The Health Care Crisis:  Where Do We Go From Here?

Robert J. Cuomo, Ph.D

Dean

Girard School of Business and international Commerce

Merrimack College

In this article I would like to analyze the current crisis the United States is facing in its health care delivery system.  The U.S. spends twice per capita on health care as other developed countries.  In spite of this, we face the following problems:

• More than 47 million Americans are without health insurance. Twenty five million are underinsured.
• The U.S. ranks 49^th in life expectancy among nations
• Medical problems account for about half of housing foreclosures
• Losing one’s job usually means losing one’s health insurance
• Health insurance premiums have increased by 87% in the last five years
• Since 1999 employer-based premiums have risen by 120% compared to cumulative inflation of 44% and wages of 29%. Because of this, businesses are forced to either lay off workers or cut health care benefits.
• Medical costs lead to almost half of all bankruptcies

We can respond to these problems in a number of ways.  Should the U.S. build upon the current health care delivery system? Should we incorporate a public option?  The path we choose will have substantial impacts on future generations.  Let’s analyze these problems and explore some potential solutions.

Some Health Care Statistics

A comparison of the health care performance of the U.S. as compared Germany yields the following statistics:

• Percent of GDP spent on health care
• Germany 10.4%
• S. 16%
• Health care spending per capita
• Germany $3,588
• S. $7,290
• Average annual growth rate of real health care spending per capita
• Germany 1.7%
• S. 3.4%
• Out-of-pocket health care spending per capita
• Germany $470
• S. $890
• Per capita spending on health insurance
• Germany $191
• S. $516
• Per capita spending on drugs
• Germany $542
  • S. $878
• Number of practicing doctors per 1,000 population
  • Germany 3.5
  • S. 2.4
• Average annual number of doctor visits
  • Germany 7.5
  • S. 3.8
• Average length of stay per acute stay
  • Germany 7.8
  • S. 5.5

In exploring the best path to developing a more effective health care delivery system, an examination of the health care system in other developed countries is very informative.

Canada

Mix of private and public care, with most of the population enrolled in the public system

Germany

Residents must have health insurance; quasi-public and private providers