And the Worst Health Care System in the World Is…

And the Worst Health Care System in the World Is…

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The United States, of course.

Oh, no, wait, it’s Canada.

Actually, I think it could be Germany.

Geez, now I think it might be the UK.

You could go on and on like this.  But you know what?

No matter how good or bad your system is, there are certain universal truths.

Here are four of them that might make you look at global health care a little differently.

First, health care is getting more expensive, all over the world.  A new study by the global consultant, Towers Watson (disclosure: Towers Watson is a Best Doctors client) found that the average medical cost trend around the world will be 10.5% in 2011.  In the advanced economies costs will rise by an average of 9.3%.  While Americans tend to think of rising medical costs as a uniquely American problem (they’ll rise by 9.9% here), it’s just not true.  Canadian costs will rise by 13.3%.  In the UK and Switzerland, they will increase by 9.5%, and in France by 8.4%.

Why is it happening?  As ever, the main drivers are the increasing availability of new medical therapies – and inappropriate use of care.  We see the same phenomenon at Best Doctors in our global experience.  Across the world, our data for 2010 showed that just over 20% of patients had an incorrect diagnosis, and about half were pursuing inappropriate treatment plans.

Second, consumers are increasingly dissatisfied with their health care experience.  The Commonwealth Fund’s 2010 survey on views of health care found that 68% of Americans think their health care system needs to be fundamentally changed or completely rebuilt.  But 61% of Canadians thought the same thing, as did 58% of French people, 52% of Swiss, 48% of the Dutch, and 75% of Australians.  All of these places have remarkably different systems, and yet none of them are very well-liked at all.

Third, time spent dealing with insurance restrictions is a major barrier to quality care in the United States – but it’s becoming a problem elsewhere, too.  According to the Commonwealth Fund, 48% of American doctors said that coverage restrictions were a “major problem” getting in the way of delivering needed care.  While it’s less of a problem outside the U.S., nearly 20% of Canadian doctors reported the same problem.  As other countries adopt U.S.-style cost controls to deal with the rising cost of care, it’s likely that doctors in those countries, too, will start to report the same trouble.

Fourth, some employers, insurers and governments are looking for a better way.  The Towers Watson study reflected something we found in our own study.  Payers are increasingly implementing programs to get people to take better care of themselves and be more involved in their health care decisions.  Programs like wellness and prevention and higher deductible plans are part of an overall approach to getting consumers more engaged in their health.  But one of the fastest growth areas is still what some call “second opinion” – programs like what Best Doctors provides – where the goal is to help make sure that every person gets the right diagnosis and treatment.  Towers Watson found that 25% of health care payers across the globe have implemented these programs.  They help make sure each person is dealt with as a patient, regardless of how good or how bad their health care system might be.

So, who really has the worst health care system?

I don’t think there’s an answer to that question, except for this: don’t get sick.

Evan Falchuk is President and Chief Strategy Officer of Best Doctors, Inc. Prior to joining Best Doctors, Inc., in 1999, he was an attorney at the Washington, DC, office of Fried, Frank, Harris, Shriver and Jacobson, where he worked on SEC enforcement cases.

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53 Comments on "And the Worst Health Care System in the World Is…"


Guest
Babe
Jan 25, 2011

This is superficial drivel and doesn’t really deal with health care at all, but merely plays with numbers.If you want to really learn about health care in the developed world, read T.R. Reid, The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care.

Guest
Jan 25, 2011

It’s clearly not America. Because we don’t have a system. At least those other countries have an attempt at one.

Guest
Peter
Jan 26, 2011

Since other countries do healthcare for about half what we do it for, 10% of $100 is $10 and 10% of $50 is $5, which increase would you rather pay?
“While it’s less of a problem outside the U.S., nearly 20% of Canadian doctors reported the same problem”
Question is how many patients (not doctors) reported insurance restrictions getting in the way of care in other countries as opposed to the U.S.?

Guest
Bob De Vita
Jan 26, 2011

The author’s title at the end reveals his bias re: getting second opinions from the Best Doctors; and he’s President of Best Doctors? Not an objective commentary at all. More like a marketing job. Too bad. I was looking for data; like: why the US ranks highest among among all nations in per capita cost and far lower in outcome measures like infant mortality. See Commonwealth Fund.

Guest
nate
Jan 26, 2011

“Since other countries do healthcare for about half what we do it for,”
Peter could you define “healthcare” for us please. I assume since your doing such a direct comparison of cost, “healthcare” in the US must be exactly the same as “healthcare” in the rest of the world. We all have the same quality of facilities, all suffer the same wait times, and everything else.
Otherwise your comment would be as inteligent as saying China does cars for 1/10th the price we do. And we know your not prone to stupid statements.

Guest
Jan 26, 2011

This post is a good illustration of how non-medical professionals muddy the already complicated picture of health care. That first comment’s description of “superficial drivel” was more than generous. [Insert favorite lawyer joke here.]
A career in food service managing the working poor has left me with a very jaundiced view of health care in America. Most of my employees live their lives with little or no contact with the system, a shameful circumstance in the richest nation on earth. Nothing here suggests that Mr. Falchuk is aware that this population even exists.

