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Fixin' Healthcare

Saturday, May 06, 2006

The Lifestyle Chronicles - Connect The Dots

When compared to other industralized countries the cost of medical care in the U.S. is high and associated with deteriorating health status. As this situation has developed, the number and percent of the population without healthcare insurance also has increased. Many have linked the rising cost and deteriorating health status to the lack of insurance. Undoubtedly, each situation aggravates the other but it is much more difficult show basic cause and effect.

Indeed, there is reason to question this assumption and bring into consideration the influence of American culture, lifestyles, public perspective of health, distorted profit motivation and how medical care is practiced. Insurance has been part of the problem in that it has contibuted to the behavior of practitioners and consumers of medical care. The appropriatness, effectiveness and efficiency of medical care and patient compliance with therapy are issues to be considered.

Prevention is neglected as a basic, functional concept in the American culture. For example, governments at all levels are notorious for lack of preventive maintenance. When treatment begins after the patient is sick, the leverage shifts from the long arm to the short arm of the lever for effectiveness, efficiency and outcome.

1. Annual U.S. per capita medical care expenditure = $5,274
2. Annual British per capita medical care expenditure = $2,164
3. Wealthier and better-educated people in both countries were much healthier than poorer and less-educated people. But, those in the top education and income level in the U.S. had similar rates of diabetes and heart disease as those in the bottom education and income income level in Britain.
4. Only 41.7% of adults with diabetes in the U.S. reported receiving all three of the tests considered critical for medical management of the disease - hemoglobin A1C, dialated eye exam and foot exam.
5. Half of individuals who suffer a stroke and have elevated levels of LDL cholesterol are prescribed statin therapy, and fewer than half of those taking a statin meet recommended lipid
goals.
6. Analysis of 25 to 30 years of follow-up for type-1 diabetes revealed reduction in mortality and renal failure rates but there was no difference for rates of cardiovascular disease events and cardiac intervention procedures.
7. The Robert Wood Johnson Foundation reported that 3 million fewer U.S. workers eligible for employee-sponsored health insurance enrolled in 2003 when compared with 1998.

1,2,3 - JAMA, May 3, 2006
4 - HHS Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey
5 - Neurology, April 25, 2006
6 - Diabetes, May 2006


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