05/24/2008 05:12 am ET | Updated May 25, 2011

Solving America's Healthcare Crisis, One State at a Time

I was sitting in my daughter's orientation for a year overseas with the AFS Program listening to this over-protective mother keep babbling on about how her daughter hadn't been assigned to a program yet, didn't have a visa, blah blah blah. When she started to fret about what would happen if she got in an accident overseas and needed healthcare I just had to but-in.

Me: "She'll probably get a lot better healthcare overseas than she would get in the US. And I'm a physician."

[And also a blogger who wrote about his experiences getting stitched up for free by a foxy Danish doctor ("Our Healthcare System Sucks")]

Unknown Woman: "But what if they don't take her health insurance in that country?"

Me: "You don't need health insurance in countries that have a national health care system."

Outside I ran into a guy who had heard my comments.

Guy: "So is this just a bunch of propaganda about how you have to wait longer for healthcare in Canada?"

Me: "It's not true that you have to wait for treatment life-threatening conditions. But you might have to wait for an MRI while you could just walk in to any place in the US and get one right away if you could pay for it or you had the right insurance. The US has over-built imaging centers and same day surgery or procedure centers (like cardiac catheterization labs) in order to pump up their profits. A lot of this imaging and procedures is not useful."

Guy: "My doctor ordered an X-ray for my back because I had low back pain. When I went to the imaging center they wanted to do a CT scan. I had to argue with them about it to do an X-ray as the doctor had requested instead of a CT scan."

Me: "It just goes to show you that when they have the expensive machines they feel that they need to use them to pay for them."

The fact is that the US healthcare system is enormously wasteful and inefficient, and is gobbling up more and more of the gross national product. Almost 16% of our GDP is spent on healthcare, versus 11% for France and 8% for Britain. As the costs of healthcare keep going up, they threaten to drown small business owners and swamp our economy as a whole; and often the expenses are for tests or procedures that aren't needed. Insurance companies, drug companies, hospitals and doctors organizations, together with their allies in government, are force feeding the American public with propaganda about our healthcare system being the best in the world, or how people are dying while waiting for their MRI in Canada.

The fact is that the data shows that people from foreign countries aren't more unhappy with their health care, 37% of Americans skip medications or recommended care because of cost -- rates well above those in any other country. In some cases, self-employed people who forgo health insurance because it is prohibitively expensive for this group of people are dying because of a lack of proper care. This is in spite of the fact that the US as a whole spends twice as much on healthcare as any other country in the world. And the price keeps going up and up.

Americans also reported the highest rate of medical errors, with one third of patients with chronic medical conditions reporting a medical, medication or lab test error in the past year.

As pointed out in a recent editorial in the New England Journal of Medicine, healthcare doesn't really respond to the supply and demand aspects of the typical marketplace, where more competition makes better "products." When you try to apply that logic to healthcare things get incredibly expensive real fast. And wasteful. And it pisses everyone off, because the "perverse incentives" of the healthcare system means that doctors can't spend time with patients, patients get tests and procedures they don't need, and everyone gets frustrated with the byzantine system of multiple insurers, that blocks efficiencies such as electronic charting and uniform billing. Competition and the private marketplace is not the best approach for healthcare. You just think it is because you've been listening to a bunch of fruit-loops like Rush Limbaugh and Neil Boortz. Turn off your radio.

The fact is that our healthcare system is broken and needs to be rebuilt from the ground up. (An opinion shared by 34% of Americans.) More Americans feel that their healthcare system is broken and needs to be completely redone than any other industrialized country.

This morning I was lying in bed listening to the radio when I got the answer. You see the Governor of the State of Georgia, Sonny Perdue, signed a bill into law that allows you to go into restaurants or parks packing a hidden gun. He also signed a bill that allowed the auto insurance industry to raise insurance premiums whenever they want. That is when it hit me: Why don't they just extend the rules to places where you can carry a concealed gun to the legislature building, so that disgruntled patients can brandish their weapons whenever corrupt politicians or their lobbyist friends want to pass legislation that will pass us further into the sinkhole of the collapsing American healthcare system?

What a lovely thought.

Rebuilding America's healthcare system. From the ground up. One state at a time. And what better state to start with than Georgia?

Doug Bremner MD is author of Before You Take That Pill: Why The Drug Industry May Be Bad For Your Health