Healthcare and Health in the US and beyond

Just a little perspective from someone intimately involved
in the US
healthcare industry.





Americans, in large part, believe they have the best healthcare system in the world. This is a myth propagated through the culture and reinforced almost daily by elected officials and healthcare bureaucrats at all levels. Let’s look at a few facts. According to the World Health Organization (WHO) the U.S. healthcare system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance. Most European nations rank in the top 20 with France
ranking first. This ranking is based on five performance criteria which include 1). overall level of population health, 2). health disparities within the population, 3).overall level of health system responsiveness, 4). distribution of responsiveness within the population and 5). distribution of the health system's financial burden within the population. If one accepts this ranking as somewhat accurate, it is particularly troubling in light of criteria 5. Individual healthcare costs for a typical American earning $100K a year is $20,000 or more annually!! While an employer picks up part of this individual burden, this typical American “spends” over $13,000 a year in insurance premiums and copays and $3500 into Medicare. Furthermore, this typical American pays up to $15,000 a year in federal income tax, of which over 20% goes to fund Medicaid (different from Medicare!), the federal Children’s Health Insurance Program (CHIP) and other health-based initiatives.

So what has all this money bought us? We are, by both US-based diagnostic criteria (we are snobs about these) and traditional medical measures the sickness nation in the world. While our mortality rates from infection and malnutrition are among the lowest in the world (but not better than Europe’s!), our mortality and morbidity rates for psychiatric, neurologic, cardiovascular disease, diabetes, cancer, etc. are among the highest.

While the US healthcare system may in fact be “better” than the WHO ranking, the health of US citizens is not. This, of course, is
the result of factors beyond the WHO criteria or the healthcare costs I have outlined above – factors such as the American lifestyle (a topic for another day). My point here today is that while Americans may make bold claims about the quality of their healthcare, they must realize they are paying more than twice as much for it as the best healthcare systems in the world. Furthermore, while
Americans may believe they have both quality and quantity in healthcare services, their health will never improve unless they invest in changing their lifestyles.

After writing and reading my post above, I had a smoke, big mac, fries and a large coke

Some 47 million U.S. residents have no health insurance, and the numbers keep growing.8.7 million are children.Employers are responding to growing cost pressures by shifting more and more health care costs onto workers, especially through larger co-pays and deductibles that must be paid at the time treatment is sought. The lack of quality health care in the United States also stems from their system’s lack of comprehensive quality measure and assurance programs, which unions now are establishing with community partners.Us health care system lacks safety controls that endanger front-line workers and patients. Staffing levels are dangerously low in hospitals, nursing homes and other health care facilities. As a result, medical errors are rising—and account for an estimated 44,000 to 98,000 needless death each year.
How can be fixed the american health care ?
Answer : Require employers to pay their fair share. The U.S. system of providing health care coverage is employer-based. Unfortunately, this system leaves too many working families uninsured or under-insured. Fifty-six percent of uninsured workers worked full-time.provide couvergae for all children who have no health insurance
Well if this is for America put it X 5 times worse and you get the health sistem situation in Bulgaria .

Maggie......interpret that "47 million US residents without health insurance" figure cautiously. You do realize that these people have access to and do receive healthcare in the US? They are covered by the Medicaid program, the CHIP program (mentioned above) and state-based health programs. This 47 million figure is something liberal politicians like to "throw around" to give the impression that these people have no access to healthcare. For the most part, these people have absolutely FREE (for them) healthcare! Anther way politicians play the "healthcare game" in america

Technically speaking, Americans do not have a health care "system". They have a number of insurance plans which provide a variety of benefits for those who fall ill.

A primary care physician may do business with 14 different insurers offering 14 different plans with 14 different levels of benefits. You get what you pay for either directly or indirectly ...no more... unless, of course, the provider is in a charitable mood. Do not confuse the payment system (private insurance]) with the health care delivery "system" [disjointed point of service treatment of individual problems].

The American health care "system" is very much like getting your car serviced as dictated by the owners ability to pay for repairs. If you can't afford it either directly (cash/out of pocket), or indirectly (through an insurance plan), you are out of luck.

The business of America is business after all, and health care is just another business.

In America, the healthcare system works beautifully for the poor. If you are sick, just show up at any ER. They can't refuse you, regardless if you can have insurance, have a job, or even have a legal right to be in America. Even better, if admitted to the hospital, they can't throw you back on the streets unless you are healthy. American hospitals lose millions of dollars each year caring for these uninsured.

Unfortunately meet seems everywhere healthcare is becoming a Big buisness .
You have money you can Try to get some better health care .you dont even you are insured then you are f "ed .
Some americans are prolly covred by some programs which is same here but that is not for most people .if the money of these programs doesnt go directly to teh pocket of some of the medical persons .
(for plague i didnt google that )

LOL @ the post-posting meal!!

Thank you Plague. I found the statistics very informative. 37th out of 191 countries even after a higher GDP spend. The WHO criteria for effective healthcare systems is also interesting.

So in essence...we can say that, 'Money can't buy you health and happiness'.

Two things I'd like to know:

1. Since many of the factors causing ill-health in the US seem to be based on over-indulgence, would it be fair to say that it is a decadent society?
2. What ranking is the UK in the WHO chart?

The UK is ranked 18th. It is regarded across the globe as a very good, although somewhat under-performing healthcare system from a service perspective. To your other question....the US mortality rates for cardiovascular disease, metabolic disease and even cancer are linked to lifestyle, and the dominant contributors there are diet and (lack of) exercise. The US rates for psychiatric disease statistically correlate best with diagnostic practices in the US versus other countries (esp autism and depression). The cause for the high rate US rates of neurogenerative disease are more enigma, but may relate to pesticide us, agricultural practices and industrial pollution and waste handling. Hope this is what you were looking for in a reply.

Yes I was! I have a philosophical perspective on this, not a 'bash America' angle.

It is about the side-effects of excessive wealth on societies in general. I have often wondered if hardship and stress brings about greater creativity and control. The Spartans and Athenians destroyed each other during their periods of greatest prosperity. The Romans became decadent and ultimately imploded. Hardship seems to bring about inventions that are useful. A comfortable existence only seems to bring about the desire to make life even more comfortable -- which sounds logical enough until you take a look at the bigger picture.

It is disappointing that the UK is only 19th.

Interesting perspective Space and one that, I believe, captures the essence of the "health problem" in developed and prosperous nations.

This guy cracks me up!!!