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Sunday, June 16, 2013

What Americans don't know about health care


There is a terrific article today in The New York Times about health care in America--and Sweden.  I contend that virtually all Americans should read it--with an open mind--and so few will.


Just a small bit from the article:

The United States spends more than $8,000 a person per year on health care, well more than twice what Sweden spends. Yet health outcomes are far better in Sweden along virtually every dimension. Its infant mortality rate, for example, was recently less than half that of the United States. And males aged 15 to 60 are almost twice as likely to die in any given year in the United States than in Sweden.

Not that Americans are about to learn anything--anything--from Sweden or anyone else (heck, learning alone is a problem for us) but it would be nice if we could read or study these other country's situations--gasp--and, as I said, learn something.

Just a few comparisons:

Doctors in the two countries also face different financial incentives. In the United States, under the fee-for-service model, they can bolster their incomes, often substantially, by prescribing additional tests and procedures. Most Swedish doctors, as salaried employees, have no comparable incentive.
Another important difference is that, unlike many American health insurance providers, the government groups that manage Swedish health care are nonprofit entities. Because their charge is to provide quality care for all citizens, they don’t face the same incentive to withhold care that for-profit organizations do...
      
The Swedes also provide drugs and other treatments only when evidence establishes their effectiveness. People can spend privately on unproven treatments, but the government refuses to impose their cost on taxpayers.

Clearly, the Swedish health care model is far more humane and moral than our profit-based one.

There was an excellent program on PBS a few years ago that did just that, too--compared other country's health care systems, one to another to ours:


This one, here, above, compared our system to the Netherlands, which is highly successful both in keeping costs down and in getting good outcomes from the health care paid for.

And then these two, from 2009 and 2012, again on PBS, comparing our costs which, by the way, are and have been the highest in the world for decades now:

 

Here's just one very indicative chart from this article:

 
And then there's this tidbit, from that same article:

Life expectancy at birth increased by almost nine years between 1960 and 2010, but that's less than the increase of over 15 years in Japan and over 11 years on average in OECD countries. The average American now lives 78.7 years in 2010, more than one year below the average of 79.8 years.

Another fact:

When we look across a broad range of hospital services (both medical and surgical), the average price in the United States is 85 percent higher than the average in other OECD countries.

If anyone in this country thinks we don't or didn't need the Affordable Care Act--aka "Obamacare"--when we spend grossly more than any other nation on the planet for that care and our results are worse than any the other, top 17 industrialized nation, they are badly and sadly mistaken.
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More PBS links on health care (in case anyone out there actually does want to learn about us and our health care system:

Toyota-inspired approach to improving care and bringing down costs.

What steps can you take to make your next hospital stay safer and cheaper?

They illustrate what the U.S. could buy with the $750 billion wasted in American health care each year, and, in a separate post, our partners at Kaiser Health News examine the "Top 7 Drivers of U.S. Health Care Costs."

In a "Reporter's Notebook," Betty Ann Bowser examines Virginia Mason's decision to eliminate a staple of the American hospital: the waiting room.

What inefficiencies have you seen in the U.S. health care system?

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