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Hooked on health

A report on America's littlest citizens offers one more reason to push for a more effective health-care system.

Adiscussion about fixing the health-care system can quickly bog down in abstractions, the arguments focused on ''delivery systems,'' ''individual mandates,'' ''access'' and so on. Yet the health-care debate at its simplest is about how, as a nation, we ensure optimal health for citizens without going broke in the process.

The task should begin in earnest to fix a system that is proving increasingly dysfunctional for individuals as much as for businesses and governments. The need to act is growing in urgency with a sputtering economy, as employers cut jobs that provided millions of families with some health benefits and cash-strapped governments roll back Medicaid and other publicly funded services to cover budget shortfalls.

Last week, U.S. Sen. Max Baucus, chairman of the Senate Finance Committee, stepped up with a call to action, presenting an initial plan for reform. Others certainly will offer competing plans. Baucus drew attention to one of the distressing realities that should be of high concern to policymakers regardless where the plan originates. He observed: ''Despite high levels of spending on health care, research documents poor quality of care received by patients in the U.S. Studies show, for example, that adults receive recommended care for many illnesses only 55 percent of the time. Children fare even worse.''

The amount of money that flows into the health-care system appears in many cases to bear little relationship to the medical outcomes for patients. The nation outspends other industrialized countries in health care, but Americans are not significantly healthier — and do poorly on some measures — than their international counterparts. For instance, a report this summer comparing 19 industrialized nations by the Commonwealth Fund Commission on a High Performance Health System found the U.S. was last in deaths that could have been prevented with timely access to appropriate care.

Children generally fare worse than adults in the quality of care they receive, Baucus noted. A March of Dimes report last week offered some of the evidence, saying ''the United States is failing hundreds of thousands of its youngest citizens on the day they are born.'' It rated the nation, and Ohio, too, a D on the rates of premature births (births occurring before 37 weeks of gestation) and efforts to prevent them.

More than a half-million U.S. babies are born before term every year. Many face costly, life-threatening complications and risks of lifelong disabilities. A small percentage of annual live births, preterm births still illustrate the key issues at the core of efforts to reform a $2 trillion-a-year health-care system. It is possible to prevent many premature births, thus reducing the enormous cost of care. But it requires hooking up women of child-bearing age to a comprehensive and coordinated structure of basic care from the start. In the end, the mandate is to ensure that all Americans have a shot at reasonably good health over a lifetime.

Adiscussion about fixing the health-care system can quickly bog down in abstractions, the arguments focused on ''delivery systems,'' ''individual mandates,'' ''access'' and so on. Yet the health-care debate at its simplest is about how, as a nation, we ensure optimal health for citizens without going broke in the process.

Get the full article here.


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