8 Facts . . .

The name of the piece is "8 facts that explain what's wrong with American health care." Wanna know what they are? My guess is, you already do know some of them, if you're a reasonably well-informed American . . . and if you're a knee-jerk reactionary or Tea Partier, you're going to deny the facts anyway. But then again what are the odds, unless you're a government snoop (and I have no doubt you're out there and I'm on a hundred watch lists), that you would be reading this subversive's screed?

So back to the point: 8 Facts that explain what's wrong with American health care. You should certainly read the entire piece. I've just hit some of the highlight language for you here. But the whole read is certainly worth your time.

1. Americans pay way, way more for it than anyone else.

"We spend $2.8 trillion on healthcare annually. That works out to about one-sixth of the total economy and more than $8,500 per person — and way more than any other country."

2. We pay doctors when they provide lots of health care, not when they provide good health care.

The best way for a doctor to make money in the United States right now is simple: prescribe treatments.The American health-care system by and large runs on what experts describe as a "fee-for-service" system. For every service a doctor provides — whether that's a primary care physician conducting an annual physical or an orthopedic surgeon replacing a knee — they typically get a lump sum of money. That's how most businesses work. Apple gets more money when it sells more iPads and the Ford gets more money when it sells more cars. But health care isn't like iPads or cars. Or, at least, it's not supposed to be.

 3. Half of the health care spending goes for five percent of the population.

 4. Our health insurance system is the product of random WWII-era tax provisions.

The health insurance tax break is the biggest in the federal budget; the government loses out on $260 billion annually by not taxing health benefits. The majority of non-elderly Americans get their health insurance at work, and with good reason: the tax-free dollar can buy a lot more medical care.

5. Insurance companies have small profit margins.

As to who makes the most money, it's mostly drug companies and device manufacturers — the people who make the things that insurance companies buy. They typically run profit margins around 20 percent. One reason the cost of American health care is so high is that insurers are so weak. Having hundreds of different carriers, for example, means no one insurer has lots of negotiating power — hence those high prices drug and device makers can charge.

6. Getting health care in the United States is dangerous.

We don't know exactly how many Americans are killed in hospitals each year, but we do know that it is a lot. In 1999, the Institute of Medicine published a seminal report titled To Err is Human, which estimated that at least 44,000 patients — and as many as 98,000 — die in hospitals each year as results of medical errors. Even using the lower-bound figure, that would mean medical errors in hospitals kill more people annually than "such feared threats as motor-vehicle wrecks, breast cancer, and AIDS." A follow-up study published in 2013 argued that the IOM numbers were a vast underestimate, and that medical errors contribute to the deaths of between 210,000 and 440,000 patients.

 7. One-third of health care spending isn't helping.

The United States spends $765 billion annually (about one third of our overall health care dollars) on things that do not make Americans any healthier. "I'm always amazed at these conversations I have with physicians," says Amitabh Chandra, a health economist at Harvard. "They'll openly say that about 50 percent of what happens in medicine is waste, but it's hard to always know which care was waste." Much of the waste in our system has to do with the fact that we run an inefficient health-care system, in which hundreds of health insurance plans all charge different prices for the same surgeries and scans. That requires lots of billing staff: for every three doctors in the United States, there are two administrative staff to handle all the paperwork. That's unique to the US system.

 

8.  Obamacare is not universal health care.

Obamacare doesn't eliminate [people without health insurance] in America; instead, it cuts the number of people lacking coverage about in half. Even after Obamacare is fully implemented, budget forecasters still expect that 31 million Americans will lack insurance coverage — a bigger group than the people buying coverage on the exchanges. Our uninsured rate will still be in the double digits, hovering around 11 percent.