The Healthcare Hostage Crisis: Comparing America's healthcare to other countries

Editor's Note: This article continues our 8-part series excerpted from the "Healthcare Hostage Crisis" chapter of AC360° contributor David Gewirtz's upcoming book, How To Save Jobs, which will be available in October. To learn more about the book, follow David on Twitter at http://www.twitter.com/DavidGewirtz. Last week, we looked at whether spending more money meant better care. This week, we look at how our healthcare compares with other countries.

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David Gewirtz | BIO
AC360° Contributor
Editor-in-Chief, ZATZ Publishing

According to 2008 health statistics from the Henry J. Kaiser Foundation, India had 32 deaths per 1,000 births and China had 21 deaths per 1,000 births. India spends the equivalent of $100 per person, per year on health and China spends the equivalent of $315 per person, per year.

America, on the other hand, spends $6,350 (per Kaiser's numbers) on each person, per year and had an infant mortality rate of 6 per 1,000. America spent 63 times more per person than India, but saved only about five times as many infants. America spent about 20 times more money on health per person than China, but saved only about three times more babies.

In terms of life expectancy, Americans are generally expected to live until the age of 80, Indian citizens to 64 and Chinese citizens to 75. We spend 63 times more per person than India, but we live an average of 16 more years. We spend roughly half a million dollars per person over an 80 year life, which is roughly half a million dollars more than the typical Indian. Speaking only for myself, getting an extra 15 years loving my wife, dreaming of fast cars, playing videogames, and drinking ice tea seems worth a cool $500,000.

The life expectancy ROI (return on investment) isn't quite as clear in China. We spend 20 times more per person per year for healthcare, but only gain an extra five years. Once again, speaking only personally, I'd take the extra five years, but it does seem comparatively costly.

But what about our infant mortality rates and life expectancy rates compared to countries far more culturally similar to the United States? How do we compare to Canada and the United Kingdom, both of whom have a form of national healthcare and both of whom spend a lot less than we do?

On average, Canada's health expenditure per capita is $3,673. In the U.K., it's $2,815. That means, per person, we spend about 1.7 times more than Canada and about 2.25 times more than England. So clearly, we should live longer and have more successful birthings, right?

Um, not so much.

Canadians live an average of 83 years as compared to our 80 and the Brits live 82 years compared to our 80. So, we're spending about twice as much as they are, and yet we're living a few years less.

Adding insult to injury, Canadians only have 5.04 infant deaths per 1,000 birthings, compared to 6.26 in America. In the U.K., which, incidentally, spends even less per capita than Canada, they have only 4.85 infant deaths per 1,000, again compared to our 6.26.

They're spending less, have guaranteed health care, and are living longer.

When you look at our spending on a national basis, the numbers are astonishing. According to the World Health Organization and the Centers for Medicare and Medicaid Services, the U.S. spends 16.6 percent of its GDP on healthcare. But Canada (remember, they live three years longer than we do) and England (they live two years longer) both spend only about 10 percent of their GDP on healthcare.

Remember, earlier, when I said the U.S. spends about $2.4 trillion each year on health? Try this on for size. Both the International Monetary Fund and the World Bank say we have a gross domestic product of about $14.2 trillion. If, instead of spending 16.6 percent of our GDP on health, we were more like Canada and the U.K. and spent 10 percent of our GDP, our healthcare costs would drop down to about $1.4 trillion each year.

We could save a trillion dollars. Each year. If you've never seen a trillion, that's a dollar sign followed by a one, with 12 zeros following it: $1,000,000,000,000. Put another way, we could each - every man, woman, and child in America - save around $3,300. Each year.

And, while hospitals are costing more and more, according to the Centers for Disease Control (CDC), the number of visits to physicians (measured in visits per hundred people) has decreased by 11 percent during the period from 2002 to 2006.

Of those private physician visits, many of them are not to the old-fashioned family doctor. Measured across all Americans, 43 percent of doctor visits are to specialists of one sort or another. For those over 65, specialist visits represent almost 60 percent of all doctor visits.

It's no wonder nobody makes house calls anymore.

But isn't our medical care better? After all, we've always been told we have the best medical care in the world. Even though we spend a lot more, have more deaths during childbirth, and live shorter lives than similar countries, it's worth it because the quality of our care is so much better. Right?

Not necessarily.

According to the World Health Organization's World Health Report, which was last performed in the year 2000, America’s healthcare system ranks at #37. Just to put this in perspective, the WHO ranked the healthcare systems of Morocco, Chile, Costa Rica, Cyprus, and even Columbia as better than us. Of course, we were one notch ahead of Slovenia and two ahead of Cuba, so at least we've got some bragging rights.

But that's just the United Nations' opinion (the WHO is a U.N. agency). What do our own medical professionals think?

No profession knows more about the quality of patient care than nurses. According to the American Nurses Association, which represents the interests of the nation's 2.9 million registered nurses through its 51 constituent member nurses associations and its 24 specialty nursing and workforce advocacy affiliate organizations, nurses aren't impressed by America's quality of medical care.

In a July 2009 survey of more than 15,000 nurses nationwide, 70 percent said the staffing for their unit or shift was insufficient. Worse, 49.5 percent said they "would not feel confident having someone close to them receive care in the facility in which they work."

That does not bode well for the quality of American healthcare.

Next up, I'll talk about how insurance is no assurance. If you thought this article was depressing, the next one will get you really, really angry.

Follow David on Twitter at http://www.Twitter.com/DavidGewirtz.

Editor’s note: David Gewirtz is Editor-in-Chief, ZATZ Magazines, including OutlookPower Magazine. He is a leading Presidential scholar specializing in White House email. He is a member of FBI InfraGard, the Cyberterrorism Advisor for the International Association for Counterterrorism & Security Professionals, a columnist for The Journal of Counterterrorism and Homeland Security, and has been a guest commentator for the Nieman Watchdog of the Nieman Foundation for Journalism at Harvard University. He is a faculty member at the University of California, Berkeley extension, a recipient of the Sigma Xi Research Award in Engineering and was a candidate for the 2008 Pulitzer Prize in Letters.