Calling on Rochester to treat the ailing medical care system

By Andre Chappel and Susan Ladwig
Rochester Democrat and Chronicle
February 28, 2007

Can you imagine a prosperous America that fails to provide vital services like public education? Why is health care different?

According to the U.S. Census Bureau, almost 47 million Americans lack health insurance. With rising premiums, even more are in danger of losing coverage from their employer. Families without coverage risk facing exorbitant medical bills. In fact, being unable to pay for health care expenses is the primary reason individuals declare bankruptcy.

Our health care system suffers from inequity for many, and unsustainable inflation and excessive costs for all. We must turn this situation around and act responsibly to ensure all Americans are protected from unreasonable risk.

Recently the Democrat and Chronicle reported that health care spending is projected to double within the next decade. America already spends twice as much on health care compared to other industrial nations, but ranks 30th for life expectancy.

Why is our system so dysfunctional? One reason is that the uninsured are more likely to be diagnosed in the later stages of disease, and more likely to be hospitalized for avoidable health problems.

The Institute of Medicine estimates that 18,000 unnecessary deaths occur each year due to lack of health insurance. Unfortunately, by saving a little money up front — by failing to cover preventive care — we spend a tremendous amount later to address major medical conditions.

Another reason for our health care system's dysfunction are the excessive administrative costs associated with our fragmented private health insurance industry, which account for almost a third of every health care dollar spent in America. If we could eliminate the administrative waste, we would save more than $350 billion a year, savings that could be used to cover all Americans, without spending more than we already do.

Many analysts consider single-payer financing with universal coverage, similar to Medicare, to be the best way to address these issues. Medicare is a public health insurance program for those older than 65. It spends less than 2 percent on administrative overhead. Medicare has the ability to control costs, and most recipients are satisfied with their care. There is a bill in Congress now, H.R. 676, with 56 sponsors in the House that would expand Medicare to cover every American from birth to death.

On Saturday, a panel discussion at the University of Rochester will explore the merits of this and many other reform options. As a community with an impressive history of planning and cooperation in health care, it's fitting that we come together to consider how we can move toward a health care system that better serves us all.

Chappel and Ladwig are graduate students in the University of Rochester's Department of Community and Preventive Medicine, in the School of Medicine and Dentistry.