On Oct. 21, The American Constitutional Society at the Levin College of Law sponsored a panel discussion exploring the current state of the United States’ healthcare system and posing the question of why it matters, cleverly titled “How’s your Health? Care?”

The panel included Dr. Robert Hatch, associate professor and director of medical education at the University of Florida College of Medicine; Dr. Nancy Hardt, professor with the Department of Pathology, Immunology, and Laboratory Medicine and the Department of Obstetrics and Gynecology and senior associate dean for External Affairs at the University of Florida College of Medicine; John Reiss, associate professor at the Department of Epidemiology and Health Policy Research and Department of Pediatrics and associate professor with the Institute for Child Health Policy at the University of Florida; and Dr. Mona Al-Amin, assistant professor at the College of Public Health and Health Professions at the University of Florida.

Hatch began the discussion by outlining the problems he sees with the current United States healthcare system. Hatch cited upward-spiraling healthcare costs as his greatest concern.

“We’re way out of line with other industrialized countries,” Hatch remarked, adding that, in the United States, costs are higher and outcomes are worse.

Hatch introduced data concerning maternal and infant mortality in the United States versus other industrialized countries as potential benchmarks for healthcare quality. Using 2007 data collected by the Organisation for Economic Co-Operation and Development, he reported that maternal mortality in the United States is 12.1 maternal deaths per 100,000 live births, nearly twice the rate of Canadian and French maternal mortality. The United States’ infant mortality rate is 6.8 per every 1,000 live births, versus Canada’s 6.3 and Australia’s five, Hatch added.

The source of this discrepancy, Hatch explained, is administrative inefficiency and the fact that the United States has 47 million people without health insurance.

Hatch explained that the distribution of healthcare services falls disproportionately upon the wealthy and those with insurance since healthcare providers can be assured of receiving ample compensation for those services. According to Hatch, Americans living in poverty-stricken neighborhoods suffer higher mortality and lower recovery rates because they are more likely to live farther from hospitals and cannot afford necessary services.

“Our system forces us to target resources on those with good insurance, not [on] those with the greatest need,” Hatch said, adding that “a system where everybody has health insurance helps get distribution of resources in the right places.”

For her portion of the discussion, Hardt explained the legislative complications that arise when trying to establish new healthcare policy.

Having once worked as a healthcare policy advisor to House Speaker Nancy Pelosi, Hardt is well-versed in the subject of legislation.

The need for the legislature to fulfill their “internal process,” Hardt said, is one reason why legislators may now be “covering their ears” to citizens’ concerns and urges for quick change.

“The process was designed by our founders to be really cumbersome and really slow like this in order to keep us from making hasty decisions,” she said.

According to Hardt, the commonalities among all of the healthcare policy proposals include increased regulation of private insurance markets, cost containment, requirement for each citizen to carry some form of health care coverage, and a greater focus on health promotion and disease prevention. Differences include the mechanisms to put these changes into effect, and how to pay for the plan.

Dr. Al-Amin proposed one possible solution to the question of funding. She explained that not-for-profit hospitals are engaging in profit-seeking behavior without penalty, and thereby furthering the discrepancy between the healthcare available to the wealthy and to the impoverished. According to Al-Amin, the government could be receiving billions of dollars in revenue from these hospitals, but instead imposes no taxes on them since they are deemed not-for-profit.

Professor Reiss echoed the other panelists’ concerns regarding increasing administrative costs and the need for shifting the focus of healthcare onto primary and preventative care, but also questioned the reasons behind the fierceness of the healthcare debate. He noted that an attitude of “all for one, none for all” prevalent in American notions of social justice impacts policymaking and impedes change.

“The money is one thing and the legislative process is another, but the values that we have as a society really is the foundation of those differences,” Reiss said.