"Americans prize individual choice and resist limiting care. 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, than they should," explains Nuwer, a professor of clinical neurology at the David Geffen School of Medicine at UCLA. "We choose to hold these values. Consequently, we choose to have a more expensive system than Europe or Canada."
Consider these statistics:
- The United States boasts the world's most expensive healthcare system, yet one-sixth of Americans are uninsured. Medical expenditures exceed $2 trillion annually, making healthcare the economy's largest sector, four times bigger than national defense.
- By 2015, the U.S. government is projected to spend $4 trillion on healthcare, or 20 percent of the gross domestic product.
- An aging 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.
- Thirty-one percent of U.S. healthcare funds go toward administration. "We push a lot of paper," says Nuwer. "We spend twice as much as Canada, which has a more streamlined healthcare system that demands doctors complete less paperwork."
- Ten percent of U.S. 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," says Nuwer.
Reforming the U.S. health care system with the goal of providing universal, affordable, high-quality care will require rethinking our overall values and paying greater attention to care-related expenditures, according to Nuwer.
Part of the problem, Nuwer believes, is that doctors are oblivious to the price tags of options they're prescribing for patients. He recommends educating physicians about the costs of care, including imaging, blood tests and specific drugs.
"Does a fancy electric wheelchair cost $500 or $50,000?" he asks. "Most doctors have no clue. We need to give physicians feedback about the dollar signs behind their orders."