There is no shortage of proposals for health insurance reform, and they all miss the point. They invariably focus on the nearly 30 million Americans who lack insurance at any given time. But the coverage for the many more Americans who are fortunate enough to have insurance is deeply flawed.
Health insurance is supposed to provide financial protection against the medical costs of poor health. Yet many insured people still face the risk of enormous medical bills for their “covered” care. A team of researchers estimated that as of mid-2020, collections agencies held $140 billion in unpaid medical bills, reflecting care delivered before the Covid-19 pandemic. To put that number in perspective,…
Hmm, that headline doesn’t seem right, does it? I mean, shouldn’t the business of healthcare be, well, health? Or, at least, caring? Actually, shouldn’t the business of healthcare be patients? After all, everyone in healthcare says it’s all about patients. Everyone says they’re patient-centered, whatever that means.
Our health care system hasn’t caught up with the evolving face of disease in America. It is still mostly a workforce of doctors and nurses who dutifully treat patients in hospitals with expensive drugs and high-tech medical devices. If we could reconfigure health care to detect and address the root causes of costly illness, health reform would be a true success.
The question often arises, "What is heath care reform and why do we need it?" The answer is almost always something like: The U.S. spends more than any other industrialized country on health care, but gets worse-quality health care. And, the U.S. is the only country that doesn't provide universal coverage to all of its citizens. Each of these claims is technically true, but also very misleading. When you look at the data, the picture gets far more nuanced. And the alleged advantages foreign countries have over the U.S. start to dissipate.
The quality of your coverage increasing depends on whether you live in a red or blue state.
Gawande, who has been writing and speaking on the problems of the US healthcare system for most of his adult life, has long bemoaned the field’s resistance to innovation. As an influential book author, New Yorker contributor, and public speaker, Gawande has become one of the foremost champions of change in healthcare delivery and policy. His ideas are about to be put to their biggest test yet.
Forget the Affordable Care Act: The future of our health care system will be shaped by a much bigger and broader fight — one that will likely culminate with a 2020 choice between private markets and an authentic government-run program in the form of a Bernie Sanders-style Medicare for All.
Americans are hypochondriacs, yet we skip our checkups. We demand drugs we don’t need, and fail to take the ones we do. No wonder the U.S. leads the world in health spending.
Don’t look to Canada, France, or Singapore for a world-class health care system. You can get the best health care in the world right here in the United States, for free. But there’s a catch: You have to be HIV-positive. Through a combination of federal and state funding, plus some very clever implementation strategies, Americans infected with HIV are eligible for incredibly comprehensive care, even if they are uninsured or underinsured. It’s amazing the program doesn’t get the attention it deserves. In fact, it should be a model for how we treat all patients.
At first glance, the struggles of NHS England appear to embody conservative arguments against the kind of single-payer health care system that many progressives in the U.S. have rallied behind as a way to expand health insurance to all Americans. In this view, the troubles of NHS England clinch the case that universal health insurance is a fool’s errand. Not so fast.
The campaign for some form of universal government-funded health care has stretched for nearly a century in the US On several occasions, advocates believed they were on the verge of success; yet each time they faced defeat. The evolution of these efforts and the reasons for their failure make for an intriguing lesson in American history, ideology, and character. Other developed countries have had some form of social insurance (that later evolved into national insurance) for nearly as long as the US has been trying to get it.
When did the country diverge from other industrialized nations and, rather than offering universal health coverage, built up a system that relied on private insurance?
Most importantly, Mr. Kimmel put a face on the importance of health insurance and the inhumanity of not providing it to those who need it most: those with pre-existing conditions. He suggested that without good insurance, Billy would have been abandoned by the health care system.
In Australia, vital services like cancer treatments are free; in the US, countless people struggle to even get screened. We spoke to cancer patients in both countries about the drastic difference single-payer health insurance can make.
Former adversaries are banding together, girding against upheaval in a rapidly changing health care environment. They are also bracing for the threats posed by interlopers like Amazon eyeing a foray into the pharmacy business or tech companies offering virtual medical care via a computer or cellphone.
The CDC blamed the increase in drug overdose deaths, as well as a continuing increase in suicides, for a drop in life expectancy in 2017, making that year the third in a row in which life expectancy fell or remained flat.
