Healthcare information portal

So: what is our excuse?

Yesterday, The Lancet published an article highlighting how Mexico is achieving its goal of universal healthcare coverage in 2012.  The article’s abstract notes:

“Evidence indicates that Seguro Popular is improving access to health services and reducing the prevalence of catastrophic and impoverishing health expenditures, especially for the poor. Recent studies also show improvement in effective coverage.”

For the record, Mexico’s GDP is $1.6 trillion–11% of the US GDP of $14.7 trillion.  In 2010, Mexico spent 6.2% of its GDP on healthcare costs, while the United states spent 17.2% of its GDP on healthcare.  Per capita, Mexico spent $916 per person on healthcare in 2010, compared to the $8,233 spend per capita in the US in 2010.  (data here)  In 2008, Mexico had a life expectancy at birth of 76 years, while the United States had a life expectancy of 78 years. (data here)   Despite an economy about 1/10 the size of the US, %GDP expenditures 1/3 of the US, and per capita expenditures approximately 1/10 that of the US, Mexico’s life expectancy is nearly equal to that of the US.  This is a striking imbalance between costs and results.

In 2002, some of the authors of the Lancet article wrote an article in Health Affairs that highlighted the difficulties faced by Mexico’s healthcare system of that time.  The article notes the fragmentation of care and the multiple parallel systems used to access and finance care (government-funded, private insurance, etc)–a situation analogous to that still present in the US.

From 2002 to 2010, Mexico’s per capita healthcare costs increased from $584 to $916 (data here); a 56% increase.  In that same time, US per capita expenses increased from $5,576 to $8,233 (a 48% increase).   Although these rates of increase are similar, the end result is very different: Mexico has attained universal healthcare coverage, while in the US we are still struggling to increase insurance to most (but not all) of our uninsured citizens…and which is far from certain as we approach our upcoming elections.  Mexico’s life expectancy increased five years (from 71 to 76) between 199-2008, while US life expetancy increased by 3 years (75 to 78) in the same period (data here), suggesting that Mexico’s increased spending had a greater impact than that of the US.

Our neighbor to the north has long had a healthcare system that outperforms ours.  Now, our less-developed neighbor to the south has found the political will and the funding to reform its healthcare system to ensure all its citizens will have access to healthcare services–and the early reports show better access to coverage and fewer catastrophic health expenditures.

So: what is our excuse for not doing better?  What is our excuse for allowing so many Americans to lack coverage, and to face bankrupting medical costs and limited access to care?  What is our excuse for continuing to place for-profit businesses and vested interests above the welfare of our fellow citizens?  What is our excuse for continuing to tolerate this dysfunctional, fragmented, overly-expensive system?