Structural Inefficiencies in American Health Care. Eric Bernstein, MD, MPH New Mexico Cancer Care Associates Santa Fe, NM. Safe topics. Money Politics Cancer Health care reform. National Health Expenditures and Their Share of Gross Domestic Product, 1960-2009 . Dollars in Billions:.
Eric Bernstein, MD, MPH
New Mexico Cancer Care Associates
Santa Fe, NM
Dollars in Billions:
5.2% 7.2% 9.2% 12.5% 13.8% 14.5% 15.4% 15.9% 16.0% 16.0% 16.1% 16.2% 16.6% 17.6%
Source: Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group, at http://www.cms.hhs.gov/NationalHealthExpendData/ (see Historical; NHE summary including share of GDP, CY 1960-2009; file nhegdp09.zip).
• 1,516,971 Personal bankruptcies 2011
• 62% of these are classified as “medical”
(Himmelstein D, et al, Am J Med 2009)
• ~940,000 “medical bankruptcies” in 2011
• 8% of NSCLC patients bankrupt within 5 years of diagnosis (Ramsey SD, et al. 2011)
Claxton G, et al. Health Aff (Millwood). 2010 Oct;29(10):1942-50.
For many specialized things, the USA is terrific
Average life expectancy at birth =33rd
DALE (disability-adjusted life expectancy) =24th
WHO World Health Report 2000 =37th
WHO World Health Report 18th
6% of GDP spent on healthcare
Breast cancer: 30-50% higher mortality
Colon cancer: 50-60% higher mortality
1.6 times that of the insured child
Chronic conditions poorly managed; Not systematic
JPUBHealth10/29/09 advance publication on line
CalHealthReform.org accessed 11/14/2009
In USA, 1 insurance employee for every two doctors
68K/year in billing costs per doctor in an office-based practice
*Organization for Economic Co-operation and Development
Hospitals 31 cents
Administrative Costs 30 cents:
- Insurance Company -20 cents
-Doctors, Hospitals -5 cents each
Doctors 21 cents
Drugs 10 cents
Going UP Going DOWN (as a percent)
“ them…hired more than 350 former government staff members”
“…At least ten others have been members of Congress”…
Karen IgnagniHealth Care Industry Spending 1.4 million/day on lobbying--The Washington Post 7/06/09, others
Source: OECD Health Data 2010 (Oct. 2010).
Source: International Federation of Health Plans, 2009 Comparative Price Report.
J themNatl Cancer Inst. 2011 Jan 19;103(2):117-28.
Cancer as an example of why the worst cancer may be the system.