Over the next five weeks in the ICU, a wave of secondary infections, also acquired in the hospital, overwhelmed his defenses. My dad became a statistic—merely one of the roughly 100,000 Americans whose deaths are caused or influenced by infections picked up in hospitals.
The future of health-care cost-cutting in America is top-down cost-cutting, not bottom-up. It’s the providers who will have to be squeezed, not the consumers.
For many critics of U.S. health care, the Canadian system of universal health care has long been viewed as an alternative, superior model for the U.S. to follow. Canada’s single-payer system is mostly publicly funded, while the U.S. has a multi-payer, heavily private system. While dissatisfaction with the U.S. health care system is widespread among Americans, Canada’s health care system enjoys high levels of satisfaction among its own population. Much of the appeal of the Canadian system comes from the fact that it seems to do more for less.
The Singapore model shows how liberal and conservative ideas can fuse.
The United States health care system is the most expensive in the world, but this report and prior editions consistently show the U.S. underperforms relative to other countries on most dimensions of performance.
In her series on the costs of health care, Elisabeth Rosenthal of The New York Times examines the price of medical care in the United States, interviewing patients, physicians, economists, and hospital and industry officials. In each installment, readers were invited to share their perspectives on managing costs and treatment.
What passes for an American health care system today certainly has not made me feel freer. Having to arrange so many aspects of care myself, while also having to navigate the ever-changing maze of plans, prices and the scarcity of appointments available with good doctors in my network, has thrown me, along with huge numbers of Americans, into a state of constant stress. And I haven’t even been seriously sick or injured yet.
What we don’t talk about as much is why. Americans don’t consume more health care than the Germans or the Japanese. We actually go to the doctor less often. The real reason American health care is so expensive compared to other countries is that the prices are higher. We pay more for everything from angioplasties to C-sections, from hip replacements to opioids.
If you've been following Vox at all, you know we love charts. So here are five to help you make sense of where US health care stood in 2016, before the Trump administration and these new health pursuits got underway.
Thanks to decades of lobbying by the US health industry, Americans pity Britain for our ailing hospitals and overworked doctors. But it’s the astronomic cost of US treatment that is truly sick.
Patients are starting to fight back. Morton is part of a class-action lawsuit that argues these insurers must make good on their contractual promise to pay for "medically necessary" services. The complaint is unique — and the eventual ruling could have national consequences as more expensive new drugs come onto the market.
A new Commonwealth Fund report is the latest to indict U.S. health care. It pegs the American system dead last in a survey of 11 developed countries. But like virtually every other study that trashes the U.S. healthcare system, Commonwealth's rankings rely on questionable assumptions, like giving weight to those systems that treat people equally rather than well. At the same time, Commonwealth ignores the problems that countries with socialized healthcare systems have actually treating people once they're sick.
Despite spending more on health care, Americans had poor health outcomes, including shorter life expectancy and greater prevalence of chronic conditions.
t’s fairly well accepted that the U.S. is the most expensive healthcare system in the world, but many continue to falsely assume that we pay more for healthcare because we get better health (or better health outcomes). The evidence, however, clearly doesn’t support that view.
In a new international ranking, the United Kingdom ranks first, while the U.S. performs poorly across almost all health metrics.
Americans with good jobs live in a socialist welfare state more generous, cushioned and expensive to the public than any in Europe. Like a European system, we pool our resources to share the burden of catastrophic expenses, but unlike European models, our approach doesn’t cover everyone.
Almost all parties agree that the health care system in the U.S., which is responsible for about 17 percent of our GDP, is badly broken. Soaring costs, low quality, insurance reimbursements and co-payments confusing even to experts, and an ever-growing gap between rich and poor are just some of the problems.
A new report shows why American health care performs so poorly compared to its rivals—and suggests the Obamacare replacement proposals aren’t the way to fix it.
Health is more about what happens outside the clinic. So why aren’t our high-tech health care systems better at addressing it?
We need such a conversation — not just about how the market fails, but about how we can change the political realities that stand in the way of fixing it.
The 2017 America’s Health Rankings® Senior Report provides a comprehensive analysis of senior population health on a national and state-by-state basis across 34 measures of senior health.
