NCPA - National Center for Policy Analysis


October 23, 2007

America's health care system has three fundamental problems: cost, quality and access, says John C. Goodman, president of the National Center for Policy Analysis.

In regard to cost, says Goodman:

  • Health care spending per capita is growing at twice the rate of growth of national income; if that trend continues, health care will crowd out every other form of consumption by the time today's college students retire.
  • The reason for this dilemma is that patients are rarely forced to choose between health care and other uses of money.
  • For example, no one is ever asked to decide whether one more knee replacement or one more MRI scan is worth the money it costs, and no one ever has to decide whether it is worthwhile to spend one-third of Medicare's budget on patients who are in the last year of life.

On the quality front:

  • According to RAND researchers, patients get recommended care only about half the time; and the type of insurance, or whether they even have insurance, doesn't seem to matter.
  • An Institute of Medicine study found that as many as 98,000 people die every year because of medical errors.
  • Other studies have shown that an appallingly low percentage of doctors and hospitals have patient records in electronic form, thereby missing opportunities to use error-reducing software.

As for access, low-income people in particular face barriers to care, says Goodman.  They have access to a limited range of doctors and clinics, and they often face rationing by waiting when they are not facing rationing by price.

Overall, there are many reasons for these problems, but by far the most important is that neither doctors nor hospitals compete for patients based on price, quality or access to care, says Goodman.

Source: John C. Goodman, "NO: It's better to force the medical sector to compete for patients," Charlotte Observer, October 22, 2007.


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