Not surprisingly, the same Commonwealth Fund survey found that US adults were the most likely to endorse major reforms: Three out of four called for fundamental change or rebuilding. Yet, a November 2013 Gallup survey found that 56% of U.S. adults say that it is not the federal government's responsibility to make sure all Americans have healthcare coverage. Unless this dichotomy can be blamed on the recent politicization of the issue because of Obamacare's rollout, there is a major disconnect. While not a root cause per se, it is a serious impediment.
How is it possible that Americans endorse major reforms, but don't want the government responsible for making sure that all Americans have healthcare coverage?
Are they naive enough to think that the so-called free market forces will somehow magically bring about reforms?
Market forces are quite capable of bringing about reforms if it is a level playing field. The problem is that in healthcare it is not a level playing field. The market power of insurers to fight high prices against consolidated hospitals and pharmacy benefit managers in most market areas is very limited. So, they offer illusory discounts to employers and individuals hidden inside inscrutable insurance products. Even large employers with clout are helpless; they have been reacting by simply shifting costs to employees through higher premiums, reduced benefits, and higher deductibles. So, it boils down to a couple of major problem areas: 1) exorbitant prices because of the leverage providers have and 2) overall lack of price transparency.
There aren't very many things one can say with certainty about healthcare in the United States. But there is one undeniable fact: Access, affordability, and insurance complexity are often worse in the United States compared to 10 other industrialized nations. The 2013 Commonwealth Fund survey conducted in 11 countries found that U.S. adults are significantly more likely than their counterparts to forgo health care because of the cost, to have difficulty paying for care even when they have insurance, and to deal with time-consuming insurance issues."
We have advocated the practice of evidence-based management in healthcare as much as evidence-based medicine. Through our research we have shined the light on critical healthcare issues that are driving the costs higher and quality lower, including huge variations in Medicare payments and excessive charge markups, drastic differences in service utilization mix tilted toward more expensive procedures, and competitiveness and affordability of health plans under Obamacare.
Our healthcare articles and analyses have been published in reputed publications as follows:
Journalists frequently incorporate or report on our views on wide-ranging healthcare challenges in their reports and stories: