The Norman Transcript


October 9, 2012

Dismal care outcomes, causes and cures



Most embarrassing of all, according to WHO statistics, the U.S. also is ranked 49th in ascending low to high in maternal mortality, behind the much less modern countries of Iran, Turkey, Serbia, Puerto Rico and Slovenia. This means that U.S. women who experience child birth die more often due to childbirth complications than women in 48 other countries, including these five relatively poorer countries.

The remaining health system quality measure is perhaps most revealing of all. What is our comparative cost for our system that results in these very poor health care outcomes? 

In a world country comparison of medical cost per capita, WHO ranks the U.S. as No. 1 in descending high to low in health expenditures. The U.S. annually spends $8,362 per person. Of the countries that have much better health outcomes than the U.S., all spend less — most of these much less — with many of the same spending a small fraction of what the U.S. spends per capita.

It also important to note that of the 49 nations that have better health outcomes than the U.S., all but one country obtain their better health outcome results by having the larger portion of their health care expenditures as governmental expenditures. Singapore is the exception.

In other words: Excepting Singapore, all world countries that exceed the U.S. in health care outcomes also have a health system of which a major portion is composed of a government health care plan. Universal coverage or near universal coverage appears to be the best explanatory key to the obtainment of good health care outcomes.

I understand that Singapore achieves this with mandatory health insurance for employers. However, the economical way that almost all of these countries achieve this and obtain their excellent health are outcomes is through having predominately government health insurance plans.

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