Paying top dollar for health care should rank us better than 37th

The great American health care reform debate is complex and mired in politics, but a couple of things are simple.

Even I can diagnose some of what's wrong with this patient.

First, there's the money we spend on health care. It's enough to give Lou Ferrigno a hernia. According to the World Health Organization, we spend the most per person on doctors and hospitals and yet are ranked 37th in the world in overall health system effectiveness.

Think about it: Spend the most, get the 37th best.

At this point, those who preach about the free market need to take a pill. (Of course, they'll pay more for that pill than in other countries. But I'll get to that.) The problem with the system can't be blamed on the nurses who make too much money or government regulators binding the hands of gifted problem-solvers. This is about profit and performance.

We spend the most and receive 1/37th bang for our buck. That needs to change.

While we're spending too much, it's necessary to mention that Americans spend more than citizens of any of the world's 30 largest economies do on their pharmaceuticals. Our corporate giants spend enormous sums on research and marketing ... and pass the savings on to a guy in Istanbul? In Guadalajara? In Perth?

This doesn't work for me. And yet our supposed representatives keep holding hands with the drug thugs, hospital cartels and insurance mobs year after year.

Of course, this doesn't mean it's all the fault of the corporate giants. We need look no further than our belt lines -- presuming we can locate them without a GPS unit -- to find a large contributing factor to the nation's health care crisis.

We're fat. And don't start trying to equate "fat" with "prosperous." That Orwellian double cheeseburgerspeak doesn't fly in a country that's not only the most obese in the top-30 world economies, but also is second only to strudel-clogged Germany in the number of coronary bypasses per capita. (I have conducted about 35 pounds of undercover research on this issue in recent years.)

Reader Mike Ault's response to the issue is typical of many attempting to wade through the political propaganda and focus on the issue.

"I am so torn on this one," the retired Metro cop writes. "On one hand, I hate to see the government get their wrong heads and ham hands into another program. No good program idea goes unpunished. ...

"On the other hand, as you so well know, long-term, life-or-death health care is stupidly expensive. ... A friend of mine has been an in-patient at Stanford Medical Center for the last 34 days undergoing cancer surgeries, and the complications that go with that. I can't even imagine what he will be spending for this life saving treatment.

"I think the only problem that most of us in the middle have is that we just have a hard time trusting the crooks and cheats and all the inside the beltway types."

But, he would agree, that's no reason to do nothing.

Reasonable people on both sides pray for relief, if not reform, but fear the great American health care machine will emerge from the congressional debate even larger and more hopelessly jumbled.

Although they approach the problem from opposite sides of the political aisle, and appear to have substantially different worldviews on the subject, Senate Majority Leader Harry Reid and Sen. John Ensign seem to appreciate that time is of the essence.

If Congress misses this opportunity for meaningful change, it won't come again soon.

While Ensign this week announced more than two-dozen changes to a working health care reform proposal, some resembling grist for future re-election mailers, Reid expressed hope a bill would reach the Senate floor in the next week.

Whether Ensign sees his suggestions taken seriously or Reid stands at the center of the debate at the end of the day, one thing is certain:

If Nevada's two senators somehow manage to fumble away meaningful health care reform, we should chase them out of office and into the Witness Protection Program.

I'll admit that diagnosing the disease is one thing and saving the patient is quite another, but failing to take substantive action in a time of crisis is unforgivable.

John L. Smith's column appears Sunday, Tuesday, Wednesday and Friday. E-mail him at Smith@reviewjournal.com or call (702) 383-0295. He also blogs at lvrj.com/blogs/smith.