The United States is undeniably wealthy — so why can’t we just use that wealth to cover the uninsured? Medical Editor Dr. Tim Johnson blogs: The United States is an undeniably wealthy country — so why can’t the US just spend more to cover the uninsured? It isn’t quite that simple. Given that employers obviously don’t want to spend the money to cover America’s uninsured, and many people can’t afford to cover themselves, the question becomes: whose money and what money are we going to spend? Many experts say what we really need to do is not spend more money but use the money we already spend in smarter fashion. Here is a statistic that blows my mind: in 2004, the latest year for this comparison, we Americans spent about $6,100 per person on health care; the average per capita cost in other industrialized countries was about $2,500. In other words we spend more than twice as much, but — here is the kicker — we don’t do any better in terms of health outcomes (longevity, infant mortality, etc.) and in many cases we do worse. So, the United States is spending a lot of money badly — on unnecessary treatment, administrative waste, and actual fraud, for example. If we could reform our health care and spend money more wisely, we could probably cover everybody without spending any more total money — just use it differently. But what does it mean to spend money more wisely? That means all kinds of possibilities. First, we need to make sure we spend money on what is medically necessary and what is proven to work rather than what patients and doctors want simply because it is the latest or the most advertised treatment, or what will make the hospital the most profit. Second, we need to reduce administrative costs by replacing the very cumbersome paperwork in our current health care with computerized records. Not only will computerized records save money in the long run, but it will go a long way in avoiding unnecessary testing, treatment errors and medication mistakes. And third, using this same computer system, we need to monitor both costs and quality of treatment to make sure patients are getting what they need in terms of both timely prevention and timely follow-up. These records can automatically tell us when kids need immunization — and when diabetics need medication changes. Currently, though, our current health care is fragmented and scattered; most hospital doctors’ patients don’t have computerized records. So how can we make this happen? That question hits on the heart of the matter. There are a lot of things that our health care system needs before things can get better. We need to have better and larger systems of health care that can bargain better with drug companies on our behalf, monitor our doctors for quality, and make sure we get WHAT we need WHEN we need it. And we are slowly starting to move in that direction. For example, there are large private health plans — like Kaiser Permanente — that have computer systems in place to do all this. And the government run Veterans Administration hospital system is doing the same thing — providing much better and safer care and at a significantly lower cost than most of the private sector — about $5,000 per person versus $6,500 per person. So we come back to the question of HOW we spend our health care dollars; if we have the political will, and the public demand, we can change health care so it can become better for the patient — and better for our national pocketbook. Check out ABC News’ week-long series Prescription for Change here.