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Editorial: Solving the health care puzzle

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Posted on September 26, 2013 |
By Angelo S. Lynn



As Vermonters begin to decipher the new world of health care through Vermont Health Connect and the health care exchange, and Republicans in Congress try — for the 42nd time — to dismantle the nation’s health care law at the expense of shutting down government, it’s worth stepping back to view the big picture: that is, how this nation’s health care compares to the rest of the world.

One place to start is with cost. In the U.S., we spent $8,233 per person in 2010 (the latest available statistics). That’s two-and-a-half times more than most developed nations in the world (or roughly $3,300), including European countries like France, Sweden and the United Kingdom. The next highest spenders were Norway, the Netherlands and Switzerland, but they still spent $3,000 less per year.

In the U.S., health care spending amounts to a whopping 17.6 percent of GDP, or to put it another way, we spend 17 cents of every U.S. dollar we generate on health care. The Netherlands is the next highest at 12 percent of GDP, while the average among the 34 developed countries that belong to the Organization for Economic Co-operation and Development (OECD) is almost half the U.S. at 9.5 percent. Canada spends $4,445 per person or 11.4 percent of GDP.

In a report produced by the OECD that studied the comparative health care of member nations, the report also found:

• In 2010, the U.S. had 2.4 practicing physicians per 1,000 people, which is well below the average of 3.1 in other OECD countries.

• The number of hospital beds in the U.S. was 2.6 per 1,000 population, again lower than the OECD average of 3.4.

• The life expectancy at birth increased by almost nine years in the U.S. between 1960 and 2010, but that’s below the average increase of 15 years in Japan and over 11 years on average in the OECD. The average American, the report found, lives to be 78.7 years, compared to 79.8 in OECD countries.

The positive side is that the U.S. leads the world in health care research and cancer treatment, as well as in other specific types of care. That’s not only better for those patients, but the research and development creates a lot of jobs. The U.S. also has shorter waiting times for patients to see doctors. Yet, the U.S. has fallen behind on public policy issues such as reducing obesity and the harmful effects of smoking or alcohol abuse. For example, in the U.S., 35.9 percent of children aged 5-17 are overweight or obese, compared to an OECD average of 21.4 percent.

Then there is this comment from Canadian multi-millionaire businessman, David Beatty, 70, who ran food-processing giant Weston Foods of Toronto, and has been described as a “tough-minded, suffer-no-fools wealth-creater that conservatives typically cheer.” In an interview with a Washington Post reporter, Beatty lauded the Canadian system for its outcomes and simplicity and specifically wondered why U.S. companies “want to be in the business of providing health care anyway… that’s a government function.”

Or consider this comparation of the U.S. and Canadian systems by Roger Martin, another Toronto native who spent years as a senior partner at the consulting firm Monitor before becoming dean of the Rotman School of Management at the University of Toronto. Martin advises U.S. corporate icons like Proctor & Gamble and Steelcase and lived in the United States for years, according to the same Washington Post report. In comparing systems, the Post wrote of Martin’s analysis, “Canada’s lower spending, better outcomes and universal coverage make it superior by definition. Plus, it’s ‘incredibly hassle-free.’ In the United States every time he took his kids in for an earache his wife spent hours fighting with the health plan or filling out reams of paperwork. In Canada, he says, ‘the entire administrative cost is pulling your card out of your pocket, giving it to them and putting it back.’”

Which brings us to political circus going on in Washington, D.C. and this question: As many columnists have speculated recently, is the real fear for Republicans not that Obamacare will ruin this country, but that it will be successful — as Medicare, Medicaid and Social Security have been, and as single-payer systems have been in the rest of the world?

Angelo S. Lynn

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