Outside editorial: Sick society needs overhaul of health care

Posted: Wednesday, December 10, 2008

Anyone who doesn't believe that the nation's health-care system has become a dysfunctional mess should read the report issued last week on "America's Health Rankings." We failed our physical exam, again, and we're not getting better.

Compiled by the American Public Health Association and two other organizations, the annual report finds that the health of Americans has failed to improve for the fourth straight year. As long as we keep doing what we're doing as a nation, the outlook is bleak and the prognosis is grim.

Here's why:

• We spend more money than other countries on medical treatment but get too little in return. As a result, the United States lags behind 27 other countries in life expectancy.

• Too many people - 46 million Americans - lack access to health care. Florida is one of the worst in this particular ranking, coming in 48th among the states, ahead only of New Mexico (49th) and Texas (50th).

• Obesity has doubled in the last 19 years, and significant reductions in the prevalence of smoking have come to a standstill, putting Americans at increased risk for a variety of chronic, deadly illnesses.

• Too many children are growing up with little of the medical attention they require. A UNICEF study found that the United States is second to last among 21 developed nations for child well-being as a result of high infant-mortality rates and other measures.

Given the severe economic times, it's a sure bet that these harsh findings will get worse. Most Americans get their health insurance through an employer, but at the rate the economy is shedding jobs - 533,000 in November, the most in 34 years - more people are going to stop seeing a doctor and stop getting medicine. They won't be able to afford it. All of this should be reason enough to convince Congress and the incoming administration that the healthcare system desperately needs an overhaul.

In the past, the insurance lobby has successfully fended off attempts to create some sort of national healthcare system with access for everyone. Remember Harry and Louise? They were the husband-and-wife team in industry commercials of the early '90s who helped to beat back the Clinton administration's attempts to reform health care. But that was then. Next month, a new president who managed to win more than 50 percent of the vote and who made health care reform a campaign pledge takes office. He has reason to claim a mandate to get the job done. The findings of "America's Health Rankings" offer more evidence to make the case for fundamental reform.

Perhaps sensing that change is in the wind, the insurance industry has come out in support of an "individual mandate," a requirement for everyone to buy health insurance. This should be a necessary component of any reform plan because it guarantees that healthy customers, as well as the sick, will be covered, helping to keep premiums relatively low. Notably, the report found that Massachusetts, which has an individual health mandate, leads the nation with the lowest uninsured and also rates near the top, No. 6, in general health statistics.

"The solution is to build a foundation for health by creating a culture of wellness and prevention," said Dr. Georges C. Benjamin, executive director of the American Public Health Association. "It is no longer acceptable to simply focus on treatment and cures."

What are we waiting for?

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