Letter: No. 1 in health spending, No. 35 in health

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Editor of the Reformer,

The 2019 edition of the Bloomberg Healthiest Country Index ranks the U.S. 35th out of the 169 countries considered. Canada ranks 16th; Cuba 30th. The ranking is of overall health, not health care specifically, but it's right in line with a depressing number of reports that do focus on health care and consistently find the U.S. lags behind most other wealthy countries in quality of health care despite spending far more on it than every country ahead of us.

All those countries ranked ahead of us have a common sense system of universal health care. Everyone can get health care when they need it, whatever their income and however sick they might be. They don't have to file for bankruptcy because they have the misfortune of getting really sick. Nor do they stay up nights juggling bills in order to pay for the health care they need, like so many Vermonters do. Vermont's "2018 Vermont Household Health Insurance Survey" reports that more than a third of Vermonters under 65 are "underinsured." They have health insurance that does not cover their medical needs. These people — many, many thousands just in Vermont — are the ones juggling all those bills in the middle of the night.

Most people don't realize how much money we pour down the sewer of administrative costs which do nothing to improve our health. A Commonwealth Fund study reported that Ontario doctors' offices spent 2.5 hours per week per doctor on administrative tasks related to health plans. In the U.S., that figure was 20.6 hours. For a 4-doctor office, that's 10 hours in Canada, 82 hours in the U.S. — 72 hours a week sliding into the sewer of commercial insurance complexity. The same phenomenon occurs in every hospital. At Lyndon State College in 2011, Antonia Maioni described the billing operation in a small U.S. hospital, which took up an entire wing, and in a much larger Canadian hospital, where it amounted to a few desks in a single room.

Things are likely to get worse. The medical journal JAMA reports that "private equity" firms are buying up increasing numbers of medical practices, hospitals, etc. What kind of care can you expect from a medical facility owned by money men determined to drive up profits and return on investment? Isn't it finally time to wise up?

Lee Russ

Bennington, March 2

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