Current US medical care is trash

Diamond (2009) predicts “The ultimate toll of a single-payer system will be a reduction in the quality of healthcare that Americans may be unwilling to bear” (p 921).

The most extensive study on the quality of healthcare among 11 first world countries is by Schneider, Sarnak, Squires, Shah, and Doty (2017). These authors synthesized 72 indicators of healthcare which they categorized in five domains. Their data is from the international surveys by the Commonwealth Fund, the Organization for Economic Cooperation and Development, the World Health Organization, and the European Observatory on Health Systems and Policies. The U.S. ranked last on overall healthcare when the five domains were combined, ranked last in four of the five domains when examined separately, and ranked last in the most important domain— Health Care Outcomes.

The U.S. ranked very high on measures of doctor-patient relationship, wellness counseling, shared doctor-patient decision making, chronic disease management, and end-of-life discussions. A disturbing finding is the U.S. ranked last in time a physician spends securing their patient’s needed medication or treatment because of insurance converge restrictions.

Consumer Satisfaction with Private and Government Sponsored Healthcare Megan McArdle (2019) correctly reports about 70% of Americans with private health insurance are “fairly satisfied with the quality of their personal coverage” (para. 3). She also correctly reports about 49% of American are on some form of private health insurance. She concludes that going to a MCA system “would be for people to give up something they know they like. That’s a big ask about something as important to people as their health insurance” (para. 8).

Ms. McArdle conclusion is reasonable, Americans with a private health insurance plan generally like their plan, but how does this compare with those on a government sponsored plan? Most Americans are on one of three government healthcare plans. For those 65 years and older it is Medicare; for those with a low income it is Medicaid; and for those having been in the military it’s the Veteran’s Administration (VA).

America’s Health Insurance Plans (AHIP, 2018) conducted a national survey of 1000 adults, all with health insurance provided by their employer. As noted by McArdel (2019), 71% were satisfied with their healthcare insurance and about 60% satisfied with the cost of their plan. Yet, 59% to 68% (depending on the size of the company) report the cost of healthcare for most Americans is unreasonable. Over 80% express dissatisfaction that with every year they are paying more and receiving less coverage.

The results of a November 2018 Gallup Poll (McCarthy, 2018) allows for a comparison in consumer satisfaction with Medicare versus private healthcare. For those with private insurance 85% rate the quality of their healthcare as excellent or good. For those on Medicare 88% rate the quality of their healthcare as excellent or good. For those with private insurance 70% rate their healthcare coverage as excellent or good. For those on Medicare, again, 88% rate their healthcare coverage as excellent or good.

Thus, the percentage of those on Medicare is slightly more positive about the quality of their healthcare and there is an 18% discrepancy in favor of those on Medicare when it comes to satisfaction with the coverage of their health plan. Also, there is a 17% discrepancy in favor of those on Medicare when it comes to satisfaction with the cost of their healthcare insurance. For those on Medicare, 68% are satisfied with the cost whereas 51% of those on private health insurance are satisfied with their cost.