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Do We Really Need Health Care Reform?

Harold E. Cohen, RPh
Editor-in-Chief



7/18/2012

US Pharm. 2012;37(7):1.

There is probably no issue more divisive in the political arena today than that of health care reform. While just about everyone I talk with from all professional and political spectrums agrees that something needs to be done to make health care in this country more available and affordable for all of its citizens, not many can actually agree 100% to a plan to make that happen. And if early political ads are any indication, health care reform will be right up there with the economy and jobs when the presidential debates heat up later this year.

According to a new report conducted by the Commonwealth Fund—a private foundation that aims to promote better access, improved quality, and greater efficiency of health care—despite the fact that Americans spend more on health care than citizens of 12 other developed nations, they are not necessarily receiving equal or better quality of care. For example, according to the study, health care in the United States costs approximately $8,000 per capita compared to Japan or New Zealand, where health care spending is two-thirds less than in the U.S., or in Norway and Switzerland, where spending is one-third less.

Furthermore, the study uncovered that patients in the U.S. fared worse in terms of asthma fatalities among patients aged 5 to 39 years and ranked poorly in diabetes-related amputations. As for in-hospital heart attack and stroke death rates, the U.S. ranks as just average. And while some may argue that the medical conditions studied were isolated and somewhat arbitrary, the study revealed that despite the U.S. spending on health care, which ranks number one among the 13 countries studied (the others were Sweden, Australia, New Zealand, France, Canada, Germany, Norway, Japan, Switzerland, Denmark, the Netherlands, and the United Kingdom) in health care dollars spent as a proportion of its GDP (17%), Americans are receiving poorer access to physicians, with just 2.4 doctors for every 100,000 citizens; only Japan ranked worse in this category.

Some of the other results from this study may surprise you. Americans also have the second worst rate of physician consultation (behind Sweden), relatively few hospital beds, and fairly short hospital stays in acute-care situations. By the time a patient in the U.S. is discharged from the hospital, it will have cost our health care system an average of $18,000 compared to $13,000 for similar care in Canada. In Sweden, Australia, New Zealand, France, and Germany the costs dip below $10,000. While this is no laughing matter, it does remind me of a joke I heard recently: How many physicians does it take to change a light bulb? The answer: It depends on the kind of insurance the light bulb has.

And the disparities in health care costs are not limited to medical conditions. When comparing the cost of the 30 most commonly prescribed medications, the report found that Americans are paying one-third more than Canadians and Germans, and twice as much as patients in Australia, France, Denmark, the Netherlands, the U.K., and New Zealand.

We clearly need to better control health care costs so that patients in this country get more “bang for their buck.” I think we have the best health care network in the world, but there is tremendous waste in the system. And that includes pharmacists not being utilized to their fullest professional potential in making sure patients remain compliant with their medications. The better a patient’s medication therapy is managed, generally the healthier the patient…and healthier patients save the U.S. health care system millions.

Do we really need health care reform in the U.S.? I’ll let you decide for yourself, but if you were to ask my opinion, the answer would be a resounding yes.

To comment on this article, contact editor@uspharmacist.com.

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