Module 4: Comparative Health Systems
U.S life expectancy compared to other countries
US - Decrease in life expectancy while increase in spending (we get very
little in terms of value from our healthcare system)
In early 1990’s US life expectancy was similar to OECD countries
Other countries have improved life expectancy more than the US in last 20
years
US top tier for life expectancy @ 60 years
US 23 year life expectancy @ 60 years ranks only 13th in the world
In 2016 & 2017 life expectancy at birth in the U.S. declined due to:
o Opioid epidemic – 137% increase in related deaths between 2000 and
2014
o Suicide rate – 24% increase between 1999 & 2014
th
12 highest infant mortality rate among:
o India
o South Africa
o Indonesia
o Columbia
o Brazil
o Mexico
o Turkey
o China
o Costa Rica
o Chile
o Russia
France, Germany, United Kingdom, and Canada all outperform the US in
infant mortality rate
Reasons U.S. healthcare spending per capita is so much higher than other
countries
Over 17% of US GDP on health care
Most other comparable countries are around 10% GDP
US healthcare worker’s salaries are more expensive
US equipment, supplies more expensive
US tends to deliver more of the expensive services
Higher staff to patient ratio
New innovation in technology
, Administrative inefficiencies
Lack of waiting lists for services
Malpractice litigation/defensive medicine
Provider incentives
o Fee-for-service- providers have incentive to deliver more health
services because they are paid for each one
U.S. rank in medical treatment of cancer
US leads in the overall survival of colon cancer
US is 2nd in 5-year relative survival from 2005-2009
US trails Cyprus in breast cancer survival rates
Methods of rationing care through supply
Right to health under international law
1948 universal declaration of human rights
Possible that US does not meet the basic human right standard
Right to health can be understood as a continuum
Different types of national healthcare systems
UK National Health Service
o Universal coverage for health insurance
Includes England, Scotland, Wales and Northern Ireland
o National Health Service is name of the government agency
responsible for the single payer healthcare system
o Established in wake of WWII, 1948
o GOAL: provide universal insurance coverage and direct provision of
health care to all British citizens and residents
o About 85% of healthcare is funded through general revenues from
national gov ( MOST of any OECD country)
o NHS directly delivers healthcare, employs almost all workers
although GPs are contractors
o Services are not entirely free
o Extra charges for private hospital rooms, small surcharge for
prescription drugs outside hospital setting, and copayments for some
services such as dental care and eyeglasses
o Private sector in health care system- 10% of British purchase this
o UK spends more per person than the average
U.S life expectancy compared to other countries
US - Decrease in life expectancy while increase in spending (we get very
little in terms of value from our healthcare system)
In early 1990’s US life expectancy was similar to OECD countries
Other countries have improved life expectancy more than the US in last 20
years
US top tier for life expectancy @ 60 years
US 23 year life expectancy @ 60 years ranks only 13th in the world
In 2016 & 2017 life expectancy at birth in the U.S. declined due to:
o Opioid epidemic – 137% increase in related deaths between 2000 and
2014
o Suicide rate – 24% increase between 1999 & 2014
th
12 highest infant mortality rate among:
o India
o South Africa
o Indonesia
o Columbia
o Brazil
o Mexico
o Turkey
o China
o Costa Rica
o Chile
o Russia
France, Germany, United Kingdom, and Canada all outperform the US in
infant mortality rate
Reasons U.S. healthcare spending per capita is so much higher than other
countries
Over 17% of US GDP on health care
Most other comparable countries are around 10% GDP
US healthcare worker’s salaries are more expensive
US equipment, supplies more expensive
US tends to deliver more of the expensive services
Higher staff to patient ratio
New innovation in technology
, Administrative inefficiencies
Lack of waiting lists for services
Malpractice litigation/defensive medicine
Provider incentives
o Fee-for-service- providers have incentive to deliver more health
services because they are paid for each one
U.S. rank in medical treatment of cancer
US leads in the overall survival of colon cancer
US is 2nd in 5-year relative survival from 2005-2009
US trails Cyprus in breast cancer survival rates
Methods of rationing care through supply
Right to health under international law
1948 universal declaration of human rights
Possible that US does not meet the basic human right standard
Right to health can be understood as a continuum
Different types of national healthcare systems
UK National Health Service
o Universal coverage for health insurance
Includes England, Scotland, Wales and Northern Ireland
o National Health Service is name of the government agency
responsible for the single payer healthcare system
o Established in wake of WWII, 1948
o GOAL: provide universal insurance coverage and direct provision of
health care to all British citizens and residents
o About 85% of healthcare is funded through general revenues from
national gov ( MOST of any OECD country)
o NHS directly delivers healthcare, employs almost all workers
although GPs are contractors
o Services are not entirely free
o Extra charges for private hospital rooms, small surcharge for
prescription drugs outside hospital setting, and copayments for some
services such as dental care and eyeglasses
o Private sector in health care system- 10% of British purchase this
o UK spends more per person than the average
