How to control health care costs in the USA

We are finally in the midst of American football season again, after so many dull months. Are you ready for: “We’re Number 1; we’re Number 1″?

School pride; conference pride; regional pride; confirmation of identity; proof of manhood.

Think Summer Olympics in London, 2012. As the Gold Medals add up, the chants will ring out … U.S.A, U.S.A.

Goose bumps; spine tingles; national pride.

Years back, when John McKay coached the USC Trojans, he used to say about the USC-UCLA football game: “It’s not a matter of life and death; it’s more important than that.”

Fast forward to the 21st Century and to our fields — health and medicine.

U.S.A., U.S.A. — we’re Number 1; we’re Number 1.

The U.S.A. is indeed Number 1 of the top 19 Western developed countries in money spent for medical and health care, in absolute dollars and in % of the Gross Domestic Product. And, we are number 1 in worst cost-effectiveness in reducing death rates.

For many years after the threat of global war posed by a hostile U.S.S.R. ended, I believed that the U.S. military-industrial complex (USMil-IC) was the greatest efficiency bumbler and resource consumption organization in the history of our country.

I mean the Pentagon declares that it won’t even be able to launch its first ever comprehensive audit of how its spends its money until maybe 2017. What?

Their supporters do always seem to identify or create new threats and wage new expensive wars.

Although illusory, the control of that growth slope is doable, simply by a new budget approved by the U.S. Congress.

But the sheer size and the unimpeded growth slopes of the U.S. medical-industrial complex (USMed-IC) has replaced the USMil-IC at the top of consumption artistry.

By steadfastly maintaining pluralism and diversity in funding streams, the USMed-IC has perfected the “divide and conquer” strategy to keep the money flowing without regard to its effect on total quality or quantity of American health and life.

Dr. Don Berwick has correctly said “every system is designed perfectly to achieve exactly the results that it achieves.”

Yep. True.

I wish I could live long enough to see the fantastic capabilities of the citizenry of the U.S.A. turn the corner and be able to say that … WE’RE NUMBER ONE … in the cost effectiveness of our health system, measured by death rates, and the length and quality of the lives of our people.

It can be done, but only by a complete redesign to a system intended to actually meet the goals of the people, not primarily those of the medical profession and its supporting industry.

George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association.

Originally published in MedPage Today. Visit MedPageToday.com for more health policy news.

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