U.S. system for health care is a disaster

The American health care system has become an actual impediment to public health. Americans are seeing that play out in real time as the pandemic progresses.

Despite the heroic efforts of doctors, nurses and health care leaders, the staggering cost of care in this country, along with the number of people without health insurance and the lack of basic health literacy have combined forces to make the coronavirus outbreak worse. Addressing those issues will be key to the nation’s future.

Start with affordability. Americans pay far more for health care than citizens of any other developed country. The U.S. depends on market forces and consumerism to control prices, but that hasn’t worked too well when it comes to keeping the public healthy.

For exampble, not every aspect of Canada’s health system would work here, but looking at the prices Canadians pay for the same services offered on this side of the border helps focus attention on the unique unaffordability of U.S. health care.

In 1970, the United States and Canada both spent about 6% of their gross domestic product on health care. But Canada made reforms that included universal coverage. Today, nearly 20% of America’s gross domestic product goes to health care while Canada spends about 11.6%. Perperson spending in Canada is about 42% of the U.S. total. And Canadian health care spending is among the highest in the developed world outside of the United States.

Here’s another example: Health insurance premiums for companies that buy coverage for their workers increased by an average of 4.4% in 2021, according to a survey by the Kaiser Family Foundation. That increase was more than double the annual rate of inflation. The average employer-supplied family health insurance coverage now costs more than $22,000, an increase of 47% since 2011. That’s not sustainable.

Even with all that spending, 28.9 million Americans were uninsured in 2020. The number of uninsured has been steadily climbing. It now represents about 9% of the overall population. And because of pandemicrelated closings and layoffs, the number could be even higher once 2021 statistics are finalized.

Even people with health insurance can be shut out of care if they don’t receive paid time off. Americans saw this early in the pandemic when many essential workers continued working while they were sick because they couldn’t afford to stay home.

Finally, Americans must reckon with health literacy. Many people fail to get appropriate testing or treatment because they do not understand their doctors’ orders, or because they do not understand why the testing and treatment is important. Great efforts have been put toward improving patient understanding.

But when a global pandemic swept the country and people desperately looked for information to protect themselves and their families, large portions of the public failed to get an accurate message.

A recent survey by the Kaiser Family Foundation found that nearly 8 in 10 Americans have been exposed to false claims about the virus or the vaccine. About 16% of Americans believe at least four of eight vaccine and virus myths examined by the researchers. Millions of Americans believe that the coronavirus is not a deadly disease even though it has killed more than 755,000 Americans. Millions more have failed to protect themselves and their families with a vaccine because of misunderstanding and misinformation.

The American health care system had problems with affordability, access and understanding before the pandemic. The coronavirus provided an eye-opening view of just how costly these failures can be: Hundreds of thousands of deaths could have been prevented. Millions were left unprotected in the face of an unfolding pandemic. Billions of dollars were spent treating a disease that, since last spring, has been largely preventable.

America cannot meet the health care needs of a developed nation without tackling affordability, access and understanding.