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Healthcare – Spend more, get less?


Healthcare – Spend more, get less

My first behind the scenes view of how the healthcare system works in the US was in 2006. This was before the topic of healthcare began to move to  center-stage.  Rising costs and insurance premiums ensured that we paid attention.

What struck me back then was that while modern medicine performs miracles on patients, access to, and delivery and management of medical care leaves a lot to be desired. This was true in 2006, and  it is true today. So as far as Healthcare goes, we spend more, but get less.

Americans have the best in Healthcare…

We have the best doctors, nurses, hospitals, equipment, techniques, and procedures at our disposal. Patients get the best medical care while under the attention of a doctor, a hospital, or a healthcare provider. However, all this seems to fall apart when the same patient is outside the healthcare system. When they are on their own. Whenever they are not under the watchful eye of ‘someone’ from the healthcare ‘system’.

This is one part of the equation. Lets hold that thought in our heads.

We spend the most…

Our investment dollars, attention, and focus is directed at this aspect of our healthcare. In improving our hospitals. To produce better doctors, nurses, and healthcare professionals. In making them safe. Ensuring that they deliver the very best known to medical science.

Total expenditure , per capita on Healthcare

All this costs us.

Not only does the US spend the highest per capita, $10,348 in 2016 on a PPP basis, it also has the largest share of the economy bar none.

But still…we get less

This would be justified if all this investment delivered. If it made Americans the healthiest people. The longest living. The fittest. But does it? Not only are Americans not the longest living, life expectancy in America has declined two years in a row.

Life expectancy at birth

Now lets put this together, take a step back and look at the picture.

We are spending more money… way more money than anyone else. We have the best hospitals, doctors, medical science at our disposal, yet we are living lesser, and less healthier lives.

I am sure this is not news to anyone.

What’s wrong with this picture?

It wasn’t clear to me either, but once I took a look at the numbers, I was surprised by some of these numbers, like the wide variance in costs of the same medicines, treatments, procedures, equipment in different markets – whether within America or when compared to other countries.

I have spent a lot of my time over the past dozen or so years trying to unpack this. To go behind the scenes. I have thought a lot about what we could do to help improve this situation.

I will use the five main determinants of health and how we look at them as a starting point. That’s what my next blog will be about… stay tuned .

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