Friday, November 03, 2006

Experts: Ailing system needs repair

Friday, September 29, 2006
Experts: Ailing system needs repair
Ron FrenchThe Detroit News

In the future, individuals will pay more, companies will pay less, and we'll all shop around more for our medical needs.

That's the consensus of five health care experts who sat down with The Detroit News to discuss the nation's health care crisis. The participants, ranging from a U.S. senator to a drug company vice president to a General Motors Corp. executive, didn't mince words.

One called the system a "national shame" and another called it "toxic." One warned that our children may be the first generation to die at a younger age than their parents.

"We spend about twice as much of our GDP (gross domestic product) on health care as anyone else," said U.S. Sen. Debbie Stabenow, D-Lansing. "We have higher infant mortality and lower life expectancy. What is wrong with this picture?

"The way we cover the uninsured in this country is the emergency room," Stabenow said. "Anyone who walks into an emergency room gets care and then GM pays for it -- because that cost has to go somewhere."

No one knows that better than Bruce Bradley, health care policy director for GM. "We need to address the toxic, upside-down financial structure (of the health industry) where providers are rewarded for doing more rather than doing better," Bradley said.

"When we build a car or truck, we do much better when our cars or trucks provide a good value and meet a consumer's needs. (But) in health care, it's a mystery."

Americans spend more on health care than anyone in the world. Some of the blame goes to hospitals, doctors and drug companies. But some also falls on Americans themselves.

"If you travel between Europe and the U.S., the first thing that strikes you is the sheer amount of obesity in the U.S.," said David Canter, senior vice president of Pfizer Michigan. "There is a definite (difference) around personal responsibility people take and what they consider to be good health habits."

"I'd encourage all our children to get more exercise, eat better, and encourage their parents to do that, too," said Nancy Schlichting, president and CEO of Henry Ford Health System. "The trend we're on now is so frightening that we're beginning to speculate that our children for the first time may not live as long as their parents."

Once Americans are sick, they demand a lot of medical care. "We have a different cultural expectation," said Kevin Seitz, senior vice president of Blue Cross Blue Shield of Michigan. "As a culture, we try to defend ourselves against death instead of embracing the idea of aging gracefully. Other cultures do not respond the same way."

Stabenow worries about the impact of health care costs on U.S. companies like GM.

"I don't think in a global economy we can continue to fund health care on the backs of businesses," Stabenow said. "I think something major is going to have to happen if we're going to continue to compete and continue to have a middle class."

"Employers like GM who step forward to provide coverage to their employees essentially get penalized in terms of their competitiveness," Seitz said. "It's a national shame."

Canter told the story of his daughter going to a hospital after getting hit in the head with a softball.

"We spent seven hours in the ER and had an MRI of her face. It cost $800. An X-ray was about a tenth of the cost. If I were paying for it, I might have said no. If someone else is going to cover the cost, there isn't much personal responsibility."

Seitz countered that buying health care isn't like buying a car. People aren't medical experts and sometimes don't know which services they need and which they don't, he said.

"If you simply say, 'Let's have everyone pay for everything,' you'll find that the things that are most basic will not be paid for," Seitz said.

Just getting hospitals to follow the same treatment regimens could save money and lives, Bradley said. "There's this huge gap between what we know should be done and what we're doing," he said. "Easily, 20 percent to 40 percent of the health care dollar isn't adding value to the patient."

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