What do Americans think about health spending?

(Note: this is cross-posted from TPMcafe because your blog host is worn out from traveling on crutches)

For us health policy wonks (or those plugged into recent data about health spending), the cost of health care in the U.S. is very troubling.  Not only do we spend more than twice as much as the other OCED countries, but it eats up an enormous percent of our GDP, at 16%.  The growth in health spending is reflected in premium increases, hospital bills, and the projected growth of Medicare and Medicaid.

If only Americans saw it this way, too.

Robert Blendon, a health opinion polling expert, made an instructive presentation for would-be reformers yesterday at Academy Health's National Health Policy Conference in Washington, D.C.  According to this August 2004 poll, 78% of Americans believe we don't spend enough on health care.

That's right -- even though we spend more than twice as much as other developed nations (and 53% more than the next most expensive country, Switzerland), Americans believe it's not enough.  It's not entirely clear why they hold this belief, but surely many Americans look at the number of uninsured and conclude we just aren't paying enough to cover them. Or that their premiums are high because insurance companies and doctors are greedily pocketing too much money.

It's not that insurance companies are greedy; it's that in our fractured care delivery system, they're very inefficient.  Most estimates place private administrative costs at 15-30%, whereas Medicare hovers around 2%. It's not that doctors are greedy either; it's that they duplicate care and continue to use expensive treatments that are no more effective than older ones.

Covering the uninsured isn't going to cause costs to go through the roof either.  A 2003 article in Health Affairs estimated that covering the uninsured would add less than one percentage point to health's share of GDP.   

These stats are all well and good, but policy makers need to connect with Americans on an emotional level.  Like: Do you worry that expensive health care is causing/will cause your employer to cut back on the number of employees? When you stayed in the hospital, did you have to repeat yourself to a lot of people?  Did you know what every test you got was for? It's essential to make these connections -- that the growth in health spending (which is in every part of health care, not just for baby-boomers and retirees), affects your job, your family, and your security.

We have a long way to go to convince the public that the way we do health care in this country is wasteful.  The first is helping them connect the dots between GM and other companies whose health costs are drowning them, and the fact that we spend too much on health care, not too little.  It's too much money not because we should treat people less, but because we pay for it in an inefficient way, we duplicate care, and we don't cover everyone we can.

Comments

[janinsanfran]

I understand everything you wrote in this post -- but I have to quibble. I know that many doctors, especially specialists and they are almost all specialists these days, make $500,000 annually.

Sorry, that's greedy. Perhaps not on a par with most CEOs, but still ridiculous. Their values suck.