Patients feel health care system’s pressure, too

Friday, February 29, 2008 | 4:00 p.m. CST; updated 11:50 a.m. CDT, Thursday, September 3, 2009

As I was having my mammogram this week, feeling the pressure of a diesel truck with wide, yet cold tires backing over my right breast, I thought what a lucky woman I was.

OK, that’s a lie. I was sucking in my breath as hard as I could, trying to make all of me smaller. The only thought in my brain was, “Owwwwwwwwwwwww.”

It was later, when I was re-inflated, that more reasonable thoughts came back. I was feeling a tad bit smug about having gotten an important-yet-less-than-fun test out of the way — especially since I’d skipped having one last year. I was also feeling lucky to have the insurance to cover the test and the access to medical technicians to give it.

We spend more on medical care than any other nation, and costs are surging. Yet, we’re not getting our money’s worth, doctors are leaving the business, and there are horrible gaps in care.

In an article in the Journal of the American Medical Association, Steven H. Woolf, a physician at Virginia Commonwealth University, wrote:

“Quality and patient satisfaction in the United States are worse than in many other developed countries, such as the United Kingdom, Canada and New Zealand. Widely recommended transformational system changes to improve access, streamline care, improve communication, and reduce errors are progressing slowly.”

You wonder what it will take to make progress. Perhaps a change in administrations? It seems too much to hope for.

But something’s got to give. The current makeshift system of trusses holding our system together isn’t going to hold much longer. The federal government’s Centers for Medicare and Medicaid Services reported Tuesday that 10 years from now all spending on health care will double to more than $4 trillion a year, or one out of every $5 the nation spends.

To get there, we’re looking at a 6.7 percent annual increase in spending, almost three times the rate of inflation. Driving that will be higher prices and an increased demand for care, which will be caused by a growing and aging population. The first baby boomers become eligible for Medicare in four years.

Two years ago, federal and state governments paid about 46 percent of health care costs. Over the next decade, that will increase to 49 percent. Of course, there’s the ongoing battle between the states and Congress over splitting the bills. In the end it all comes back to us.

The thing is, there isn’t just one problem with our health care system.

We need to sort out the Medicare system so that it will properly care for our aging population for years to come and still be something that we can afford.

We need to improve access to medical care for the uninsured and the underinsured.

We need to institute reforms so that people who want to practice medicine actually get to do so — instead of spending their time dealing with insurance companies, trying to justify their decisions.

We need to do more to promote preventive care. We’re doing better, by encouraging people to stop smoking and to get in shape. It’s a tough sell. By nature people would rather take a pill to make them thin than change their diet or exercise. And human nature is a pretty tough critter to fight. But we could do more in this battle. We’re spending probably less than 5 percent on prevention. And we could make important tests such as mammograms more widely available. They’re a cost-effective way of heading off cancer.

Actually, I was thinking we should start by giving mammograms to all members of Congress, male and female. Surely we could find some part of the anatomy, even a hand, to put in the machine’s masher. The key would be to keep applying pressure until the representative or senator agrees to work seriously on health care.

And it would be covered by their insurance. Perfect.

Mary Lawrence teaches editing at the Missouri School of Journalism.

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