The Healthcare Gap


Blog post by Joe Babaian

New 11-Country Study: U.S. Health Care System Has Widest Gap Between People With Higher and Lower Incomes

Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care, The Commonwealth Fund Report

People are excited for tonight’s Game 6 of the World Series in LA. Being a Houstonian, I see and feel everyone here abuzz with the excitement of watching the home team swoop in for the win. Thinking about sports doesn’t usually link to healthcare, but in today’s uncertain times, I find myself considering new connections all the time – rich food for thought I’m certain!

With this in mind, I was thinking about those lucky enough to be flying into LA from Houston to cheer their Astros tonight. Certainly, people of above average means in most cases – which is indicative of the freedoms and opportunities we all enjoy (I hope). In my strongly held opinion, healthcare should be less related to means and more related to the generally expected standards and levels. Those levels are what we find worldwide in nations that put healthcare forward as a core competency for their citizens, just as we intend.

This year, The Commonwealth Fund released their report Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care. I love solid data and the report really digs in and analyzes international healthcare – the best way to judge and make decisions when you couple this data with human empathy. A great combination! Do take time to review the report, I’m sure you’ll find as much value in it as we did here at #hcldr.

Some key takeaways from the report to consider for today’s #hcldr:

Despite having the most expensive health care, the United States ranks last overall among the 11 countries on measures of health system equity, access, administrative efficiency, care delivery, and health care outcomes. While there is room for improvement in every country, the U.S. has the highest costs and lowest overall performance of the nations in the study, which included Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. The U.S. spent $9,364 per person on health care in 2016, compared to $4,094 in the U.K., which ranked first on performance overall.

“The highest costs and the lowest overall performance…..” is not the way we want anything of critical national value to be described. Period. Let that sink in as we further consider:

The U.S. ranks last overall on health care outcomes. Compared to other countries, the U.S. comes in last on infant mortality, life expectancy at age 60, and deaths that were potentially preventable with timely access to effective health care.

This isn’t the position we choose but it’s the position we find ourselves in. Several brighter notes were highlighted in the report, so we are not focused on all doom and gloom. Let’s look at what we are doing right! In fact, we pride ourselves (looking at you, you, and you over there) on advanced and enlightened care processes – the report bears this out:

The U.S. ranks in the middle for care process, which is a combination of four separate measures: delivery of preventive services, safety of care, coordinated care, and patient engagement. On three of the four measures, the U.S. ranks near the top, coming in third on safety and fourth on prevention and engagement. The U.S. tends to excel on measures that involve the doctor–patient relationship, wellness counseling, and preventive care, such as mammograms and adult flu shot rates.

I have given just a taste of the full report, but I can assure you the data is transparent and accessible – you’ll be glad you took the time to read it. I am not doing an in-depth summary or analysis of the report, but I want to spark the conversation surrounding this healthcare gap between the U.S. and the rest of the world with which we compare ourselves. These gaps impact each of us from patients to clinicians and everyone supporting each.

Let’s pull the collective #hcldr community together to tackle this subject!

Please join us Tuesday, October 31, 2017, at 8:30 pm ET (for your local time click here) as we discuss the following topics:

  • T1: What are the implications related to the income gap seen in healthcare measures in the U.S.? Examples?
  • T2: How do you align the high U.S. level of healthcare expenditures with the poor overall rankings? Real Solutions?
  • T3: The U.S. tends to do well on care processes. How can these successes be leveraged to other parts of healthcare?
  • T4: What is your definition of “best healthcare” and what metrics matter most to you? Examples?

References for Review

“Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care,” July 2017.
Photo Credit

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