EDITORIAL:

Eco­nomic down­turn im­per­ils the most vul­ner­a­ble cit­i­zens in the U.S.

Modern Healthcare - - NEWS -

Hard eco­nomic times put the most vul­ner­a­ble at risk

Notes on the news: A few ob­ser­va­tions about the lat­est CMS re­port on U.S. health­care spend­ing are in or­der. While the rate of growth re­mained low at 3.9% in 2010, that in­crease was still more than twice the gen­eral in­fla­tion rate, and to­tal spend­ing climbed to $2.6 tril­lion.

The re­port, pub­lished in the Jan­uary is­sue of Health Af­fairs, casts doubt on the cur­rent cost-re­strain­ing abil­ity of the na­tion. Just days be­fore the CMS is­sued its fig­ures, Amer­i­can Hos­pi­tal As­so­ci­a­tion sta­tis­tics showed com­mu­nity hos­pi­tals posted a record-break­ing mar­gin of 7.2% in 2010 with more than $52.9 bil­lion in to­tal prof­its (Jan. 9, p, 12). Those re­sults re­flect, at least in part, the prices charged by U.S. providers, which are the high­est in the world. For more on that, con­sult the com­par­a­tive price re­ports of the In­ter­na­tional Fed­er­a­tion of Health Plans. Here’s a link: bit.ly/ghnnke.

The most trou­bling as­pect of the lat­est news is that the CMS an­a­lysts at­trib­uted the slow­down to the ail­ing Amer­i­can econ­omy. They said con­sumers con­tin­ued to post­pone med­i­cal care. De­clin­ing pri­vate health in­sur­ance cov­er­age— some be­cause peo­ple have lost their jobs—and in­creased cost-shar­ing among em­ployer-based plans squeezed con­sumers suf­fer­ing from the ef­fects of the Great Re­ces­sion (or Lesser De­pres­sion). The prob­lem is that this hurts poor and mid­dle-in­come Amer­i­cans. The less-for­tu­nate may take a pass on needed treat­ment. They will even­tu­ally turn up in the hos­pi­tal or doc­tor’s of­fice acutely sick and as un­com­pen­sated-care or Med­i­caid cases.

And be­lated birth­day greet­ings to world-fa­mous the­o­ret­i­cal physi­cist Stephen Hawk­ing, who turned 70 about a week ago. Many peo­ple know him for his best-sell­ing book A Brief His­tory of Time.

Hawk­ing takes more than a the­o­ret­i­cal in­ter­est in time. He is one of the world’s most high-pro­file suf­fer­ers of amy­otrophic lat­eral scle­ro­sis, com­monly known as Lou Gehrig’s dis­ease, and is con­fined to a wheel­chair, al­most com­pletely par­a­lyzed and un­able to speak with­out the aid of a voice syn­the­sizer. His longevity de­spite more than 40 years of af­flic­tion with ALS is ex­tra­or­di­nary.

We men­tion this be­cause in the mid-2009 health­care de­bate an In­vestor’s Busi­ness Daily editorial opined that a per­son as dis­abled as Hawk­ing “wouldn’t have a chance” as a pa­tient in Bri­tain’s National Health Ser­vice be­cause it would re­gard his life as “es­sen­tially worth­less.”

More than a few peo­ple noted that Hawk­ing is as Bri­tish as West­min­ster Abbey. He was born in the U.K., lives there, grad­u­ated from the Univer­sity of Ox­ford and taught at the Univer­sity of Cam­bridge, where he was named to a pro­fes­sor­ship once held by Isaac Newton. Af­ter the editorial was pub­lished, Hawk­ing told the U.K. news­pa­per the Guardian, “I wouldn’t be here to­day if it were not for the NHS. I have re­ceived a large amount of high-qual­ity treat­ment with­out which I would not have sur­vived.”

Amer­i­cans in this elec­tion year will again be bom­barded with as­ser­tions that health­care is wretched ev­ery­where else and that the U.S. is the best of all pos­si­ble med­i­cal worlds. The mis­in­for­ma­tion will be dis­sem­i­nated by peo­ple who will try to blot out the truth that the cit­i­zens of most other ad­vanced na­tions are guar­an­teed ac­cess to high-qual­ity care at far lower prices (see above) and do not go bank­rupt if they get sick. No coun­try’s sys­tem is per­fect, but many for­eign cit­i­zens en­joy out­comes and life spans ex­ceed­ing ours.

What do you think? Write us with your com­ments. Via e-mail, it’s mh­let­ters@modern­health­care; by fax, dial 312-280-3183.

NEIL MCLAUGH­LIN

Man­ag­ing Editor

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