For anyone following my articles, I hope it has come across thatI am extremely frustrated with our system. Much of thatrevolves around the incredibly high cost. But that’sonly part of the story…

If we paid as much as we do and it resulted in a top-notchsystem, I think my frustration would be at levels that are moremanageable. However, the World Health Organization ranked our system 37^th, meaning wesit just below Costa Rica and barely above Slovenia! Largely basedon outcomes, this report speaks to a system that doesn’t put thepatient first, where the few quality providers are largely out ofreach to the masses, and one in which we often wind up worse offafter we receive care than we were before.

It is on this point that I get the most amount of pushback fromthe public. They ask me “Why do people travel from all overthe world to get care in the U.S.?” This is a legitimatequestion. Let me give you a statistic. As of 2007, the nationwith the second highest number of MRI machines per 1 millionresidents was Italy, with 1,097. France, the top-rankedhealth care system, had 350. The U.S.? We have 7,810per 1 million residents. This is an insane number thatrequires mass volume of MRIs just to be financially viable. CT scanners are even worse. We had 10,535 per million versusFrance, with 659. So, why do people come to the U.S. forcare? Because sometimes, faster access to mediocre care (atbest) is better than waiting months for really good care.

This disproportionate amount of care exists in in all areaswithin the U.S. Outpatient facilities, hospital beds, labs,pharmacies… Therefore, we have a tremendous amount of not greatcare available to us at a price most of us cannot afford. Medical bills are now responsible for 67 percent of allbankruptcies in the U.S., and over half of those who file havehealth insurance! So even with insurance, we still cannotafford the cost nor the insane volume of care we receive.

When a car salesperson or real estate agent recommends a car ora house, don’t we hold the recommendations of even the mostseasoned professional a little suspect? Don’t we verify whatthey tell us about cost, quality, warranty, school district, etc.before signing on the dotted line? Why do we nothold our doctors to the samestandard? Do we not think that doctors’ adviceis affected by their own life experience? Things like priormalpractice suits, or how they are paid and the extra income theysometimes receive by referring patients out for expensive tests andprocedures?

Until we hold our doctors and hospitals to the same standards aswe do those we sell us less important things, like our cars orappliances, until we force them to provide a low cost, high qualityservice, until we ask about what they are recommending, and howmuch they charge, and make sure we are getting value, our systemwill continue to rise in cost and decrease in quality. Afterall, don’t we have more on the line when getting care than whenbuying a new refrigerator? In that case, shouldn’t we askmore questions, not less?