I’ll Take That in Small Bills, Please

So, I hear that this year’s U.S. health expenditures will total 2.2 trillion dollars. Um, yeah, trillion.As in nearly 20% of our own GDP. As in over $7,000 for every U.S. citizen. I remember reading somewhere that the U.S. spends more on Mother’s Day cards and gifts than the entire GDP of Chad--which came in at $6.5 billion in 2006--and probably more than a few other nations. In fact, 63 nations come in behind Chad, fully a third of all the countries ranked by the World Bank and the IMF. So, by comparison to that venerable institution of Mother’s Day, how does health care rank? Sad but true, Mom and apple pie do not hold a candle to health care. If our health expenditures were a country in their own right, they would tie with France for the sixth-largest GDP in the world. I don’t know about you, but somehow I don’t feel like I am getting that great a bang for that huge a buck.

Not to get too predictable, but let’s trot out a couple of stats. Among developed nations, the United States has the second-worst newborn mortality rate, bested (worsted?) only by that powerhouse Latvia, and in the good company of Poland, Hungary, Malta, and Slovakia. I don’t know about you, but I am just brimming with pride. On the other end of that scale, although Americans are living longer, we are not doing as well as 41 other nations. Something is not quite right when the richest, most powerful nation on earth cannot get a better ROI for its health care dollar.

There is no question that there is phenomenal care and technology available in this country. But something is mucked up in the delivery. According to a California 2004 study, 51% of each dollar goes to physician and hospital services, with 10% going to prescriptions, and a surprisingly small 7% to administration. So, why aren’t we healthier? And why do we have so many uninsured?

I don’t have the answers to those questions, but I do know that our experience here at TriNet demonstrates why it is better to have more people in the insurance pool. Our business model requires health care coverage, and there is no question that this sort of “universality” produces more stable rates, less benefit erosion, and far greater choices.