The Policy Farm Team

Robert Nelb

Yale University

Everyone’s been talking about how our nation’s health care system is sick: 47 million Americans are uninsured, $480 billion is wasted each year when U.S. spending is compared to other countries, and health care costs are expected to double in the next ten years.

But now it’s time to get personal: now it’s time to talk about how our health care system may be making you sick.

Yes, I’m talking about you – the student comfortably seated in the upper middle class. You may think that you’re privileged enough to be exempt from today’s problems of health care, but guess again. A crippling health care system means poor quality of care for everyone in the health care system – even you.

You’ve probably heard the statistic that U.S. life expectancy ranks below Cuba and Chile, and you may have even read the statistic that a lack of health insurance kills 18,000 Americans each year, but new studies are beginning to suggest that even wealthy Americans are sicker than they should be, particularly with debilitating and costly chronic diseases. Unlike Rudy Giuliani’s blatantly false statistics on prostate cancer, these findings aren’t too promising.

Last year, for example, a study in the Journal of the American Medical Association showed that for middle-aged white males, the prevalence of diabetes, heart disease, and cancer among the highest socioeconomic status in the United States is worse than the rates in the lowest socioeconomic status in the United Kingdom even though high-income Americans smoke less, drink less, and weigh about the same as low-income Brits.

In my own senior thesis research that I’m finishing this semester, I’ve found that the hospitalization rate for diabetes in Manhattan’s richest neighborhoods is about one and a half times the hospitalization rate for London and Paris’s poorest neighborhoods. Even after taking into account the different numbers of people with diabetes, New Yorkers as a whole are nearly twice as likely to be hospitalized for diabetic complications as residents of London.

These higher rates of disease and complications result in more deaths. The death rate for white Americans age 55-64 is 18% higher than the death rate of the same population in England. After 65, the differences in mortality begin to level off, perhaps because of America’s long-standing “socialized medicine” scheme know as Medicare?

As the movement for national health reform gains momentum, some groups are starting to recognize that our dysfunctional health care system has become a true public health threat. The American Cancer Society, for example, has recently decided to devote its entire advertising budget to health reform because, as they state on their website, “inadequate access to timely, quality health care is one of the greatest barriers to winning the war on cancer.”

The problem in the U.S. isn’t that we don’t have good doctors – it’s that we don’t have a good system. Although, American universities may be a hotbed for cutting-edge research, the sad reality is that many people with health insurance don’t have access to it. The U.S. may have some of the shortest wait times for non-emergency medical procedures, but according to a recent study from the Commonwealth Fund, one in four Americans has to wait at least a week for an appointment when he or she needs medical attention, which is more than one and a half times the rate in the U.K.

These figures don’t even take into account all the unnecessary bureaucracy in the U.S. system. Not only does administration in America cost more than twice as much per person as the UK, but it also prevents doctors from providing high quality care and leaves each patient with a pile of bills and paperwork when they leave the hospital. Even a college graduate will have difficulty navigating this system.

Here in Connecticut, the most egregious example of poor access is of lower-income families who are enrolled in Medicaid. A recent study of Connecticut Medicaid Managed Care companies showed that only one in four Medicaid patients could even schedule an appointment with an approved provider. The situation has become so bad that last week, Governor Rell was forced to suspend the state’s contract with these providers.

Unfortunately, in the presidential campaign so far, candidates have only been talking about access to health insurance, not access to health care. While covering the nation’s 47 million uninsured should be a national priority, these new insurance plans won’t be worth the paper they are printed on if we can’t fix the more fundamental flaws in our health system that deny people the basic care they need.

In the end, our health depends on it. There is no reason why citizens of the United States of America should continue to accept health care that is mediocre compared to the rest of the developed world. It’s about time that our political leaders take a bold stand to create a health care system that actually improves the health for you, for me, and for every American.