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Eight Reasons US Healthcare Costs 96% More Than Cuba's--With the Same Results

Why does Cuba's healthcare system do so much with so little money--while we do so little with so much? The author visits Cuba, and revisits US health costs, to find out.

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4. Sickness looping

According to the Center for Disease Control (CDC), each year 2 million Americans get infectious diseases in hospitals. The massive over-treatment endemic to health care in America increases costs in two ways: (1) the cost of the unnecessary treatment itself; and, (2) the cost of treating the sickness which results from the original treatment. We could say that “sickness looping” is when treatment loops back on itself and requires yet more treatment.

This is a major medical expense, responsible for about a third of all medical care. The second best-selling category is heartburn drugs known as proton pump inhibitors (PPI), which accounted for $14 billion in the US in 2008. But 60% of PPI prescriptions for hospitalized patients may be unnecessary. Since the drugs inhibit calcium absorption, those taking high-dose PPIs long-term are 2.65 times more likely to have hip fractures. They are twice as likely to develop pneumonia and almost three times as likely to get a potentially deadly infection. Most disturbing, they may cause heartburn and acid reflux, which they are supposedly treating.

Too much radiation can be very unhealthy. From 1980 to 2010, the average lifetime dose on non-therapeutic diagnostic radiation increased sevenfold, increasing the risk for cancer. As much as 2% of cancers could be due to CT scan radiation.

Did you think that the value of hormone therapy [HT] for menopausal women was thoroughly debunked? After all, it does not improve either memory or cognition. But it is associated with increased dementia, stroke, blood clots and heart attacks. After 50 million women stopped using HT, estrogen positive breast cancer dropped by 15%. So, when Martha Rosenberg saw a 2010 article describing industry’s efforts to began pushing it again, she thought it was like “seeing an article suggesting cigarettes may be good for you after all.”

5. Insurance looping

In addition to the 47 million uninsured Americans, there are over 60 million who are underinsured. We could say that “insurance looping” occurs when failure to provide treatment loops back into medical costs, making them higher rather than lower.

A Health Affairs article confirmed that the uninsured are more likely to be untreated, resulting in illnesses progressing and their treatments being more expensive. According to lead author Dr. Andrew Wilper, “…they’re not getting care that would prevent strokes, heart attacks, amputations and kidney failure.”

Those without adequate treatment also receive more hurried care when they do get it. They often have no alternative but use the Emergency Room, making the ER more crowded for everyone.

6. Doctors’ fees

The US has some of the highest paid doctors in the world. Even though there is no difference in patient survival rates for coronary bypass operations in the US and Canada, US heart surgeons bill at least twice as much.

The 6 and 7 digit income figures for US physicians often stem from practices that are not particularly helpful to patients. A California study in the 1960s “showed that when physicians owned X-ray facilities, their patients ended up being X-rayed twice as often as patients whose physicians referred them to outside labs.” Illinois brought legal actions “against 20 MRI operators in the Chicago area for allegedly paying kickbacks to doctors who helped keep their machines supplied with patients.”

7. What needs to be researched?

Over half of the world’s spending on medical research is in the US. This has resulted in some amazing new techniques; but the increase in life expectancy gets smaller each decade. Focusing on increasingly rare disorders is likely to benefit the wealthiest half of families who spend 92% of US health care dollars.