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The following is presented as part of The Columbian’s Opinion content, which offers a point of view in order to provoke thought and debate of civic issues. Opinions represent the viewpoint of the author. Unsigned editorials represent the consensus opinion of The Columbian’s editorial board, which operates independently of the news department.
News / Opinion / Editorials

In Our View: U.S. health care system requires checkup

The Columbian
Published: October 25, 2023, 6:03am

Recent strikes by workers highlight the problems with American health care.

The United States spends the most money on care but routinely is assessed to have mediocre results. As Harvard Medical School reported in 2021: “Despite spending far more on health care than other high-income nations, the U.S. scores poorly on many key health measures, including life expectancy, preventable hospital admissions, suicide, and maternal mortality. And for all that expense, satisfaction with the current health care system is relatively low in the U.S.”

Specifically, a study from Kaiser Family Foundation determined that Americans spent an average of $12,914 on health care in 2021. The next-highest expenditures were in Germany, with an average of $7,383. Meanwhile, the World Bank Group ranks the United States at No. 59 in terms of expected life expectancy.

Recent strikes in Clark County at Kaiser facilities and, now, PeaceHealth Southwest Medical Center, will not alter those underlying facts. But they add another layer to the issues facing health care in this nation.

This week, some technicians and therapists at PeaceHealth launched what is planned to be a five-day work stoppage. That followed a three-day strike by some workers this month at Kaiser outlets, including in Clark County. Unions representing 75,000 Kaiser workers in multiple states — amounting to the largest health care strike in U.S. history — since have reached a contract agreement with employers.

While short-lived strikes inconvenienced patients and added to tension between workers and employers, they were merely a symptom of the diseases infecting American health care. Those symptoms are most acute in rural areas, where the cost-benefit analysis by providers is quickly leading to a reduction in services.

According to the Center for Health Services Research at the University of North Carolina, 195 rural hospitals have shut down since 2005 in the United States. As U.S. News & World Report surmises: “More than 60 million Americans live in rural areas, and they are generally older and more likely to be in poorer health compared with people living in more urban areas. Rural residents can face less access to health care services and have to travel greater distances to receive care when a facility closes. Prior research indicates a potential relationship between traveling farther to receive health care and poorer health outcomes.”

The Affordable Care Act, passed in 2010 and colloquially known as Obamacare, was designed to mitigate many of the problems with America’s health care system. It has been successful in some regards while exacerbating other issues.

Since the legislation went into effect, the number of uninsured Americans has fallen from approximately 17 percent to 12.2 percent. The availability of insurance helps to bolster preventive care and early intervention, which reduces long-term costs. But the rise in costs has continued to outpace inflation, adding to pressures on the system.

Meanwhile, the COVID pandemic added to workplace stress. Kaiser officials said: “Every health care provider in the nation has been facing staffing shortages and fighting burnout. During the Great Resignation in 2021-22, more than 5 million people left their health care jobs across the country.”

The issues are complex, and the biggest problem is that they show no signs of abating. Congress, care providers and insurance companies must work together to reduce costs and improve outcomes in a system that is at a critical juncture.