Stephen Green: America's Strange Health Care Debate

Stephen Green: America's Strange Health Care Debate

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So, relative healthcare costs. The United States as a government, according to the 2009 World Health Report, expends $3,076 US on healthcare per capita per year, which puts it third in the world behind Luxembourg ($4,992) and Denmark ($3,239) and then followed (top ten)by:

1. Netherlands ($2,785)
2. Austria ($2,737)
3. France ($2,727)
4. Germany ($2, 664)
5. Iceland ($2,628)
6. Canada ($2,587)
7. Sweden ($2,583)

These, however, are only government healthcare expenditures, and all of the other countries listed here have essentially national, not free-market healthcare systems.

The Report also tracks total national healthcare expenditure as a percentage of gross domestic product, public and private. Here then are those relative figures, for the top ten countries:

1. United States (15.8%)
2. France (11%)
3. Denmark (10.8%)
4. Switzerland (10.8%)
5. Germany (10.6%)
6. Austria (10.2%)
7. Canada (10.0%)
8. Sweden (9.2%)
9. Spain (8.4%)
10. Japan (8.1%)

The United States relative to its GDP expends, counting both government and private funds, 43% more on health care than does the next highest country, which is France.

Compared with Canada (aren’t we always comparing our HC system to Canada’s?) the US expends, in public and private funds together, 63% more on healthcare. So with the highest healthcare costs in the world, what are we in the United States getting in the way of results, i.e., HEALTH?

One standard measure of the effectiveness of our healthcare system might be life expectancy at birth, in years. According to WHO, the nation with the highest life expectancy is Japan, at 83 years, followed by Italy, Australia and Switzerland, at 82 years. You may expect to live to be 81 if you live in Canada, Israel, Netherlands, Norway, Singapore, France, Sweden, New Zealand and Andorra. People in Austria, Belgium and Cypress live to the age of 80, on average. Costa Ricans and people in Finland live on average to be 79. Citizens of the U.S., along with those of Chile, Denmark and Cuba die on average at age 78.

The infant mortality rate calculates the number of deaths at birth, per 1000 births, for both sexes. The U.S. is tied at six deaths per thousand with the countries of Thailand, Slovakia, Lithuania and Hungary. Among the countries with FEWER than six deaths per 1000 live births are Slovenia, Singapore, San Marino, South Korea, Lithuania, Estonia, Cuba, Cyprus and Andorra.

It is worth noting, in respect of the infant mortality numbers just cited, that the WHO annual report also tracks the percentage of births attended by skilled health personnel. While the number for attended U.S. births is high, at 99%, there are 46 countries that have 100% of births attended. These include Albania, Barbados, Bosnia, Brunei, Canada (oops!) Chile, Croatia, Cuba (again) , Cyprus and the Czech Republic, along with Kazakhstan, Kuwait, Poland, Quatar , Moldova, Malaysia, and Libya. Also Turkmenistan, United Arab Emirates and Uzbekistan.

Maternal mortality rates per 100,000 live births are also rated. The United States loses 11 mothers per 100,000 live births. Countries which lose fewer than that include Canada, Croatia, Czech Republic, Hungary, Israel, Kuwait, Latvia, Malta, Poland, Slovakia and Macedonia. In all, a total of 31 countries suffer fewer than 11 maternal deaths per 100,000 live births.

The point here is not to denigrate the “American Healthcare System.” It is among the finest in the world…..AMONG the finest in the world. It is indisputably the most expensive in the world….. by far. A little realism and a dash of humility would probably help us to improve it further. ...