Bush's health care initiatives will make America's system worse

EMBARGO: 00:01H (London time) Friday February 17, 2006. In North America the embargo lifts at 18:30H ET Thursday February 16, 2006.

The health initiatives mentioned in US President George W Bush's annual State of the Union address are likely to make America's health care system even more expensive and inequitable, states an Editorial in this week's issue of The Lancet.

America has the world's most expensive health care system. Costs continue to spiral, far outpacing inflation, and now consume 16% of US gross domestic product. The number of uninsured, most of whom are low-income workers and their families, continues to climb and is now estimated to be 45 million, roughly one in seven Americans. Therefore, it came as a surprise when Mr Bush dedicated only two short paragraphs of his speech to health care and did little more than tout three old initiatives, states the editorial. Bush promised to promote the use of electronic records and information technology, he asked Congress to change US medical malpractice laws to cap damages, and he again pushed health savings accounts (HSAs).

The Lancet comments: "None of these proposals comes near to the comprehensive reform needed to address the problems that beset the US health-care system. Increased use of electronic records and information technology, though needed, will take years to implement--and even then, they will not make a sizeable dent in health costs. Changes in medical malpractice laws are likely to reduce the often staggeringly high malpractice premiums paid by many US doctors, especially those in high-risk specialties such as obstetrics and neurosurgery, and may reduce some costs because of the practice of "defensive medicine", but alone will do little to reduce overall health spending. And HSAs are likely to make things worse."

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Contact: The Lancet press office T) 0207 424 4949/4249 pressoffice@lancet.com


Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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