🌍Healthcare: Where in the world does the U.S. fit in?

What’s in for today:

• Healthcare in the U.S., compared to other countries

• Epic’s AI

• Readmission rates, FDA’s new surveillance program, and increasing costs

LET’S TALK!

U.S. versus the world

It's no surprise that these athletes took advantage of a healthcare system that's often considered the gold standard in healthcare. At least in most high-income countries.

The difference between the U.S. healthcare system and those of other countries can be eye-opening. In fact, a study by the Commonwealth Fund found that the U.S. is the only high-income country without universal healthcare. As we dig into how American healthcare stacks up against other countries, it becomes clear why many people are curious about alternative models

Price Tag

The United States is well-known for its advanced medical technology, world-class hospitals, and cutting-edge treatments. However, these benefits come with a steep cost. The U.S. healthcare system is the most expensive in the world, with per capita spending reaching about $12,555 annually.

In the United States, many people experience financial difficulties when trying to access necessary healthcare services. The cost of a basic doctor's appointment can easily reach hundreds of dollars, while more complex medical treatments or hospital stays can lead to bills amounting to hundreds of thousands of dollars. As a result, some individuals even forgo healthcare altogether, despite having insurance.

Misconception of “Free” Healthcare

When we hear about "free" healthcare in other countries, it can sound like a dream come true. But the truth is a bit more complicated. In countries like France, Norway, and the United Kingdom, healthcare is free at the point of use, but it’s not actually free. For example in France, healthcare is funded through a mix of taxes from employees, employers, and general tax revenue. French citizens enjoy a standard of care with coverage that includes doctor visits, hospital care, and even homeopathic treatments. However, the system is not entirely free—patients often pay a small portion of their medical expenses out-of-pocket, and additional private insurance is common.

On the other hand, Norway, the 5th best public health system according to US News & World Report has a system funded largely by taxes and oil revenues. While healthcare services are mostly free at the point of use, Norwegian citizens also contribute through taxes, and there are modest copayments for certain services. The result is a system where everyone is covered, with the overall tax burden (42.6 of GDP) slightly higher than in the U.S (26.6%).

Wait Times

One of the most talked-about trade-offs of universal healthcare systems in countries is the issue of wait times. Universal healthcare means that everyone has access to services, which can lead to long waits for non-emergency procedures. But how true is this?

• In France, the average wait time for a Generalist is 6 days, 21 days for Gynecologist, and 80 days for Ophthalmologist (Statista Data, 2017)

• In Canada, the median wait time for a general practitioner is about 27.7 weeks (189 days), 6.6 weeks (46 days) for a CT scan, and 13.1 weeks (91 days) for a specialist (Fraser Institute, 2023)

• In the U.S., wait times vary by state:

Quality of Care

When it comes to healthcare quality, the U.S. and other countries have their own strengths and weaknesses. The U.S. is home to some of the world's leading medical institutions and specialists, offering state-of-the-art treatments that attract patients from around the globe. However, the quality of care can vary widely depending on one's insurance coverage and financial resources. Access to high-quality care can be limited in rural areas, exacerbating health disparities.

In contrast, countries like France and Norway prioritize equal access to care for all citizens, which can lead to better overall public health outcomes. France, for instance, consistently ranks high in global healthcare rankings, with a strong emphasis on preventive care and patient satisfaction. Norway's system is also known for its high standard of care and positive health outcomes, thanks in part to its emphasis on equity.

However, these systems are not without challenges. The emphasis on universal access can sometimes mean that cutting-edge treatments or technologies are slower to be adopted compared to the U.S. Moreover, while the average quality of care may be high, those seeking the most advanced treatments may still need to look elsewhere.

Why should you care?

The comparison between the healthcare system in the United States and those abroad encompasses several intricate factors. In the U.S., individuals have swift access to state-of-the-art medical care, provided they can afford it. However, the cost of healthcare remains a substantial barrier for a significant portion of the population. Conversely, countries such as France and Norway offer more evenly distributed access to healthcare, although this often comes with higher taxes and longer wait times for certain medical services.

Ultimately, the selection between these healthcare systems hinges on individual priorities such as affordability, accessibility, and innovation. As the landscape of healthcare continues to transform globally, comprehending these trade-offs is crucial for individuals who seek the optimal healthcare, whether domestically or internationally.

TRACKING: AI IN HEALTHCARE

• Epic Systems is enhancing its EHR software with new AI capabilities to improve patient care. The updates include automated patient messaging, voice technology for charting, and features for medical insights at the point of care. Epic is also collaborating with Microsoft to integrate large language models and is working on over 100 AI projects to enhance healthcare. (Source)

POLICY & INDUSTRY NEWS

🩺The CMS has released data on unplanned readmission rates in 2022. The hospitals with the lowest readmission rates are Hospital for Special Surgery in New York City, St. Luke’s Regional Medical Center in Boise, Idaho, and New England Baptist Hospital in Boston. On the other hand, hospitals with the highest readmission rates are Oroville Hospital in California, St. Lucie Medical Center in Port Saint Lucie, FL, and LA Downtown Medical Center in California.

🏥The FDA is developing a post market surveillance program to monitor safety issues related to medical devices using data from EHRs, billing claims, and pharmacies, starting with two devices by December and expanding annually over the next five years.

🥼The costs of healthcare and childcare in the U.S. have significantly increased since 2000. This is primarily because these industries require a lot of labor and cannot easily be automated or scaled. Although wages in these sectors have gone up, the costs are expected to stay high, which will continue to put pressure on household incomes and savings.