napoleon
This type of the question which researchers tend to avoid, because
it is enormous. One can spend days and days researching it,
and question always remains: how much you want to read?
There are tons of studies, lot of statistics, and also controversy.
How do you compare quality of care? The cost of living is different - but
cost of living does not determines quality of life nor does cost ( or
percentage of GNP spent on health ) determines quality of care
measured
as by usual indicators.
Just as a preview, here is one study which compares what people in US
spend and get with other countries:
---------------
Overhead and Efficiency
A more plausible suspect is administrative overhead in the U.S.
health care system. For example, a study by Steffie Woolhandler, et al
concluded that, "administration accounted for 31.0 percent of health
care expenditures in the United States and 16.7 percent of health care
expenditures in Canada." Their view is that switching to a Canadian
style national health insurance system would reduce administrative
costs.
-----------------
http://www.techcentralstation.com/032105B.html
People compare quality of care by life expectancy, child mortality, ...
but these numbers depend on diet, lifestyle, and other factors as described here.
e.g.
Japan
People in Japan have the longest life expectancy in the world. This
could be part down to low cholesterol levels in traditional Japanese
diet, which is practically free from saturated fats. Popular
ingredients in a Japanese diet include fish, seaweed, tofu, soybeans,
rice and soba noodles (source: www.naturalelixir.
http://www.prb.org/Content/NavigationMenu/PRB/Educators/Human_Population/Health2/World_Health1.htm
And the picture is changing rather quickly.
In India:
Going by measures of improved healthcare in terms of life expectancy
and infant mortality, India has certainly made progress. Life
expectancy during the period (1951-2003) has increased from 37 to 65
years. Infant mortality (per 1000 live births) during the same period
has come down to 64 from 150. Also, death rate (per 1000) and birth
rate (per 1000) have also come down from 25 to 8 and from 41 to 25
respectively during the same period. The pharmaceutical industry is a
major contributor for the improvement in health indicators. This is
noteworthy, considering the fact that neither sanitation nor
environmental hygiene has improved significantly during the period.
http://www.indiaoppi.com/pharmindindia.htm
In Eastern Europe, which like India
is recipient of health tourism (from western Europe) and recipient of outsourced
jobs, health care is in transition from 'socialized medicine' to a US
model. Quality is increasing, but cost is increasing much faster.
Health insurance is compulsory but for most, it is paid 100% by
employer; lot of the generic
(not always reverse engineered but traditional) drugs are being
replaced by more expensive brands, but there is more of a selection.
Subjectively, health care is a great bargain compared to US.
http://www.europarl.eu.int/workingpapers/saco/101/default_en.htm
http://economist.com/surveys/displaystory.cfm?story_id=2895909
I think I did not answer your question. You may ask me to remove
this, but I hope you will ask instead ask for clarifications. Your
question is interesting and I have personal experience of working in
US and elswhere on which I can draw.
To summarise my subjective opinion: Other countries to not have the enormous
cost of litigation explosion, which affects the health industry more than most.
The other countries do not (yet) have regulatory monopoly which drug
companies enjoy in US. (Remember how president Bush was worried that
cheap medicines imported from Canada may not be safe?). Finally, the
care for employed and insured worker in US is higher then elsewhere
(particularly in dental care).
Other countries do not have same obsession (or selfinterest) with IP as US has.
Other countries do not have same constituency with strong beliefs which leads
'Tony Schiavo' type controversies and costs.
So, it is all of the above: Patient in other counties go without some
very expensive technology, drugs and frills.
Patients in other caries get much better care per dolars,
the people in US get for their.
Does this answer at least part of your question?
Hedgie |
