Professional Documents
Culture Documents
"I have argued for years that we do not have a health care system in America. We
have a disease-management system - one that depends on ruinously expensive
drugs and surgeries that treat health conditions after they manifest rather than giving
our citizens simple diet, lifestyle and therapeutic tools to keep them healthy”
- Andrew Weil
Accessibility
• Only 30% of Americans report that they can access a doctor on the very day they need one, as opposed to 41% Britons and 55%
Germans.
• 67% percent of Americans -- more than in any other country -- say it's difficult to get care on nights, weekends, or holidays with
resorting to the emergency room, where care is costlier and, if your injury is not grievous, less efficient
Accommodation
• Americans are the least likely to report that their doctors explain things in ways they understand or say doctors spend enough
time with them (56%of Americans say they do, as compared to 70% of Germans). Americans are most likely to report that test
results or medical records were unavailable during our scheduled appointments. They also don’t have ideas about the doctor-
patient relationship.
Acceptability
• Americans are the most likely to report a medical, medication, or lab error, with 20% saying they've experienced one of the above
over the past year. For those of us with chronic diseases, the rates are even higher. Our overall self-evaluation of the treatment
we receive is solidly in the middle of the pack, with 70% expressing satisfaction.
Affordability
• The U.S. had the highest pharmaceutical spending per capita among its peers at $1,443, the researchers found, compared with
an average of $749 for all 11 countries.
Why is US behind other countries despite large spending?
Drivers of Health Care Spending in US Uneven Coverage of Health Insurance
Prohibitively high cost • Health insurance premiums in the U.S. are rising fast.
• 31% of uninsured adults reported not getting or delaying From 2005 to 2015, average annual health insurance
medical care because of cost, compared to 5% of premiums for family coverage increased 61%, while
privately insured adults and 27% of those on public worker contributions to those plans increased 83% in the
insurance, including Medicaid/CHIP and Medicare. same period. This rate of increase outpaces both
inflation and increases in workers’ wages.
Rise of chronic diseases, including obesity
• Patients with chronic illness in their last two years of life • While the majority of U.S. citizens have health
account for about 32% of total Medicare spending insurance, premiums are rising and the quality of the
insurance policies is falling. Average annual premiums
for family coverage increased 11% between 1999 and
High administrative costs
2005, but have since levelled off to increase 5% year
• Larger firms spend a smaller percentage of their total
between 2005 and 2015.
expenditures on administration, and nationwide
estimates suggest that as much as half of the $361
billion spent annually on administrative costs is wasteful • Deductibles are rising even faster. Between 2010 and
2015, single coverage deductibles have risen 67%
• In March, 2010, President Obama signed the ACA into law that made hundreds of significant changes to the U.S. healthcare system
between 2011 and 2014. Provisions included in the ACA are intended to expand access to healthcare coverage, increase consumer
protections, emphasises prevention and wellness, and promote evidence- based treatment
• Beginning in January 2014, almost all Americans are required to have some form of health insurance from either their employer, an
individual plan, or through a public program such as Medicaid or Medicare.
• A major provision of the ACA was the creation of health insurance marketplace exchanges where individuals not already covered by
an employer-provided plan or a program such as Medicaid or Medicare can shop for health insurance. Individuals with incomes
between 100% and 400%of the federal poverty line would be eligible for advanceable premium tax credits to subsidise the cost of
insurance. Currently, only 14 states operate their own exchanges
Digitisation of Health Care-The way forward
• Digital health care technology is delivering solutions to tackle the increasing need for better diagnostics and more
personalised therapeutic tools.
• It also is creating challenges for governments, health systems, and insurers, which must collect, analyse, and store more
and more data.
• Digital and AI technologies will help enable on demand interaction and seamless processes to improve patient
experience.
• Robotic process automation (RPA) and AI will allow caregivers to spend more time providing care and less time
documenting it as well as help enhance their development and learning.
• Digital supply chains, automation, robotics, and next-generation interoperability will drive operations management and
back-office efficiencies.
• https://www.theatlantic.com/health/archive/2017/07/us-worst-health-care-commonwealth-2017-report/533634/
• https://www.theguardian.com/us-news/ng-interactive/2017/jul/25/us-healthcare-system-vs-other-countries
• https://www.newyorker.com/magazine/2009/12/14/testing-testing-2
• https://www.vox.com/policy-and-politics/2017/5/4/15545068/ahca-expert-analysis
• World Industry Outlook, Healthcare and Pharmaceuticals, The Economic Intelligence Unit, June 2017
• High-value health care: Innovative approaches to global challenges, Deloitte, 2016, citing Roberto Tapia-Conyer et
al., “Enablers and inhibitors of the implementation of the Casalud model, a Mexican innovative healthcare model for
non-communicable disease prevention and control,” Health Research Policy and Systems 14, no. 51 (2016), DOI:
10.1186/s12961- 016-0125-0.