Year after year, the health-care debate centers on universal coverage.

It's a laudable goal. But all too often, the single-minded focus on this objective is a distraction from achieving what most Americans really want: inexpensive, easy-to-use health insurance. As currently structured, the American system is ill-equipped to provide this.

The solution to this problem is not a government-run health-care bureaucracy. Rather, it's a private insurance system dedicated to more than just treating the sickest among us. Right now, we have a sick-care system. What we need is a health-care system.

To understand what this means, look at one of the major causes of the soaring cost of medical care: preventable chronic diseases. Obesity is one such chronic condition. In the past quarter-century, the number of obese Americans has roughly doubled. On top of that, the incidence of related conditions such as diabetes is rising.

Chronic illnesses such as these, which require constant care over a lengthy time frame, were responsible for 75 percent of American health-care spending in 2006. If we are serious about expanding health coverage, we must work to prevent chronic diseases before they emerge.

What can we do to better fight chronic conditions?

For starters, health-insurance plans must be simplified so that patients know what they're paying for. With most kinds of insurance, such as automobile insurance, consumers understand the financial consequences of potentially destructive behavior such as reckless driving.

With health insurance, on the other hand, consumers are less aware of the costs of their behavior. By typically relying on their insurance companies to resolve the details of their medical bills, patients have little insight into the payment process and thus have little incentive to avoid costly hospital visits.

If patients knew how much their unhealthy decisions were costing them, they'd be a lot more vigilant in safeguarding their health.

We could also benefit from a revolution in the way that medical information is stored and accessed by health-care professionals. In most doctors' offices, medical records are still kept in file rooms filled with stacks of tattered folders containing handwritten forms.

Thanks to this antiquated method of medical record-keeping, information is often lost, unnecessary medical tests are ordered, and patients can be misdiagnosed. Aside from driving up health-care spending, errors such as these make it difficult for patients to get the care they need when they need it.

Mistakes and wasteful spending can be avoided by digitizing health records in a national computer database. Such a database would allow doctors to access reliable medical information quickly, even for new patients, and facilitate accurate diagnoses.

According to a recent study published in the medical journal Health Affairs, such a database could save the U.S. health sector $80 billion a year. The relevant technology has existed for years. All that's needed to implement it is the political will.

Finally, we should work to make sure that health insurance is within the reach of all Americans. Expanding coverage doesn't require a government takeover of the health sector. Instead, we can do so through tax credits, vouchers, and subsidies.

Small businesses who can't afford to cover their employees should receive tax credits to make it easier for them to do so. Similarly, families who can't afford coverage should be eligible for government subsidies so that they can purchase insurance policies that suit their needs. It's certainly cheaper to help people seek low-cost, preventative care than it is to treat chronic illnesses that develop down the road.

With these common-sense reforms, we can remove waste from America's health-care sector and make it easier, less expensive, and more attractive for individuals to live healthier lives.

Gary Applebaum, M.D., is a senior fellow at the Center for Medicine in the Public Interest. He is the former executive vice president and chief medical officer of Erickson Retirement Communities.

Comments (2)

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written by Rich, November 13, 2008

Dr. Applebaum has said it all - he is right on target. We need to get Barak in touch with him!!!

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written by steven montross, November 14, 2008

Here's my prediction. We are in a "healthcare bubble" that will probably pop within the next two years along with the economy. You can socialize the hell out of it but will likely be as "successful" as the bank bailout. Call me a tinfoiler but I seriously don't think obesity is going to be a problem in the future except maybe from inactivity.

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