Reforming the Health Care System: An American Paradox
An article on yesterday's Federal Page misstated the relative numbers of elderly in the U.S. and Canadian populations. The proportions of persons over 65 in the United States is 1.2 percentage points higher than that in Canada. (Published 2/7/92)</br></br>Ask Americans their opinion of the U.S. health care system, as poll after poll has done, and the majority say it is in need of major reform. But ask them how they like the quality of the care they receive personally and they say just the opposite: They are well satisfied.</br></br>This is the paradox faced by President Bush today as he unveils his administration's long-awaited health care reform package, a paradox that has bedeviled all those debating how to fix the U.S. health care system. How it is that a problem of such apparent gravity remains an abstraction for so many Americans? How can a system be so bad if it leaves so many so happy?</br></br>The answer, according to health care experts, is that the three distinct problems at the heart of the health care crisis - that health care dollars are spent unwisely; that the nation's health care bill is rising too rapidly; and that the burden of paying that bill is shared unequally - are largely invisible to the Americans passing through hospitals and doctors' offices.</br></br>This is, in the words of many pushing for reform, a crisis of the hidden infrastructure of the health care system. It involves the way that dollars flowing from employers and government agencies to medical providers and insurers often go to the wrong places, the wrong procedures and the wrong people, burdening some too much and others too little.