Prevalence and trends in obesity among US adults,

The U.S. health care system is troubled by the excessive expense of health care, and health care costs continue to rise. The increasingly high cost of health care is making health insurance more expensive and decreasing the number of Americans covered by insurance. Substantial portions of the insured eventually find themselves underinsured, and a disproportionate number of racial/ethnic minorities are socioeconomically disadvantaged and negatively affected by the high cost of health care. The extremely high cost of health care contributes to racial/ethnic health disparities and also creates a class of Americans in the majority middleclass who have disparate outcomes.

The excess health care costs in the U.S. do not translate into better outcomes. Overall, U.S. outcomes are not especially better than most other developed countries. Commonly accepted measures of outcome include the infant mortality rate and life expectancy. The U.S. has cancer mortality rates similar to those in Canada, Switzerland, and other western European countries. These are all countries where per capita health care costs are significantly lower than in the U.S.

The ACS is a vocal advocate for rational, high-quality, evidence-based use of medicine. We have a vibrant cancer control program that convenes panels of unbiased experts to assess clinical and epidemiologic data and write guidelines and recommendations concerning cancer prevention and screening. The ACS health promotions activity stresses public education about cancer prevention and patient education about quality treatment. Our advocacy group promotes transformation of the current health care system as well as support for cancer research, including research on payment reform.

It is only through stressing quality, efficient health care and having an open mind toward change that we can control costs and reach all Americans in need of health care. We should be concerned about the rational use of health care to prevent further rationing of health care.