To Sum It Up: Health Care Costs

Is America's health care system really the best, or just the most expensive?

With the exception of the United States, all industrialized nations have some form of universal health care. Generally, this exists in three models. First is single-payer national health insurance. Canada, Denmark, Norway and Sweden are examples of countries with single-payer systems, in which health insurance is publicly administered and most physicians are in private practice. Second, the British and Spanish systems are examples of countries with national health services, in which physicians receive government salaries and hospitals are publicly owned and operated. Finally, there exists a multi-payer system in countries like Germany, France, and Japan in which a highly regulated insurance system of non-profit sickness funds serve as fund collection and reimbursement mechanisms. The system is compulsory, and the cost is shared by employers and employees. In the United States, most health care facilities are privately owned, and most health care workers are employed by private corporations. Some health care costs are paid for by federal and state governments, and some are paid for privately. Medicare, a federally funded insurance program, covers those 65 and older. Medicaid is funded jointly by states and the federal government and covers qualifying low-income people. Veterans are also able to get very low-cost or free health care through the federally funded Veterans Health Administration system. Americans who do not qualify for these programs either have individually or employer purchased health insurance or no health coverage at all. About 47 million Americans have no health insurance, and millions more have such poor coverage that a major illness would bankrupt them. According to a 2004 Institute of Medicine study, Insuring America's Health, roughly 18,000 Americans die every year because they lack health insurance. The above table shows health care expenditures, life expectancy, and infant mortality figures for the United States compared to the five largest European economies plus Sweden and Japan. Health care spending in the United States is by far the highest in the world, and averages $6,102 per person. The Canadian system only costs 51% as much, and Japan's system only 37% as much. Infant mortality (deaths/1,000 live births) in the United States is 6.43, which ranks 8th among these eight countries and 42nd in the world overall. The United States also ranks 8th among these countries in average life expectancy at 77.9 years. When compared to all countries, Americans only rank 48th in life expectancy. The average patient does not benefit from the excesses of our expensive medical system. We should be getting more for our health care dollars.