UCLA expert blames American values for health care crisis. - Pharma Marketletter

'To heal our ailing health care system, we need to stop thinking like Americans.' That is the message of two articles by the University of California at Los Angeles, USA's Marc Nuwer, an expert on national health care reform, published in Neurology, the journal of the American Academy of Neurology.

'Americans prize individual choice and resist limiting care,' says Dr Nuwer, a professor of clinical neurology at the David Geffen School of Medicine at UCLA. 'We believe that if doctors can treat very ill patients aggressively and keep every moment of people in the last stages of life under medical care, then they should. We choose to hold these values. Consequently, we choose to have a more expensive system than Europe or Canada,' he said.

Consider these statistics:

- the USA boasts the world's most expensive health care system, yet only one-sixth of Americans are insured. Medical expenditures exceed $2,000.0 billion annually, making health care the economy's largest sector, four times bigger than national defense;

- by 2015, the US government is projected to spend $4,000.0 billion on health care, or 20% of the nation's gross domestic product;

- an aging US population will boost spending. Half of Medicare costs support very sick people in their last stages of life, and experts estimate that Medicare funds will be exhausted by 2018;

- 31% of US health care funds go toward administration. 'We push a lot of paper. We spend twice as much as Canada, which has a more streamlined health care system that demands doctors complete less paperwork,' Dr Nuwer says; and

- 10% of US expenses are spent on 'defensive medicine' - pricey tests ordered by doctors afraid of missing anything, however unlikely. 'Doctors don't want to be accused in court of a delayed diagnosis, so they bend over backwards to find something - even if it's a rare possibility - in order to cover themselves,' he adds.

Reforming the health care system in the USA, with the goal of providing universal, affordable, high-quality care will require rethinking the nation's overall values and paying greater attention to care-related expenditures, according to Dr Nuwer.

Part of the current problem, he says, is that doctors are oblivious to the price tags of the options they are prescribing for their patients. He recommends educating physicians about the costs of care, including imaging, blood tests and specific drugs.