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AMERICA’S WEIGHTIEST HEALTH ISSUE: NOT OBESITY, BUT BLOATED HEALTH CARE EXPENSES pp. 43-48 $100.00
Authors:  (George Everett, Orlando, Florida)
Abstract:
The presidential campaign of 2008 has reawakened discussion of the rapidly rising costs of
the United States of America (USA) health care system. Most of the political sparring has
focused on how to cover the roughly 15% of Americans who are uninsured rather than how to
deal with the far more troublesome and vexing problems of overwhelming total medical
expenditures. After briefly stabilizing in the 1990’s, health care costs have soared to 16% of
Gross Domestic Product (GDP) and are projected to approach 20% of GDP by 2017 [1]. If
the general trends of the last four decades continue, health expenditures will grow by 2 – 3 %
of GDP per decade. Because the baby boom generation is nearing Medicare eligibility,
federal outlays for medical costs are expected to grow exponentially. The Medicare Trustees
recently reported that $432 billion was spent by Medicare in 2007 and that Medicare expects
to owe $36 trillion over the next 75 years [2].
While most developed countries have also faced rising health care costs, the USA has, by
far, the highest costs in the world, whether measured by percent of GDP or by per capita
spending [3]. Furthermore, nearly all other developed countries have universal or nearly
universal health coverage. If the uninsured in the USA are covered in the near future, an additional spike in total health care costs is likely [4] but with an improvement in subsequent
health measures for the newly covered persons [5].
If higher health care expenditures resulted in objective and subjective improvements in
health measures, a strong argument could be made to let the costs rise to some maximally
beneficial level. Unfortunately, there appears to be virtually no relationship between greater
use of health services and improved health outcomes or patient satisfaction. In a pair of
landmark studies, Fisher, et al [6] demonstrated that health care spending in different regions
of the USA varied by more than 60%, after adjustment for price differences and other factors,
with no difference in health outcomes or patient satisfaction [7]. 


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AMERICA’S WEIGHTIEST HEALTH ISSUE: NOT OBESITY, BUT BLOATED HEALTH CARE EXPENSES pp. 43-48