International Comparison of Health Systems

Comparison to other OECD nations: Australia, Austria, Belgium, Canada, France, Germany, Japan, the Netherlands, Sweden, Switzerland, and the United Kingdom.

United Kingdom Healthcare system

publically funded and operated

Switzerland healthcare system

compulsory private insurance system

United States Healthcare System

voluntary private insurance

Medicaid & Medicare (Date and purpose)

1965

Medicare —> for people aged 65 or older

Medicaid —> for low-income people

Affordable Care Act (Date and Purpose)

2010

expanded US health system to create near-universal eligibility for health insurance coverage for legal residents.

US GDP overtime (1970, 1980, 2020, 2023)

1970 —> 7% of GDP (relatively similar spending with other countries)

1980 —> US health spending grew significantly faster

2020 —> 19.5% of GDP spent on health (up from 17.5% in 2019)

2023 —> 17.6%

Largest category of health spending in both US and comparable countries is spending on…

inpatient and outpatient care

• payments to hospitals, clinics, and physicians for services

• fees such as primary care or specialist vists, surgical care, provider-administrated medications, and facility fees

Americans spent _____ on inpatient and outpatient care, compared to _____ in peer countries

$8,353

$3,636

Patients in the US have _____ average hospital stays and _____ physician visits per capita

shorter, fewer

US spends more on inpatient and outpatient care than most peer nations spend on __________

their entire health systems

The cost of prescription drugs cost ___ in the US than in comparable nations in 2022

more

Spending on Health administration is _____ ______ in the US than in comparable countries. This includes spending on running governmental health programs + overhead insurers

much higher

US spends _____ per capita on preventive care than peer nations (health programs, education for immunizations, disease detection, emergency preparedness)

• spending more than doubled between 2019 and 2020 from $343 to $741 per capita, declined to $649 by 2022)

more

The only category of spending in which the US spends less than most comparable countries on a per-person basis is ______ _______ care

long-term care

Life Expectancy

1980 —> 73.7 (similar to residents in most wealthy countries)

1996 —> ___ became the first nation to report an average life expectancy of 80 years

2012 —> All peer countries had also achieved this milestone

2019 —> average US resident would be almost ___ years shorter than the life of the average resident of comparable nations

COVID —> life expectancy dropped by almost ___ years.

By 2023, life expectancy rebounded to 78.4 yeras, still 1.3 years below pre-pandemic levels + over ___ years below the average among peer nations

Japan

4 (78.8 vs. 82.7)

two from 78.8 to 77.0 (2019 to 2020)

four

Years of Life Lost

difference between their age of at death and the specificed age is recorded as life years lost

United States has the __________rate of years of life lost per 100,000 population aged 75 years old in 2021.

highest

The US has a significantly higher rate of years of life lost due to ______ _________, _________ ________, and _________ _______ (including drug overdose)

heart disease, transport accidents, and accidental poisonings

Most other countries have a ______ rate of years of life lost due to cancer

similar

Children and teens in the US are ____ likely to make it to adulthood than in peer countries, with the US having higher rates of ______ _____ accidents, _____ deaths, and ______ deaths among children and teens.

less likely

motor vehicle accidents, firearm deaths, and suicide deaths

US performs _____ on maternal mortality and patient safety measures than peer countries

worse

The US performs _____ or _____ than peer nations in mortality rates within 30 days of acute hospital treatment and patient safety (i.e. rates of post-operative sepsis)

similarly or better

30-day mortality rates after hospital admissions for heart attacks are _____ in the US and the average of comparable countries. However, the 30-day mortality rates for schemic strokes were _____ deahts per 100 patients in the US compared to an average of 6.9 deaths per 100 patients in similar countries.

similar

4.5, 6.9

the US is an outlier with the highest rate of pregnancy related deaths (____ deaths per 100,000 live births in 2023) compared to similar countries (______ deaths per 100,000 live births)

3x diference

18.6, 5.1

Maternal mortality rate for Black Mothers is about ____ times the rate for White mothers

three

People in Switzerland pay ____ out-of-pocket on health care

more

($1,688 vs $1,425) per capita

More than _ in 4 Americans report skipping consultations, tests, treatment, or follow up.

____% report skipping medication

Only _____% of the US population is uninsured

1 in 4

9.2%

About ___% of Americans were able to make a timely appointment, somewhat below the average of peer nations (____%)

51%

57%

The US has just _____ practicing physicians per 1000 residents compared to an average of ______ among peer nations

2.7, 3.8

Most other nations have somewhere between _______quarter and ________half of all physicians employed in primary care

one quarter and one half

In the US, only______% of doctors are general physicians, including primary care physicians

12%

the US only has ____ psychiatrists per 1000 residents, lowest of all peer nations.

0.15

Although the US has a high number of specialist providers, only _______ are psychiatrist, compared to an average ______ of specialists in other countries. Psychiatry remains one of the ________-paid physician specialties in the US.

6%

10%

lowest