Healthcare Costs - Some Reflections

As of 2016, the percentage of the Gross Domestic Product in the USA spent on healthcare was appropriately 17.9 %.  Healthcare expense grew 4.3% or around $10,348 per person (National Health Expenditures Data) Our healthcare costs are higher than those found in other higher income countries such as Great Britain (9.7%), Netherlands (10.5%) Germany (11.3%), France (11%),  and Denmark (10.8%). (Health Care Spending in the United States and Other High-Income Countries)

Health outcomes regarding average life expectancy in Hawaii, Minnesota, Connecticut are similar to those in Sweden, Germany, Great Britain, and Denmark.  Dr. Ashish Jha of the Harvard T.H. Chan School of Public Health and senior author in his study Health Care Spending in the United States and Other High-Income Countries study indicates that many healthcare outcomes comparison in some states to these countries is similar.  Many of these countries have similar populations as some of these states.  The USA is much larger and more diverse nation than those to whom our healthcare system is often compared. It seems once a person gets into the healthcare system they do well as those in other high-income countries. Health Care Spending in the United States and Other High-Income Countries

Utilization of services in the USA as reported by the Organisation for Economic Co-Operation and Development data. The USA does not appear much different than other high incomes countries regarding structural capacity, access, and quality, and healthcare utilization. Dr. Ashish found utilization of healthcare services in the USA was not different than that in Denmark, Netherlands, Germany, France, and the UK.Health Care Spending in the United States and Other High-Income Countries - Video

The primary contributors to higher costs are administrative costs, healthcare professional labor, and pharmaceutical.  Administrative costs in the USA average 8% compared to other countries 1% to 3%. Medicare while many opponents of government managed care administrative costs are around 2% (Medicare is More Efficient Than Private Insurance). Physician and nurses salaries are also higher in the USA than in most other countries.  Primary care physician average $218,173 while in other high-income countries salaries are $86,607 to $154,126.  The USA medical education system is more costly and more prolonged than those in other countries. Regarding pharmaceuticals in different counties, the average cost ranges between $466 to $939 while in the USA is $1,443. Health Care Spending in the United States and Other High-Income Countries

In the past several years the Congress, as well as the President, have failed to find solutions to address this issues at least from a Federal level.  There has been some progress made at the State level by some to create an expansion of Medicaid, require individual mandatory insurance purchases thus lowering the costs of premiums, and well as provide insurance companies  “safety” coverage in case of unexpected losses.   Read more about this at 4 States Are Restoring the Individual Mandate to Buy Health Insurance with 9 states considering individual mandate rules: report

Maybe change will only come when the private sector takes ownership of creating health policy and innovations to reduce the costs of healthcare.  Amazon, Berkshire Hathaway, and JP Morgan Chase have announced Atula Gawande a well-known surgeon and best selling author to be the lead in a new company formed by this partnership with an aim to reduced healthcare costs.  With the combined companies having over one million employees the deep pockets of Jeffrey Bezos of Amazon, Warren Buffett of Berkshire Hathaway, and Jamie Dimon of JP Morgan Chase just might interrupt the healthcare system that is often inefficient and absorbed by seeking financial incentives that may or may not relate to improving quality.  Clearly, Congress and the healthcare industry has been unable to accomplish this task Washington Post June 20, 2018
Dr. Bob