A lingering hockey injury forces a science writer to reconsider his criticism of American medicine
Health care is in the midst of a seismic shift, from a model that rewarded providers for the volume of care to one focused on the value patients receive from that care. This is in response not only to rising costs but to legislative mandates from the Affordable Care Act and Medicare. Providing patients with quality care at lower costs so they can lead healthier lives is a trend that’s accelerating for a reason: because it works.
New delivery systems are rapidly changing the face of healthcare, and staying abreast of new developments can be a constant challenge.
It’s time to use that wealth and that clout to tackle the social drivers of health. Hospitals and health care systems must mobilize to treat—and ultimately, prevent—diseases caused by poverty, inequality, racism, and loneliness just as aggressively as they mobilize to attack a cancer with sophisticated drugs and surgeries.
It is impossible to understand the US health system without considering America’s ideological and political context.
There will come a time in the not too distant future when we look back at the healthcare system as it is today with shame and embarrassment. We’ll wonder how anyone got the right kind of care and rue the policy and clinical decisions that have made oursystem unaffordable, inaccessible, wasteful, and inferior to our peer nations.
It turns out there never was any central logic at work. The evolution of the American health care system began in the 1920s, when choices boiled down to which crazy cure you preferred.
The only large rich country without universal health care.
For example, the use of telemedicine skyrocketed, and many think it's an innovation that's here to stay. Patients like the convenience — and for many conditions, it's an effective alternative to an in-person visit.
Americans spend vast sums on health care. Certainly, health care is expensive all over the world, and it makes good sense for rich countries to spend large amounts to extend their citizens’ lives and to reduce pain and suffering. But America does this about as badly as it is possible to imagine.
The US health care system is famous for its expense and its waste. In a 2019 study, Shrank et al1 estimated that about 25%, or $760 billion to $935 billion, of the $3.6 trillion the US spends on health care annually is potentially wasteful.
In the 1990s, Taiwan did what has long been considered impossible in the US: The island of 24 million people took a fractured and inequitable health care system and transformed it into something as close to Sen. Bernie Sanders’s vision of Medicare-for-all as anything in the world.
The United States is at greater risk than other industrialized countries from the COVID-19 outbreak, he says. Why? “We have a really bad social safety network.” Things like universal access to healthcare and paid sick leave mandates are just two of the things that could improve it, he says.
Before the pandemic, the healthcare industry often relied on people’s ability to move around and meet face-to-face. Everything was based on patients being able to get to a clinic or a hospital to participate in a clinical trial or speak to their doctor. The pandemic forced us to acknowledge that the industry needs to be able to do much more remotely.
Acoronavirus is so tiny that 1,000 of them could be stacked in the thickness of a sheet of paper. It is an invisible threat, and it is making vivid the shortcomings of our health care systems.
Italy's healthcare system isn't perfect, but the people who live here are some of the healthiest in the world. Other countries can learn a lot from its example, writes Susan Levenstein, an American doctor in Rome.
For decades, the health insurance industry has been scaring Americans about Canada's health care system. We hear from a whistleblower about his role in the disinformation campaign.
Coverage needs to be free at the point of care — no co-pays or deductibles — because leaving patients on the hook for large medical costs is contrary to the purpose of insurance. A natural rejoinder is to go for small co-pays — a $5 co-pay for prescription drugs or $20 for a doctor visit — so that patients make more judicious choices about when to see a health care professional. Economists have preached the virtues of this approach for generations.
Why isn’t universal coverage through a national health insurance system even being considered in America? Research in health policy points to three explanations.
The recent legislative debacle in Washington, D.C., tells us the biggest problems facing American medicine are unlikely to be solved in our nation’s capital. We must, therefore, seek solutions in unexpected places.
Universal health care is hard, but it should be possible — and eight more things I discovered from visiting other countries.
The U.S. health system is a mix of public and private, for-profit and nonprofit insurers and health care providers. The federal government provides funding for the national Medicare program for adults age 65 and older and some people with disabilities as well as for various programs for veterans and low-income people,
The VoteHealth 2020 movement is inspired by our team, advisors, champions, partners and volunteers. Since our start in summer 2020, we’ve led targeted initiatives to get out the vote (GOTV) in innovative ways.