Another wake up call report, this time from the Urban Institute. How many of these reports do we need before we, the American people wake up to the reality that we have the most expensive health care system in the world, but not the best? The take home message from this new study could not be any clearer. The entire report is available here.

While the evidence base is incomplete and suffers from other limitations, it does not provide support for the oft-repeated claim that the “U.S.health care is the best in the world.” In fact, there is no hard evidence that identifies particular areas in which U.S. health care quality is truly exceptional.

… Many Americans would be surprised by the findings from studies showing that U.S.health care is not clearly superior to that received by Canadians, and that in some respects Canadian care has been shown to be of higher quality.

We Americans are indeed best at something. We’re the most expensive. Hats off to us, even when it comes to the health of the nation, we rely on the free market, and unfettered capitalism.

But we know the truth. We know conclusively that our health care system isn’t the best in the world, only the most expensive. The statistics don’t lie.

In 2008 health care spending in the U.S. was $2.4 trillion and is projected to reach $4.3 trillion by 2012. Yet we are far from the top (not even in the top 25) countries in terms of overall life expectancy or in preventing infant mortality.

So what’s meant by “best?” Most profitable, perhaps?

Insurance companies have spent millions of dollars promoting what they laughingingly call, “bipartisan reform”, but in reality, they’re doing their level best to kill the “public option.” Why are they so intent on requiring all Americans to buy private insurance? Simply to bring more customers into the pay or die U.S. healthcare system? Do you imagine for a second that they care about your health?

Let’s ask Gary Diego whether he thinks in a medical crisis, the insurance company is there for us. Gary made a terrible error, and he’s close to bankruptcy because of it. As his wife lay dying before his eyes, he was supposed to find out whether the nearest hospital was in or out of network! Think you’re insured, think again!

On the evening of March 1, 2008, Gary Diego was relaxing with his wife, Ellen, when she abruptly lost her hearing, began repeating herself, and seemed to be losing her grip.

Alarmed, Diego rushed her to his insurance company’s in-network hospital, near his home in Truckee, Calif. Unable to handle what was determined to be bleeding in the brain, the hospital quickly transferred her to Renown Regional Medical Center in Reno, Nev., where she spent 17 days in intensive care. While recovering, she caught pneumonia and died.

A few weeks later, a still-grieving Diego learned from his insurer, Health Net, that he owed the Reno hospital $75,462.77. The reason? The hospital was not in his approved network.

… As Diego’s bills continued to arrive, he discovered that he also owed money to out-of-network doctors and testing laboratories for services not covered by insurance. “It’s amazing how many individual doctors and test labs are involved,” he said.

All of this was on top of a $14,000 deductible he had chosen to keep his premiums down.

Yesterday it was Gary Diego, tomorrow it’s you or me.

Insurance companies are making record profits. The average employee contribution to his premium has increased 120 percent since 1999 and the benefits have decreased. Because of the frightful unreimbursed out-of-pocket costs, otherwise know as, leaving the American people holding the bag, medical bankuptcies are at an all time high.

Over sixty percent of all bankruptcies are at least in part the result of medical expenses that regular Americans, many of whom thought they were well insured, can’t pay.

Always remember, when you’re facing huge medical bills, after dutifully paying premiums year-after-year, that for-profit insurance companies are massive denial machines—they are in business to maintain profit and they accomplish this by denying care and not paying claims.