State of Health In the United States, 2008

Posted on January 23, 2009 - 19:42

State of the U.S.A Health Indicators, Committee on the State of the USA Health Indicators, Institute of Medicine, 2008

"...........Policymakers, the media and the public should focus on 20 specific health indicators as "yardsticks" to measure overall health and well-being of Americans, says a new report from the Institute of Medicine (IOM).

By providing information be compared over time, these 20 indicators will help Americans track the nation's progress on improving health and the effectiveness of public health and care systems.


The indicators are intended for the health section of a new Web site that the nonprofit State of the USA Inc. http://stateoftheusa.org/ -- (SUSA) http://stateoftheusa.org/ is building as a tool for measuring and monitoring the nation on several fronts. The site will aim to help people become more-informed and active participants in national discussions about important topics - such as health, education, and the environment - by giving them a way to measure national progress from year to year and to compare it to that of other countries. Until recently, only researchers and academics have had the capacity for this kind of analysis.

The 20 proposed indicators together provide a broad picture of Americans' health and the nation's health systems. They reflect a range of factors that determine well-being, including how many individuals engage in certain risky or healthy behaviors, how well patients fare from the care they receive, and to what extent health professionals and facilities are meeting specific goals.

IOM's Proposed Health Indicators


Part I - Health Outcomes

1. Life Expectancy at Birth - number of years that a newborn is expected to live if current mortality rates continue

2. Infant Mortality - number of deaths of infants less than 1 year old per 1,000 live births

3. Life Expectancy at Age 65 - number of years of life remaining to a person at age 65 if current mortality rates continue

4. Injury-Related Mortality - age-adjusted mortality rates due to intentional and unintentional injuries

5. Self-Reported Health Status - percent of adults reporting fair or poor health

6. Unhealthy Days, Physical and Mental - mean number of physically or mentally unhealthy days in past 30 days

7. Chronic Disease Prevalence - percent of adults reporting
one or more of six chronic diseases: diabetes, cardiovascular disease, chronic obstructive pulmonary disease, asthma, cancer, and arthritis

8. Serious Psychological Distress - percent of adults with serious psychological distress as indicated by a score of 13 or higher on the K6 scale


Part II - Health-Related Behaviors

9. Smoking - percent of adults who have smoked 100 or more cigarettes in their lifetime and who currently smoke some days or every day

10. Physical activity - percent of adults meeting the recommendations for moderate physical activity, which are 30 minutes of moderate intensity activity at least five days a week or 20 minutes of vigorous intensity activity at least
three days per week

11. Excessive drinking - percent of adults consuming 4
(women) or 5 (men) or more drinks on one occasion and/or consuming more than an average of 1 (women) or 2 (men) drinks per day during the past 30
days

12. Nutrition - percent of adults eating a good diet as indicated by a score of 80 or more on the Healthy Eating Index

13. Obesity - percent
of adults with a body mass index of 30 or more

14. Condom Use -
proportion of youth in grades 9 through 12 who are sexually active and do not use condoms, placing them at risk for sexually transmitted infections


Part III - Health Systems

15. Health Care Expenditures - per capita health care spending

16. Insurance Coverage - percentage of adults without health coverage via insurance or entitlement

17. Unmet Medical, Dental, and Prescription Drug Needs - percent of non-institutionalized people who did not receive or delayed receiving needed medical services, dental
services, or prescription drugs during the previous year

18. Preventive services - percent of adults who are up-to-date with age-appropriate screening services and flu vaccination

19. Preventable Hospitalizations - hospitalization rate for ambulatory care-sensitive conditions

20. Childhood Immunization - percent of children between 19 and 35 months old who are up-to-date with recommended immunizations

Comments

Health Care System, United States

The following are facts that are believed to exist regarding the present U.S. Health Care System. This may be why about 80 percent of U.S. citizens understandably want our health care system overhauled desperately due to the inadequate health care they receive and access:

The U.S. is ranked number 42 related to life expectancy and infant mortality, which is rather low.

However, the U.S. is ranked number one in the world for spending the most for health care- as well as being number one for those with chronic diseases. About 125 million people have such diseases. This is about 70 percent of the Medicare budget that is spent treating these terrible illnesses. Health Care costs are now well over 2 trillion dollars of our gross domestic product.  This is three times the amount nearly 20 years ago- and 8 times the amount it was about 30 years ago.  Most is spent with medical institutions, as far as health expenditures are concerned.   One third of that amount is nothing more than administrative toxic waste that does not involve the restoration of the health of others. This illustrates how absurd the U.S. Health Care System is presently.  Nearly 7000 dollars is spent on every citizen for health care every year, and that, too, is more than anyone else in the world.

We have around 50 million citizens without any health insurance, which may cause about 20 thousand deaths per year.  This includes millions of children without health care, which is added to the planned or implemented cuts in the government SCHIP program for children, which alone covers about 7 million kids. 

Our children.

Nearly half of the states in the U.S. are planning on or have made cuts to Medicaid, which covers about 60 million people, and those on Medicaid are in need of this coverage is largely due to unemployment.  With these Medicaid cuts, over a million people will lose their health care coverage and benefits to a damaging degree.

