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Business of Health

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Business of Health

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The business of healthcare continues to expand at record rates. Seems like just about everyone you know is in the health care business. Without a doubt it is probably the largest industry worldwide other than energy.

No place on earth spends more on healthcare than the United States. The U.S. currently has expenditures that cost twice as much, but with poorer outcomes when compared to other developed countries. Besides the usual statistics that the U.S. lags in the areas of infant mortality and life expectancy, have you heard of the following?

In 2011 a study by SAVE THE CHILDREN ranked the U.S. 31st out of 164 countries in the Motherhood Health Index, one of the lowest among developed countries, because it had the highest lifetime risk of maternal mortality among the industrialized countries.

A 2009 survey by the Commonwealth Fund revealed that despite spending the most for healthcare, the U.S. lags behind in terms of access to care, the use of financial incentives to improve the quality of care, and the use of health information technology and adoption of other innovations. More specific findings show:

• More than half (58%) of U.S. physicians—by far the most of any country surveyed—said their patients often have difficulty paying for medications and care. Half of U.S. doctors spend substantial time dealing with the restrictions insurance companies place on patients’ care.

• Only 29 percent of U.S. physicians said their practice had arrangements for getting patients after-hours care—so they could avoid visiting a hospital emergency room. Nearly all Dutch, New Zealand, and U.K. doctors said their practices had arrangements for after-hours care.

• Only 46 percent of U.S. doctors use electronic medical records, compared with over 90 percent of doctors in Australia, Italy, the Netherlands, New Zealand, Norway, Sweden, and the United Kingdom.

• Twenty-eight percent of U.S. physicians reported their patients often face long waits to see a specialist, one of the lowest rates in the survey. Three-quarters of Canadian and Italian physicians reported long waits.

• While all the countries surveyed use financial incentives to improve the quality of care, primary care physicians in the U.S. are among the least likely to be offered such rewards; only one-third reported receiving financial incentives. Rates were also low in Sweden (10%) and Norway (35%), compared with large majorities of doctors in the U.K. (89%), the Netherlands (81%), New Zealand (80%), Italy (70%), and Australia (65%).

• Patients with chronic illness require substantial time with physicians, education about their illness, and coaching about treatment, diet, and medication regimens. Care teams composed of clinicians and nurses have been shown to be effective in providing care to people with chronic conditions and in improving outcomes. The use of such teams is widespread in Sweden (98%), the U.K. (98%), the Netherlands (91%), Australia (88%), New Zealand (88%), Germany (73%), and Norway (73%). It is less prevalent in the U.S. (59%) and Canada (52%), with France (11%) standing out on the low end.

According to Commonwealth Fund President Karen Davis following the 2009 survey: "Access barriers, lack of information, and inadequate financial support for preventive and chronic care undermine primary care doctors' efforts to provide timely, high quality care and put the U.S. far behind what many other countries are able to achieve. Our weak primary care system puts patients at risk, and results in poorer health outcomes, and higher costs. The survey provides yet another reminder of the urgent need for reforms that make accessible, high-quality primary care a national priority.”

You have to be an idiot to realize that the U.S. health care system needs a fix. But, bear in mind other countries have their problems too, Just ask a Brit who can’t go on dialysis at age 65 or a Canadian, except premiers, that is still waiting for a hip replacement or the last mammogram report or that next specialist or MRI appointment.

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So, how healthy is the business of health?