The World’s Best Healthcare

As the U.S. Supreme Court saved the Affordable Care Act for the third time, the Washington Post interviewed seven health economists and public health experts to ask what other nation has the world’s best healthcare and if we should emulate it. All of those questioned seemed defensive, suggesting they believe in American Exceptionalism. They never did address why American healthcare is so expensive or answer the question about what other nation has the best healthcare system. They instead changed the question and started discussing factors of a good healthcare system.

* Public Health & Wellness, as measured in things like average longevity and infant mortality, tend to favor nations that prioritize prevention and make relatively healthy lifestyle choices. The U.S., with superior technology in many areas, ranks near the bottom on these health & wellness measures. We are ranked #37 in the world’s best healthcare by WorldPopulationReview.com.

* Health Outcomes from Treatment of a disease, illness, or injury varies greatly by class, depending on what one can afford. And health inequality in the U.S. has become extreme. So, even though some of us get great healthcare, we still rank poorly in the world’s best healthcare.

* Quality with No Constraints refers to the care and outcomes available to those who can afford the best. Unfortunately, in the U.S. we have tens of millions with no insurance coverage and who get inferior care. The best example I can recall was when Apple’s Steve Jobs needed a transplant and was able to fly on his private jet at a moment’s notice to get it.

* Cost per Person, or as a share of GDP, varies greatly and largely depends on how care is paid for. The price we pay in America is higher, because our unconstrained capitalist society encourages profit, seemingly above all else. And that profit motive is spreading like an epidemic.

* Population Coverage is interesting, because all other rich nations cover their entire population universally and still have lower overall costs and generally better health outcomes. None of those interviewed discussed why. In the Ezra Klein video at the top of my article, Why American Healthcare is So Expensive, he shows that the U.S government spends about as much as governments in other rich nations. It’s our private healthcare spending that is so out of whack.

* Patient Satisfaction (not mentioned) is another measure of a successful system, combining many of the other factors listed. It also includes things like friendliness, confidence, and how mistakes are handled. But here in the U.S., trust in government is at a historical low. It’s not just our healthcare system that’s broken; it’s also our politics and form of capitalism, where the playing field is anything but level and fair.

* Political Influence and Corruption (not mentioned) refers to ideological differences of opinion in what is the proper role of government, and whether the rich should pay to keep the poor healthy. What many people fail to realize is that diseases like COVID-19 spread regardless of wealth if essential workers lack PPE or vaccination. They also forget that uncompensated visits the hospital emergency room raise overall costs for everyone else.

HEALTH SAVINGS POTENTIAL

Also avoided in discussions like this is how much we could save each year if only we matched the average of what other rich nations spend on healthcare. It seems no one want to mention the $2 trillion/year of savings potential if we just matched the Average of what the others spend, even as their universal healthcare systems provide better public health. We could save even more if we set higher goals, such as becoming a world leader instead of dead last.

HEALTH PROSPERITY POTENTIAL

If economic prosperity were measured across the entire nation, rather than as the stock price of individual corporations, we might look differently at making strategic investments in a healthy, skilled, and highly-productive workforce. We might even pay them enough to become consumers of the goods and services they produce. But elections and public policy have been corrupted, with the Citizens United decision making it too easily influenced by unlimited amounts of dark money from wealthy individuals able to shape it for their own selfish benefit.