 About 70 percent of citizens have some form of health insurance, and the premiums for their insurance have increased nearly 90 percent in the past 8 years.  About 45 percent of health care is provided by our government- which is predicted to experience a severe financial crisis in the near future with some government health care programs, it has been reported.  Most doctors want a single payer health care system, which would save about 400 billion dollars a year- about 20 percent less than what we are paying now.  The American College of Physicians, second in size only to the American Medical Association, supports a single payer health care system.  The AMA, historically opposed to a single payer health care system, has close to half of its members in favor of this system.  Less than a third of all physicians are members of the AMA, according to others. 

Our health care we offer citizens is the present system is sort of a hybrid of a national and private health care system that has obviously mutated to a degree that is incapable of being fully functional due to perhaps copious amounts and levels of individual and legal entities.

Health Care must be the priority immediately by the new administration and congress.  Challenges include the 700 billion dollars that have been pledged with the financial bailout that will occur, since the proposed health care plan of the next administration is projected to cost over a trillion dollars within the first year or so of the proposed plan to recalibrate health care for all of us in the U.S.  Yet considering the hundreds of billions of dollars that are speculated to be saved with a reform of the country’s health care system, health policy analysts should not be greatly concerned on the steakholders who may be affected by this reform of our health care system that is desperately needed.  Tom Daschle leads this Transition’s Health Policy Team.  And we also have Ed Kennedy, the committee chair and a prolific legislator.  So if the right people have been selected for this reforming team, the urgency and priority regarding our nation’s health care needs should be rather overt to the country’s citizens.

Half of all patients do not receive proper treatment to restore their health, it has been stated.  Medical errors desperately need to be reduced as well, it has been reported, which should be addressed as well.

 It is estimated that the U.S. needs presently tens of thousands more primary care physicians to fully satisfy the necessities of those members of the public health.  This specialty makes nearly 100 thousand less in income compared with other physician specialties, yet they are and have been the backbone of the U.S. health care system.  PCPs manage the chronically ill patients, who would benefit the most from the much needed coordination and continuity of care that PCPs historically have strived to provide for them. Nearly have of the population has at least one chronic illness- with many of those having more than one of these types of illnesses.  A good portion of these very ill patients have numerous illnesses that are chronic, and this is responsible for well over 50 percent of the entire Medicare budget.

The shortage of primary care physicians is due to numerous variables, such as administrative hassles that are quite vexing for these doctors, along with ever increasing patient loads complicated by the progressively increasing cost to provide care for their patients.  Many PCPs are retiring early, and most medical school graduates do not strive to become this specialty for obvious reasons.  In fact, the number entering family practice residencies has decreased by half over the past decade or so.  PCPs also have extensive student loans from their training to complicate their rather excessive workloads as caregivers. 

Yet if primary care physicians were increased in number with the populations they serve and are dedicated to their welfare.  Studies have shown that mortality rates would decrease due to increased patient outcomes if this increase were to occur.  This specialty would also optimize preventative care more for their patients.  Studies have also shown that, if enough PCPs are practicing in a given geographical area, hospital admissions are decreased, as well as visits to emergency rooms.  This is due to the ideal continuity in health care these PCPs provide if they are numbered correctly to treat and restore others.  Also, the quality improves, as well as the outcomes for their patients.  Most importantly, the quality of life for their patients is much improved if there are enough PCPs to handle the overwhelming load of responsibility they presently have due to this shortage of their specialty that is suppose to increase in the years to come.  The American College of Physicians believes that a patient centered national health care workforce policy is needed to address these issues that would ideally restructure the payment policies that exist presently with primary care physicians.

Further vexing is that it is quite apparent that we have some greedy health care corporations that take advantage of our health care system.  Over a billion dollars was recovered for Medicare and Medicaid fraud last year through settlements paid to the department of Justice because some organizations who deliberately ripped off taxpayers.  These are the taxpayers in the U.S. who have a fragmented health care system with substantial components and different levels of government- composed of several legal entities and individuals, which has resulted in medical anarchy, so it seems.

Thanks to various corporations infecting our Health Care System in the United States, the following variables sum up this system as it exists today.  Perhaps the United States National Health Insurance Act (H.R. 676) is the best solution to meet our health care needs as citizens, it appears.  We would finally have, as with most other countries, a Universal Health Care system that will allow free choice of doctors and hospitals, potentially, and health care for all completely.  It should and likely will be funded by a combination of payroll taxes and general tax revenue which is realistically possible.  Because the following needs to be corrected regarding the U.S. Health Care System:

Access- citizens do not have the right or ability to make use of this system as we should.

Efficiency- this system strives on creating much waste and expense as it possibly can.

Quality- the standard of excellence we deserve as citizens with our health care is missing in action.

Sustainability- We as citizens cannot continue to keep our health care system in as it is designed at this time- as it exists today.

http://www.mckinsey.com/mgi/publications/US_healthcare/index.asp

Dan Abshear

    

More Healthcare Workers

Part of the state of the current health care system is that we don't have enough health care workers to adequate treat minor conditions instead of the over-worked doctors. Training more nurses through the various online nursing degree programs will surely help.