The Nation's Health Care System - Is The U.s. Health Care System Ailing?

While medical care in the United States is often considered the best available, some observers feel the system that delivers it is fragmented and in serious disarray. A report from the Institute of Medicine (IOM) of the National Academies, Crossing the Quality Chasm: A New Health System for the 21st Century (Washington, DC: Committee on Quality of Health Care in America, Institute of Medicine, 2001), described the nation's health care system as disjointed, inefficient, and in need of a major overhaul.

Dr. John P. Geyman, a retired physician and professor emeritus at the University of Washington in Seattle, believes that U.S. health care does not compare favorably with services provided in other industrialized Western nations. In Health Care in America: Can Our Ailing System Be Healed? (Boston, MA: Butterworth-Heinemann, 2002), Dr. Geyman contends that escalating costs and wide variations in access and quality are symptoms of our diseased health care delivery system.

Dr. Geyman cited the nearly forty-three million uninsured Americans (15% of the total 288 million people estimated by the U.S. Census Bureau to be living in the United States in 2002) and the fact that the United States has the highest health care expenditures of any of the world's other twenty-eight industrialized countries as indicators of serious systemic problems. By 2004 the Census Bureau estimated the number of uninsured Americans had exceeded 44 million. Dr. Geyman also noted that for eleven key indicators of health care quality (including measures of life expectancy at different ages) the United States earned tenth place or lower when ranked among thirteen industrialized nations. Dr. Geyman also observed that among comparable Western industrialized countries, the U.S. population is the only one without universal health insurance.

Dr. Geyman contends that the traditional approaches to solving health care delivery problems have been ineffective because they are incremental—shortsighted and piecemeal—rather than broad changes intended to provide optimal health care services to the greatest number of people. Global reform of health care financing is one solution Dr. Geyman offers to improve the system. He advocates a single-payer system, under which the government would pay for universal coverage but leave delivery under private control, intervening only as needed to improve access, affordability, and quality.

Other physicians, including Dr. Rudolph Mueller, a specialist in internal medicine just beginning his medical career, agree with Dr. Geyman's assessment. In As Sick as It Gets: The Shocking Reality of America's Healthcare, A Diagnosis and Treatment Plan (Dunkirk, NY: Olin Frederick, 2001), Dr. Mueller cited statistics to support the premise that the American health care system spends more money than other countries to deliver poorer results. Dr. Robert Lebow, a family practice physician who dedicated his career to serving indigent patients, offered still another scathing indictment of the health care system in Health Care Meltdown: Confronting the Myths and Fixing Our Failing System (Chambersburg, PA: Alan C. Hood & Co, 2003). Like Dr. Geyman, Dr. Lebow calls for a single-payer system to correct inefficiencies and equitably distribute health care resources to uninsured and underinsured Americans.