I recently had the opportunity to critique the 2010 Affordable Care Act (ACA) [
]. I documented that the 3 pillars of health care delivery—quality, cost, and access—were
flawed in the old health care model. Unfortunately, the ACA does not adequately address
these 3 issues. I also pointed out that cost is the number one problem, not quality.
Cost is negatively affected by the bureaucracy of our health care system because of
waste, fraud, and loss of value. The cost of the medical bureaucracy is staggering.
In the United States, it is $1059 per capita per year. In contrast, in Canada it is
$307. In the US health care system, administrative workers account for 27.3% of total
health care costs. In Canada this figure is 3.1%. If the United States had a single-payer
system, this would save $375 billion a year in health care costs according to a 2003
article in the New England Journal of Medicine [
[2]
]. The authors of this study estimated there are 1 million workers (specifically middlemen)
who are doing unneeded work.To read this article in full you will need to make a payment
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© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
