Sunday, February 17, 2013

Mapping Healthcare (Part 1)

Having become employed by Pfister Waggen (an industrial scale maker) I was inducted into the German national healthcare system.  Early after starting my job, a physical was required in order to establish a health baseline.  Stripped to my underwear, I stood in a long line of men slowly plodding from station to station having my blood pressure taken, my ears examined, my body prodded and poked.  While the experience was dehumanizing, it seemed to me the very symbol of notorious German efficiency applied to universal healthcare.  It was a very similar to the process used by the U.S. Army on new recruits.

Efficient and dehumanizing medical exam.
In America today, my lovely lady has several health issues requiring her to see many different and expensive specialists.  Hours are spent waiting in rooms, moving from one clinic to the next at great cost.  The doctors are kind, helpful and the experience is as pleasant as it can be.

There appears however, to be much time and resources dedicated to the infrastructure of care rather on than on the care itself.  Each professional specializing in one narrow area with staff and resources duplicated in many places.  Each office has separate records and billing to support their independent, decentralized infrastructures.  The inefficiency of the system stands in stark contrast to that of the German experience I had.  It is humane but wasteful.

In these two posts are the results of my exploration of public data about what is going on in the United States with healthcare.  I wanted to know how states compare with cost, access, and need for healthcare. Note you can click on map captions to see the source of my data.

Health Insurance Rates
Who is Insured?

About 1 in 6 United States citizens have no health insurance.  This represents about 54 million people who rely upon charity for accident, disease and routine care.

The rate of non-coverage is growing at  about 1% a year, meaning that over 3 million people a year lose their insurance and are at greater risk.

The elderly and the rich are are actually gradually improving their access to health insurance, while the  poor and women are losing their access.  This is happening despite the Affordable Care Act (Obama-care) allowing 18-25 year-olds to remain on their parents insurance plans.

Costs are Rising

The current trend in healthcare expenses is not sustainable. Costs of healthcare are increasing much faster than the number of people requiring healthcare.  These costs are robbing the United States of our ability to compete globally by diverting money from savings, investment, retirement, and diverting more and more of our labor pool.

Access to healthcare
Sickness Sucks

No one wants to die.  No one wants to be sick.  Given enough resources, we would all do what ever it takes to help ourselves live as long as we can.  We also want to stay as healthy as we can.

This implies that demand for health will remain high, no matter the level of the supply.  When supply and demand do not find a balance, markets fail.

Government or Private?

Since healthcare demand may always be greater than healthcare supply, using a purely market solution to find a balance is probably not practical. Some kind of intervention to keep the market in balance seems prudent.

A pure government solution has an associated bureaucracy.  Bureaucracies tends to grow when civil servants are not tied directly to economic outcomes.

Neither an all government or all private system will find balance and get the greatest bang for our buck with healthcare.

Conservative Identification 
Conservative Identification

Our uninsured are concentrated in the southern states and sparsely populated mountain states.  While not universally true, self identified politically conservative states are more apt to have people without health insurance.

This map displays the "conservative advantage," defined as the percentage conservative minus the percentage liberal in each state.  When compared with the other maps here, it generally appears that conservative states have more need for healthcare and less of it available.

Here is a good overview of the differences between conservative versus liberal views on healthcare.  In simple, over-generalized terms, conservatives view self-responsibility to be the driver for whom should get healthcare, while liberals tend to view healthcare as a social safety net to be provided to all in need.

In the next post here, I will investigate some of the demand issues with the U.S. healthcare system at a state level.

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