U.S. Healthcare On Life Support: Resuscitating the Dying System

The United States is the only industrialized nation in the world that does not mandate quality health insurance for all its citizens. Forty-eight million Americans are uninsured, fifty-one million are on Medicaid, and at least sixteen million more are underinsured. More than one-third of the population of the United States is without adequate health insurance.

In addition, the United States has the costliest healthcare system of any nation by far, and much of the money is wasted on unnecessary bureaucratic paper chases. Healthcare costs will continue to rise because of expensive cutting-edge treatments and medications and because of a vast graying population of baby boomers. Meanwhile, infant mortality rates are higher in the U.S. than in most industrialized nations, access to care is declining, waits in emergency rooms are becoming longer, and insurance premiums are rising faster than the cost of living. Few, if any of us, believe our system is fair, affordable, compassionate to the indigent, worth the costs, or as safe as it should be.

All of this makes Stephen Weinberg’s U.S. Healthcare on Life Support one of the timeliest books of the decade. Weinberg, a practicing cardiologist for nearly three decades, realizes that in order for policy makers, legislators, and ordinary citizens to engage in productive debate and to fix the existing problems, they must first understand the healthcare system and its weaknesses completely. Too much of the time, debate takes place in a vacuum, without reference to facts and to actual underlying problems.

The purpose of U.S. Healthcare on Life Support is to provide the information that will facilitate informed and productive debate about the real issues. This is the only concise and comprehensive book discussing all the issues relevant to the healthcare crisis.

Dr. Weinberg adopts an objective approach, annotating all information where possible and providing real-life examples of issues confronting contemporary practitioners. The importance of these issues could hardly be greater. As Dr. Weinberg writes: If you lack a comprehensive understanding of the issues and do not take part in what should be a national discussion, you will lose the opportunity to express your desires as to how you want your healthcare system to function and how it will be financed. Your personal health, longevity, and quality of life are at stake, as well as your money. The system is on life support and is in danger of not surviving, and, if it fails, we will all pay the price.

U.S. Healthcare on Life Support is the tool Americans need to understand and then correct the problems afflicting our nation’s healthcare system. This major contribution to the national debate over healthcare will help focus the attention of citizens and legislators on realistic solutions.

Whereas other books about the healthcare crisis have addressed isolated aspects of the problem in a merely anecdotal manner, Stephen Weinberg’s U.S. Healthcare on Life Support offers a comprehensive but concise and thoroughly annotated analysis of the situation from the perspective of a medical professional. U.S. Healthcare on Life Support aims to educate readers—whether they be legislators or ordinary citizens—about the system and its discontents. Only by thoroughly understanding the problems, Weinberg argues, can one participate in a meaningful way in national debates that might lead to productive solutions.

A practicing cardiologist for nearly three decades, Weinberg has been “living” the healthcare problem for all that time and so is particularly well situated to explain it to others. He began this project with a simple desire to try to figure out, in mathematical terms, why our healthcare system is so costly compared to the systems of other industrialized nations—and why healthcare costs are growing faster than the general cost of living. Weinberg’s mathematical bent perhaps owes something to his background as an engineer; regardless, it serves the reader well, as Weinberg presents the facts and follows the money.

The bulk of U.S. Healthcare on Life Support offers a cogent and objective economic analysis that includes numerous instructive comparisons between U.S. healthcare expenditures and those of Canada and European nations. Weinberg focuses on such key issues as physician salaries, uncompensated medical services, de facto price controls, hospital costs and efficiency, and malpractice premiums, in each case identifying where problems in the current system lie, how much they are costing all of us, and which ones can most effectively be corrected. The analysis is sober (and sobering), leading inexorably to dire conclusions that should be cause for profound concern, as when Weinberg points out: “The poor reimbursement policies of this country are creating a very serious crisis wherein quality professionals are leaving healthcare and young men and women are not choosing to enter. We will all pay the price for this."

The diagnosis of the initial chapters is followed by a series of prescriptions in the final chapters. Weinberg’s sensible Golden Rule for reforming the system is: “The healthcare dollar should be sacred and should be used for providing care and nothing else!” Weinberg proposes many practical steps toward more sensible stewardship of healthcare dollars. Most notably, he advocates a single-payer system, which could save the U.S. about $1,400 per person and in excess of $400 billion annually in administrative costs alone. Weinberg rejects the label “socialized medicine” for this system, pointing out that it is no more “socialized” than Medicare is. He also believes a single-payer system can be implemented that avoids the negative aspects of the Canadian and United Kingdom systems.

Even more important than these specific proposals, however, is the analysis of the underlying problems, which provides a framework for productive debate about the issues. By knowing the facts and the actual problems, one can begin to formulate realistic solutions. Anyone who wants to be informed about the state of healthcare in twenty-first-century America needs to consult Dr. Weinberg’s U.S. Healthcare on Life Support. It should be mandatory reading for all our legislators and for all concerned citizens.

Stephen E. Weinberg, MD, FACC, is a board certified cardiologist with nearly thirty years of experience. He is a founding member of Cardiovascular Associates of the Delaware Valley and was Managing Partner for thirteen years. He has worked at Our Lady of Lourdes Medical Center, Kennedy Health System, and South Jersey Health System since 1978. Dr. Weinberg was also director of the Cardiac Diagnostic Center of Southern New Jersey and the Delaware Valley Heart Institute. In addition, he is Clinical Assistant Professor of Medicine at UMDNJ School of Osteopathic Medicine and