People in the United States pay more per capita on health care than any other people in the world — $10,224 per person, according to 2017 figures compiled by the Peterson-Kaiser Health System Tracker. The people of Switzerland came in a distant second at $8,009.
This means the United States already is paying nearly twice as much per capita as nations with widely discussed socialized health care systems, such as Sweden ($5,511) and the United Kingdom ($4,246).
That is not an argument to do away with competitive forces within health care. It is, rather, an argument for re-introducing those forces into a system that has become complicated by big pharmaceutical companies, secrecy and an insurance system that keeps consumers a step removed from confronting the actual cost of the procedures they require.
The Affordable Care Act, otherwise known as Obamacare, focused almost entirely on extending insurance coverage to all Americans, offering competitive insurance exchanges and subsidies for people who otherwise were uninsured or unemployed. Although much of the original version of this has been dismantled, it was always just a partial solution.
The real driver of unobtainable health care in this country is cost. In April, the consumer price index for health care inflation hit 10.7% for the previous 12-month period, according to an analysis of figures from the Bureau of Labor Statistics by modernhealthcare.com. Understanding why this is happening and getting control of it is key to ensuring more people get the care they need.
The Trump administration just announced a proposed rule that would require hospitals to publicly release the prices they have negotiated with insurance companies for each procedure. This would take effect in January, although it faces tough challenges from both hospitals and insurance companies. Ironically, the administration cites a provision in Obamacare, a law it otherwise has disparaged, as giving it the authority to impose such a rule.
The plan would be another important step toward controlling costs, but, again, it would be an incomplete one. Knowing the costs of a procedure may lead patients to shop for a lower price, but the actual price they pay after insurance deductibles, co-payments and percentages are considered is likely more important to average people.
The University of Utah may be formulating a more complete solution. As we have noted before, the U.’s Health Care system is undertaking a remarkable years-long study of the entire cost calculus of treatments and protocols.
Already, this has resulted in a discovery that joint-replacement patients face a better chance of full and quick recovery if their surgeries are scheduled for early in the day, allowing them to get out of bed with the help of a physical therapist later that same day. Simply changing schedules led to an 11% drop in costs through faster recovery times, as was chronicled by the American Medical Association.
Clearly, rising health care costs are complicated, and the solution will require a multi-pronged attack.
The U.’s detailed analysis already has received national attention and undoubtedly will provide more valuable information to push this along. Certainly, transparency — not only by hospitals and insurers, but also by pharmaceutical companies — will be important, as well.
Competition, transparency, giving consumers a reason to comparison shop and a reliable system rating outcomes based on hospital success rates all need to be combined to put downward pressure on costs and upward pressure on quality. This has worked in so many other industries. If it works in health care, universal access would become that much easier.