Let's Talk Health Care, Shall We?

It turns out that Dr. Julie Gerberding (pictured) of the Centers for Disease Control wrote a Letter to the Editor of the Murdoch Street Journal today, telling us, among other things, that…

Right now, 75% of our current health expenditures target treatment for preventable conditions caused by tobacco use, poor diet and inactivity, alcohol and drug use, motor-vehicle crashes, firearms and other risks. It's time to broaden our conversation about reform to include the entire health system.

I actually agree with a good bit of that (always more we can do when it comes to prevention), and I think, to further “broaden our conversation,” we should ask Dr. Gerberding why top officials at the Centers for Disease Control and Prevention received premium bonuses in recent years at the expense of scientists and others who perform much of the agency's scientific work (here).

And let’s also “broaden our conversation” to ask Gerberding why she refused to extend the six-year term of Dr. John Howard, in charge of the National Institute for Occupational Safety and Health under Gerberding’s CDC, for 192 more days, particularly when Dr. Howard was so widely respected (apparently rankling Gerberding and HHS Secretary Mike Leavitt because Howard advocated for those EMT workers at Ground Zero - here).

And I think this is more information we can use to “broaden our conversation,” in particular…

When the United States is compared with other industrialized countries on major markers of health, we rank 31st in life expectancy and 36th in infant mortality. These statistics are all the more disturbing given that we score first in healthcare expenditure. According to the Commonwealth Fund National Scorecard on US Health System Performance for 2005-2006,[1] the US healthcare expenditures as a percentage of gross domestic product (GDP) are nearly double those of other countries. So what do we get for all of this money?

• The United States ranks last among 6 industrialized nations for the highest percentage of adults who went to the emergency department in the past 2 years for conditions that could have been treated by a primary care physician;

• The United States ranks 16th out of 19 industrialized countries for mortality before age 75 that is potentially preventable with timely and appropriate medical care; and

• The United States has the highest percentage of national healthcare expenditures spent on health administration and insurance among 11 major countries, including: the United Kingdom, France, Canada, Germany, and Australia.

(I realize some of this may fall outside Dr. Gerberding's purview, but it should still be noted - also, registration is required for the medscape link...sorry.)

Fortunately, I’m quite sure that incoming HHS Secretary (pending confirmation) Tom Daschle is quite aware of these matters (and why Dr. Gerberding didn’t resign out of principle given this episode is something that utterly baffles me).