What’s missing in debate?

Friday, Aug. 21, 2009 | 2:09 a.m.

From loud town-hall meetings to sober debates in Congress, people this summer have argued over proposed changes in the country’s medical system. Most of the discussion has centered on insurance plans and covering those who cannot afford them.

What is largely missing from the debate is serious discussion about the quality of care. For example, the American medical care system is often touted as the best in the world, yet our country doesn’t come close to being the healthiest in the world. The Sacramento Bee recently reported that nearly every other industrialized country is ahead of America in health. For example, the United States trails other countries on such health indicators as life expectancy and infant and maternal death rates.

For the trillions of dollars we, as Americans, spend each year on health care, we don’t seem to be getting our money’s worth.

For example, a 2006 study found that rich white Americans, who don’t have a problem getting medical care, were more likely to have diabetes, high blood pressure, heart disease and cancer than their counterparts in England.

So much for the belief that you get what you pay for. Americans should be concerned that the country’s health system doesn’t get better results.

Experts say Americans contribute to their own demise through poor diets and a lack of exercise. But there is also the issue of seeking routine treatment and screenings from a primary care physician — ideas that are part of President Barack Obama’s health care plan.

“Even in the United States, in locations with a higher concentration of primary care providers, people have somewhat better outcomes and also lower costs,” said Dr. James Kahn, a professor at the University of California, San Francisco.

The bottom line is that the country has strayed from what should be the main focus of the health care debate. Instead of worrying about the intricacies of insurance, people should be focused on doing what it takes to improve the nation’s health.