The U.S. Health care system is on a dangerous path, with a toxic combination of high costs, uneven quality, frequent errors, and limited access to care. Our nations health care is going to smash into economic reality. We currently have dysfunctional health care competition, those in now strive not to create value for patients but to capture more revenue, shift costs, and restrict services…..that’s a fact. Redoing Health Care presents a wide gap of indicators of problems confronting the system. Evidence, taken together, lead to the same overwhelming conclusion, the system is broken, and the magnitude of the problem is staggering.

To reform health care, we must change the nature of competition itself. Redefining Health Care provides an overall framework for diagnosing and solving this immense problem, with detailed action steps for all participants in the health care system. Per capita health care cost in the United States surpasses that of most other developed countries. U.S. Consumers report higher dissatisfaction with their health care system than do consumers in other developed nations.  Although U.S. Costs are high, they have not enabled greater access to medical care in the United States than elsewhere. There were 45.8 million Americans without health care coverage in 2004, up from 39.8 million in 2000.

Today this number is approaching 50 million. Although hospitals provide free care for the uninsured, that approach is far from ideal. Access to primary care, rather than just emergency treatment, is essential to providing good care. Higher cost U.S. Health care does not result in longer life expectancy for Americans than for citizens of other developed countries, or more years of good health. Also out of a thirteen countries studied for health care indicators, the U.S. Ranked twelfth, with the worst ranking on years of life lost from preventable medical conditions before age 70. Extensive study shows that there is not a gap, but a chasm, between the quality of care that Americans should receive and the quality of care that most actually do receive. The best American health care is world-class, but the average quality leaves a bad taste in your mouth. A recent RAND study of thirty types of preventive, acute, and chronic care in twelve metropolitan areas found that Americans receive, on average, only about 55 percent of the care that is suggested by established medical standards. Medical errors at todays pace is the leading cause of death in the United States.

 In 1999 the Institute of medicine said their research showed that on average annually 67,000 deaths occurred in hospitals from medical treatment errors. In 2004, HealthGrades estimated about 195,000 per year died from medical screw ups. Today, this estimate by many third party organizations is said to be 240,000 per year die from hospital medical errors! Quality varies across regions and among providers. Recent research on Medicare found that there were very different standards for different regions. These variations cant be healthy for any system. Differences in spending among states are present across the board, in Medicare, Medicaid, and private health care spending. But higher cost does not mean higher quality. Regions with higher spending do not have more access, better outcomes, higher satisfaction, reduced mortality, or improved access to care. The creation and implementation of medical knowledge is extremely slow. On average, it takes about seventeen years for the results of clinical trials to become standard clinical practice. This delay is not seen in almost all industries in this nation.This helps also helps create less quality care. Malpractice premiums and lawsuits disrupt care and costs. Professional liability premiums are growing at an unprecedented rate, with U.S. Doctors spending more than $6 billion per year on malpractice premiums. Lets not even mention the addition of billions of dollars spent each year by hospitals and nursing homes.

More damaging than the cost of premiums may well be the threat of malpractice suits, which causes doctors to practice “defensive” medicine. This can be seen as unnecessary tests, over diagnosis, and redundant or unnecessary treatment. Administrative costs are just stupid high and rising. Estimated health care costs spent on administration are a staggering 25% of hospital spending and are estimated to be over 30 percent of all health care spending.