As one of the 50 million Americans presently without health insurance, I'm sitting here, fingers crossed, hoping I don't get sick.  So far, I've been lucky.  As I observe politicians debate about how to best water-down reform of the health care system while acting as if they're actually doing something, one thing has become crystal clear:  The US system of health care is insanely inefficient. . 

Spending on health care in the US accounts for over 16% of GDP and continues to rise.  Other advanced countries, like Japan and the UK, spend around 8%.  Yet, they manage to insure their entire populations while providing measurably better results. 

From birth (America ranked 24th out of 27 countries in infant mortality in 2005) to death (America ranked 24th out of 28 countries in life expectancy) Americans fare far worse than countries with government managed health systems.   In between, medical costs for Americans are a factor in over 60% of personal bankruptcies.  Medical errors kill upwards of 100,000 patients a year.

Is this "best health care system the world has ever known"?  Maybe in the world of the Senator who said that - Alabama Republican Richard Shelby -  and some of his colleagues, but not for the country as a whole.

If a study carried out by the McKinsey Institute is accurate, the system is monster of inefficiency that led them to conclude that "the United States spends $650 billion more on health care than might be expected given the country's wealth and the experience of comparable members of the (OECD)."

As put by health care economist Uwe Reinhardt, who referenced that same study in an op-ed in the Times:

One thing Americans do buy with this extra spending is an administrative overhead load that is huge by international standards...excess spending on administration would amount to about $120 billion in 2006 and about $150 billion in 2008. It would have been more than enough to finance universal health insurance this year.

When republican strategist Frank Luntz tells his benefactors to cry out in mock obstinance: "No Washington bureaucrat or healthcare lobbyist should stand between your family and your doctor"  he ignores the fact that the political class itself, by failing to reorganize the healthcare system, IS that "bureaucrat".  The only thing standing between 50 million uninsured Americans and a doctor is our weak-kneed government itself. 

Since government managed healthcare has been  hounded off the table as an entrée into socialism, the public option, if it's not compromised out of existence, is the only item still on the menu of market failure mitigation.  President Obama says it could force the insurance companies to trim the fat of their own bureaucracies and discipline the system into greater efficiency.  Maybe companies would then reconsider the value of the wild salaries paid to executives like Aetna's CEO Ron Williams who walked with $24 million dollars last year. I'm not sure what good Mr. Williams has done to deserve $92,000 a day for a year of five day work weeks, including vacations.