Why is it that among the top six industrialized countries we have the highest expenditure on healthcare per capita, but the lowest female life expectancy and the highest infant mortality rate?
In Ian Morrison’s book, Health Care in the New Millennium, Morrison says, “In Glasgow, healthcare is a right; carrying a machine gun is a privilege. Somehow America got it the wrong way around. Ironically the only group of Americans with a right to healthcare is people in the prison. Three strikes and you are covered.” I heard Morrison's presentation at the recently concluded annual meeting of the Society of Hospital Medicine. Thought provoking and insightful, his discussion had the perfect balance of all of the necessary ingredients for it to be great: a controversial topic, humor and a lot of data. Since I am particularly bothered by the state of healthcare in our country, it touched a chord with me, which is what forced me to buy his book, and I encourage you to do as well.
Let us continue to explore the study I touched upon in the previous blog. Why is it that among the top six industrialized countries we have the highest expenditure on healthcare per capita, but the lowest female life expectancy and the highest infant mortality rate? Sum total, we are spending lot of precious dollars to achieve the worst outcomes as compared to Germany, Canada, Japan, the United Kingdom, and even France. Did you notice?
Perhaps we should learn a few tricks from them before renaming our French fries to freedom fries. The highest female life expectancy and the least infant mortality came from Japan, which spends 7.2% of GDP as compared to America’s 14.2%. NPR recently investigated this subject as well. The Japanese physician interviewed was shocked when asked what percentage of population is denied coverage due to pre-existing conditions. He could not understand the question, never having heard of such a preposterous thing. “What do you mean by not covering a pre-existing condition? This is what the patient is seeking insurance for.” What a concept. Also, zero percent lose insurance coverage even if they lose their jobs. What novel concepts. Sounds like a futurist writing…a fictional novel about health care in America. But these are facts of health insurance coverage in a country which spends only 7.2% of GDP as compared to our 14.2%. I give up.
Perhaps the basic problem here is healthcare coverage is outsourced to companies which are for profit. The basic purpose of their book of business is to make profit, not to provide health care. When the architects of their boards and management sit down to draw frame works and matrices, their aim is to improve the net. The share prices are tied to the net profit; the CEOs’ salaries and bonuses are dependent on the money made, rather than on the lives saved, coverage provided, and health maintained. Emotions alone will not fix it, though, we should audit what are we doing wrong, learn from other’s experiences and hope that next January will bring a much needed change, no matter who occupies the throne.