinton's abortive effort to reform healthcare in 1994.
Garson credits “tremendous leadership by President Obama” in setting goals, but letting Congress work out the details of a final plan. “Any plan," he said, should have “four major components parts: access, quality, coverage, and cost control.” Although he opposes a “public option,” as such Garson quoted himself in a recent Congressional Quarterly panel discussion as “favoring anything that leads to a “pathway for covering the uninsured.” Garson thinks the Democratic plan is a good starting point subject to negotiation in the legislative process.
Garson does "get the feeling" that the same industry interests and forces that used fear to defeat the Clinton Plan may be "rearing their heads" again. Whether or not reform becomes a reality this time around will have to await a final vote in the Congress.
Dr. Garson speaks only for himself rather than as a representative of UVA, but has been intimately involved with healthcare reform efforts since before 2000. For further information on his positions, click on two articles by or about him listed below. His 2007 book “Health Care Half Truths” is available through the National Book Network.
Al Portner is a former daily newspaper editor and publisher in seven states and author of the forthcoming “Mark Twain and the Tale of Grant’s Memoir.” He can be reached at alanportner@gmail.com.
For more info:
Dr. Garson points out $700 Billion in savings to be had.
Dr. Garson on healthcare reform from "Circulation" in 2000
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