There are 2 methods that I might have spent twice as much on doughnuts. I might have bought twice as lots of doughnutsI could have purchased the exact same variety of doughnuts but got truly elegant ones and paid twice as much, or some combination thereof. Right? If we're investing two times as much as other high-income countries, we're attaining that by either doing twice as much health care, paying twice as much for the same amount of health care, or some combination.
Overall costs is quantity times Additional info rate. This concept that we're overusing health care, that we're doing so much to our patients, we're providing a lot health care, that's why we invest so much. All the policy things is about trying to decrease that overuse, our culture of overuse. I would state that much of the policy focus has been on the amount side of things.
Let's have a look at the information. One hypothesis I often hear is, as an American culture, we fast to go the doctorat the drop of the hat, I Visit the website get a little pain, Americans are off to see the physician. We first ask the question, let's look at physician sees per capita (what is universal health care).
This is doctor sees per capita in a given year: The mean has to do with 6. 6, and the United States has to do with four. By the way, in Japan, the mean is 13. The average Japanese sees their physician more than when a month. For every 24-year-old who hasn't entered four years, there are people who are going every other week.
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6 and we're a great bit listed below that. We're not seeing the doctor as much as these other nations. Then individuals look at that and say, "Ah, perhaps the issue is not enough. Not enough prevention, insufficient medical care, and it's all leading to too numerous hospitalizations. The issue is overuse of medical facilities.
We said, let's look at healthcare facility discharges per population. And here is the mean, right, 149 per thousand population. And here is the United States: a bit second-rate. Surprisingly, Germany seems like a little bit of the outlier, where hospitalizations per population are much, much greater. The other thingso this is simply hospitalizations, right? Healthcare facility discharges per populationanybody have a sense of how our lengths of stay compare to those of other countries, these other countries? We're method shorter, way much shorter.
is? Yeah, three. In the Medicare population it resembles 4, four and a half, because they're a bit older, however in the three to four days. In Japan, about 14. Right? I remained in Japan a couple of years ago checking out a community healthcare facility. It was amazing to me. There were clients sitting around playing cards around a table.
Right? It's like they got the four days of IV, then they changed to the oral, and now we're simply observing them 2 days post-oral antibiotics, just making sure they're great. It's interesting in terms of, if you think of it: less hospitalizations, much shorter lengths of stay. And what you realize is we invest far fewer days in the health center than any other high-income nation.
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The third, on this overutilization bit is that, the problem is we do a lot of tests and procedures. I put a little asterisk in there to remind myself to make a point, which is, obviously, when you speak about we do too many tests and treatments, a huge part of that Have a peek at this website hypothesisa big part of the driving consider the policy world, and I enjoy to enter more on thisis the sense that the issue is that the doctors in Americawe're just out there overtesting, overprocedurizing, fee for service.
So, let's look at some empirical information, and there's a little bit of assistance for a few of this and not so much for others, however let's take a look at the data. MRIs. MRIs, we are high. Sure, we have more MRIs per population than typical, but not some insane outlier. Knee replacements, here we truly are primary.
We have more obesity than almost all of these countries, actually, than any of these countries, so it's not an overall surprise that we're going to get more knee replacements. Hip replacements, I anticipated similar numbers on hip replacements. I stated, "Oh, our knee replacements are high, our hip replacements are going to be high." Surprisingly, not so much.
Meaning, once again, we see Germany showing up near the top, however we're really slightly below average. Coronary angioplasty, a procedure that has actually gotten a lot of attention for concerns about overuse. Sure enough, we're a little bit on the high side, and here's Germany again ... Once again, what we see is we're a little high up on some things but not necessarily others, and here's Germany on coronary angioplasty.
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healthcare expense is mostly about supplying too much care, about overutilization. Right? I don't see it. We have fewer hospitalizations, less medical professional sees - who is eligible for care within the veterans health administration. Tests and procedures, I view as a variety. Right? We do more MRIs, and knee replacements, and angioplasties. We do fewer hip replacements. The way I consider it is, when it pertains to usage of health care services, we're above average on some things, we're below par on other things, and on average, we're quite averageon usage.
Another fast one, I'm going to just show you this information and after that keep going. Really, this is one I've even stated publiclywithout information and it ends up I was wrongthe one notion that has come up over and over once again is that all these nations are mainly primary care, we're mostly professionals, and that the specialist-primary care physician mix is off.
Then the very first time my colleaguesI remember they entered my office and they said here's the data on specialty mixand the information was that here was the mean across these countries, and here was the U.S., right in the middle. I didn't believe it. I simply thought this can't be right.
The proportion of physicians who are medical care, and on the right is Sweden and Denmark, where it's just 2233% in France, 54% of doctors are primary carethe greatest difficulty with this figure is everybody calls it all different terms. Is it basic professionals? Is it generalists? Is it main care doctors? What we did was we stated, we do not care what you call it, let's discuss what people are really doing in the workplace.
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And then we went to both national statistics workplaces of each of these nations along with 3 to 5 professionals from each nation, and we revealed them their information (what countries have universal health care). I keep in mind talking with the guys from Switzerland and saying, "Hey, we find that 48% of your physicians are medical care, based on this definition.
The 43% for the U.S. originates from the Kaiser Household Structure, which is an outstanding source of information, using the AMA Masterfile nationwide service. There are other studies and information from the U.S. that put the number a little lower. We can have a dispute about which number is best, but this is our finest at doing an apples-to-apples contrast. how many countries have universal health care.
