House Call

By Rushabh K. Patel
Posted June 29, 2005


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The global healthcare crisis has reached America, but universal coverage is not the answer

If you were to open up your daily newspaper and come across an article addressing the current “global health crisis,” odds are that it is referring to the failure of developing countries to cope with the dire health issues facing them. Tragic and far-reaching as this situation undoubtedly is, it doesn’t come as a surprise. Take any underdeveloped nation afflicted by poverty and an inadequate healthcare system and you are sure to have a recipe for disaster. More confounding is the oft-mentioned healthcare crisis that is debilitating the developed world even in this age of unparalleled prosperity and sweeping technological advance. While the plight of poor countries can at least be traced to concrete causes, the same is not true of the serious problems facing the healthcare systems of the world’s most affluent regions.

In the United States, for instance, the ranks of the uninsured are burgeoning, medical costs are spiraling out of control, and doctors are being put out of business by escalating malpractice insurance premiums. Titans of industry such as the formerly invincible General Motors Corporation are being brought to their knees by mounting health care costs and archaic pensions systems. As if things weren’t bad enough, a rapidly aging population is expected to put even more pressure on the already dysfunctional system. Inevitably, the “profit-hungry” insurers and drug giants that dominate the U.S. healthcare system have been the easiest targets for criticism. Driven by frustration, public sentiments have decisively turned in favor of universal, government-run medical insurance á la the model of the European welfare state. Private healthcare, however, has become more out of fashion than your dad’s snazzy leopard-skin bellbottoms. Regardless of the fact that the current of public opinion is inching towards an increased socialization of medical care, this so-called healthcare crisis largely stems from widespread inefficiencies that would infinitely multiply were there greater government interference.

Even as Americans from Main Street to Capitol Hill seem to be cozying up to the idea of a government-run health care system as a panacea for all the ills plaguing the current healthcare scheme, the idealized welfare states of Europe are themselves in a dicey situation. In fact, to observe the calamitous results of a more pronounced role of the government in the health care sector, one need only look at our European brethren. They may not be reeling under enormous medical bills thanks to the “enlightened” policies of their respective governments, but the quality of care they are receiving is simply appalling. Take, for instance, the National Health Service in Britain. The NHS is terribly understaffed, under-equipped, in addition to being plagued by a slew of financial problems and outright mismanagement. In spite of dramatically lower health care costs, the NHS and similar public health systems tend to be deficient in the quality of the care provided and most treatments involve excessively long periods of potentially dangerous waiting. Moreover, observers have noted that these public health systems lag far behind the U.S. in terms of medical innovation. Our friendly neighbors in Canada, meanwhile, are so fed up with the single-payer health care system in force that they actually want to have the freedom to turn to private providers. In fact, earlier this month the Canadian Supreme Court struck down Quebec’s bank on private health insurance, perhaps sounding the death knell for the public healthcare system.

In the sense that neither of the existing healthcare paradigms is able to cope with ever-increasing medical costs, this truly is a global health crisis. Luckily, it is possible to escape from this quagmire. What is needed is a new model for dealing with the healthcare issues facing the developed world in the twenty-first century. At the root of the present-day predicament is a system that is saturated with inefficiencies through and through. In the case of the public systems, bureaucratic red tape and careless management have proved paralyzing. Similarly, the regulatory burdens inflicted on the private healthcare system in the U.S. have given rise to rampant inefficiencies in the administration and provision of medical services. While this had indeed provided a livelihood for millions of paper-pushers, the overall effect has been to increase the cost of healthcare to astronomical heights. Add to these gross inefficiencies the sizable costs of patient overuse given that patients are not paying out-of-pocket for medical care and instances of out-and-out abuse, and consequent hefty healthcare costs, begin to make sense.

The key to solving the global health crisis then lies in reducing the regulatory load and relentlessly eliminating inefficiencies. Unfortunately, this is easier said than done. While the public health system has failed miserably in this respect, the private sector has not done much better. In the United States, health maintenance organizations (HMOs) have mostly failed in their efforts to control costs, and have instead put the squeeze on medical professionals and ushered in an age of reduced benefits for insured patients. Nevertheless, in order to forestall the prospect of a comprehensive health crisis in the industrialized world, it is imperative that the inefficiencies present in the healthcare system are purged and replaced with a more rationalized structure.

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Copyright 2005 The Dartmouth Independent
The opinions printed within are those of the authors and do not represent those of Dartmouth College.