Guest
Jan 26, 2011

Thanks for all of the comments.
Bob De Vita –
You caught me, I am biased.
My bias is that everyone should get the right medical care. Too often, they don’t.
We do business in dozens of countries, covering millions of people in pretty much every kind of health care system. I can tell you that the experience of being sick is distressingly similar, no matter where you are.
Far too often, patients face important decisions without the support they need. I have yet to see a system which is a success at this, which is what really matters.
Health care, unfortunately, gets so steeped in politics that it is hard to talk about in terms of what things are really like. These studies paint a picture that is quite different than what you would expect, and so they deserve more attention than they have gotten.
Cheers,
Evan Falchuk

Guest
nate
Jan 26, 2011

“Most of my employees live their lives with little or no contact with the system, a shameful circumstance in the richest nation on earth.”
Interesting joinder of perceptions, probably not intended, John. These people that have very little or no contact with the system, how many of them own a cell phone? How many smoke? How many drink? How many wear nice clothes and have a flat screen TV on which they play PS3 or X-Box 360?
You are correct we are the richest nation on earth, our poor live better then the middle class of almost all other nations. Bigger homes, more cars, AC, etc etc.
Is it a flaw of our nation that people that enjoy so much frivilous consumption don’t have enough money left for healthcare or is it a flaw of the people that value a flat screen TV over a check up?
I also am in contact with a large population of poor and don’t feel I need to work harder and pay more in taxes so those who give a fraction of my effort can live even more comfortably.

Guest
Heather
Apr 23, 2011

Nate, I find your comment amusing, because a month of our COBRA would cover a cell phone, a flat screen television, a few cases of beer, some nice clothing, and an X-Box 360.

It is, perhaps, a triumph of our age that material goods are now so disposable and cheap that “everyone” can afford them.

It is not, however, a moral failing (as you seem to imply) that some people choose them over the health care they would still not be able to afford.

Guest
nate ogden
Apr 23, 2011

no one in the entire country chooses consumer luxary over insurance necessitity? No moral short commings at all?

Guest
Peter
Jan 26, 2011

“Peter could you define “healthcare” for us please.”
assets.opencrs.com/rpts/RL34175_20070917.pdf

Guest
Jan 26, 2011

Hi Mr. Ballard,
I guess it’s fair to say there’s nothing in my post about the working poor. Then again, it wasn’t the subject of my post.
Now, you raise an interesting point.
There is the problem of health coverage on the one hand, and health care on the other.
We have a problem in America with making sure all of us have good health coverage – and not just those with the means to afford it.
But we also have an insidious problem with health care. Everyone, covered or not faces challenges with getting the right care – and it’s getting worse.
Published studies show it, so you don’t have to take my word for it.
It’s driven by the fact that policy-makers don’t value the time patients have with their doctors. They don’t value the ability of doctors to think about their problems, integrate information, and come up with good solutions.
It’s not just in America, but all over the world. It’s killing medicine, and hurting patients.
Evan Falchuk

Guest
rbar
Jan 26, 2011

Nate, you are just propagating the libertarian welfare myth. I simply don’t believe that you are in contact with many poor people; and your perspective who is poor and who not and what they consume may be warped. I see working poor in the hospital and occasionally in outpatient practice, and I also see their usually decrepit cars on the streets or in parking lots. Fact is that outside of some urban areas, you cannot get around and to work except without a private car. Yes, most of the cars that were build in the late 80s or later have AC anyway (working or not). I would bet that some poor may own flat panel TVs, but this is relatively low cost, one time expense that cannot be equivocated with the cost of health insurance on the private market. I am making a very good income but I am still able to see poverty, even though I wished it doesn’t exist; you just perceive what you want to see.
Re. HC abroad, I worked in 2 European countries (France and Germany), care was good and included high cost services like transplant sx etc. I would admit that certain peak institutions (such as Mayo Clinic or many academic centers) have a consistent level of excellence in most subspecialties that MAY be unmatched in Germany (not so sure whether some university clinics in France are at a similar level), but that also comes with an extreme price tag and applies only to a small fraction of US HC.

Guest
Jan 26, 2011

Hmmm…
Am I to gather that bloggers who discuss topics that relate to their own companies should keep their “superficial drivel” to themselves? If yes, I think you’ll see a number of bloggers out of business.
Many times it is their experiences gathered through their professions that allow them insight into healthcare that some of us find quite interesting, regardless if it is perceived as “marketing”. In fact, I’m pleased to say that my company offers the Best Doctors service. I’m even more pleased to say that I have not had a reason to use it! (No offense, Evan!)
Babe, were you expecting a solution to the healthcare system that fixes all of its ills? Keep in mind that this is a short blog. Maybe you should wait to read Evan’s book which is coming out….well, I have no idea if he’s writing a book. My point is this: you can only do so much in a blog vs. writing a book.
As far as sharing a few key facts in a short blog, I think the piece hit the mark. Drivel or no drivel… 😉
Signed,
DJK
author of A Musing Healthcare Blog
http://amusinghealthcareblog.wordpress.com
Twitter: @a_musinghcblog
(Wait, can I market here? Ah, too bad…I just did. Enjoy my senseless drivel, everyone!)

Guest
inchoate but earnest
Jan 26, 2011

DJK,
and here I thought Babe was giving Evan a recommendation for some hip new hair gel…
8^)

Guest
Jan 26, 2011

Bang!
I actually think Superficial Drivel would be a good product name.
Evan

Guest

Evan,
Here is an essay on healthcare in the homogenous country of Finland:
http://medicalexecutivepost.com/2009/03/29/reflections-on-healthcare-and-karate-in-finland/
Hope R. Hetico RN, MHA
[Managing Editor]