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Our Health Care 37th In The World: Not Just For Veterans

Written by veterans  |  28. August 2009

Last week I looked at eight health care falsehoods: - 01 - Government Will Decide What Care I Get (a.k.a. they won't give grandma a hip replacement): FALSE - 02 - The Bill Is Paid For: FALSE - 03 - Private Insurance Will Be Illegal: FALSE - 04 - The House Bill Requires Suicide Counseling: FALSE - 05 - Families Will Save $2,500: FALSE - 06 - Medicare Benefits Will Be Slashed: FALSE - 07 - Illegal Immigrants Will Be Covered: FALSE - 08 - Health Care Reform Will Change VA Benefits: FALSE This week I'll take a look at what I consider to be the worse FACT concerning our health care. The List - Partial The World Health Organization's ranking of the world's health systems: 1 - France 2 - Italy 3 - San Marino 4 - Andorra 5 - Malta 6 - Singapore 7 - Spain 8 - Oman 9 - Austria 10 - Japan 11 - Norway 12 - Portugal 13 - Monaco 14 - Greece 15 - Iceland 16 - Luxembourg 17 - Netherlands 18 - United Kingdom 19 - Ireland 20 - Switzerland 21 - Belgium 22 - Colombia 23 - Sweden 24 - Cyprus 25 - Germany 26 - Saudi Arabia 27 - United Arab Emirates 28 - Israel 29 - Morocco 30 - Canada 31 - Finland 32 - Australia 33 - Chile 34 - Denmark 35 - Dominica 36 - Costa Rica 37 - United States of America 38 - Slovenia 39 - Cuba More About the US, 37th In The List Performance - Overall Health System: 37th Performance - On Level of Health: 72nd Health Expenditure Per Capita in International Dollars: 1st Responsiveness - Level: 1st Responsiveness - Distribution: 3rd - 38th Fairness in Financial Contribution: 54th - 55th About The Criteria Responsiveness: The nations with the most responsive health systems are the United States, Switzerland, Luxembourg, Denmark, Germany, Japan, Canada, Norway, Netherlands and Sweden. The reason these are all advanced industrial nations is that a number of the elements of responsiveness depend strongly on the availability of resources. Fairness of Financial Contribution: When WHO measured the fairness of financial contribution to health systems, countries lined up differently. The measurement is based on the fraction of a household s capacity to spend (income minus food expenditure) that goes on health care (including tax payments, social insurance, private insurance and out of pocket payments). Colombia was the top-rated country in this category, followed by Luxembourg, Belgium, Djibouti, Denmark, Ireland, Germany, Norway, Japan and Finland. Colombia achieved top rank because someone with a low income might pay the equivalent of one dollar per year for health care, while a high- income individual pays 7.6 dollars. In North America, Canada rates as the country with the fairest mechanism for health system finance " ranked at 17-19, while the United States is at 54-55. Overall Level of Health: A good health system, above all, contributes to good health. To assess overall population health and thus to judge how well the objective of good health is being achieved, WHO has chosen to use the measure of disability- adjusted life expectancy (DALE). This has the advantage of being directly comparable to life expectancy and is readily compared across populations. The report provides estimates for all countries of disability- adjusted life expectancy. DALE is estimated to equal or exceed 70 years in 24 countries, and 60 years in over half the Member States of WHO. At the other extreme are 32 countries where disability- adjusted life expectancy is estimated to be less than 40 years. Many of these are countries characterised by major epidemics of HIV/AIDS, among other causes. Distribution of Health in the Populations: It is not sufficient to protect or improve the average health of the population, if - at the same time - inequality worsens or remains high because the gain accrues disproportionately to those already enjoying better health. The health system also has the responsibility to try to reduce inequalities by prioritizing actions to improve the health of the worse-off, wherever these inequalities are caused by conditions amenable to intervention. The objective of good health is really twofold: the best attainable average level " goodness " and the smallest feasible differences among individuals and groups " fairness. A gain in either one of these, with no change in the other, constitutes an improvement. Responsiveness: Responsiveness includes two major components. These are (a) respect for persons (including dignity, confidentiality and autonomy of individuals and families to decide about their own health); and (b) client orientation (including prompt attention, access to social support networks during care, quality of basic amenities and choice of provider). Distribution of Financing: There are good and bad ways to raise the resources for a health system, but they are more or less good primarily as they affect how fairly the financial burden is shared. Fair financing, as the name suggests, is only concerned with distribution. It is not related to the total resource bill, nor to how the funds are used. The objectives of the health system do not include any particular level of total spending, either absolutely or relative to income. This is because, at all levels of spending there are other possible uses for the resources devoted to health. The level of funding to allocate to the health system is a social choice " with no correct answer. Nonetheless, the report suggests that countries spending less than around 60 dollars per person per year on health find that their populations are unable to access health services from an adequately performing health system. The List 1 France, 2 Italy, 3 San Marino, 4 Andorra, 5 Malta, 6 Singapore, 7 Spain, 8 Oman, 9 Austria, 10 Japan, 11 Norway, 12 Portugal, 13 Monaco, 14 Greece, 15 Iceland, 16 Luxembourg, 17 Netherlands, 18 United Kingdom, 19 Ireland, 20 Switzerland, 21 Belgium, 22 Colombia, 23 Sweden, 24 Cyprus, 25 Germany, 26 Saudi Arabia, 27 United Arab Emirates, 28 Israel, 29 Morocco, 30 Canada, 31 Finland, 32 Australia, 33 Chile, 34 Denmark, 35 Dominica, 36 Costa Rica, 37 United States of America, 38 Slovenia, 39 Cuba, 40 Brunei, 41 New Zealand, 42 Bahrain, 43 Croatia, 44 Qatar, 45 Kuwait, 46 Barbados, 47 Thailand, 48 Czech Republic, 49 Malaysia, 50 Poland, 51 Dominican Republic, 52 Tunisia, 53 Jamaica, 54 Venezuela, 55 Albania, 56 Seychelles, 57 Paraguay, 58 South Korea, 59 Senegal, 60 Philippines, 61 Mexico, 62 Slovakia, 63 Egypt, 64 Kazakhstan, 65 Uruguay, 66 Hungary, 67 Trinidad and Tobago, 68 Saint Lucia, 69 Belize, 70 Turkey, 71 Nicaragua, 72 Belarus, 73 Lithuania, 74 Saint Vincent and the Grenadines, 75 Argentina, 76 Sri Lanka, 77 Estonia, 78 Guatemala, 79 Ukraine, 80 Solomon Islands, 81 Algeria, 82 Palau, 83 Jordan, 84 Mauritius, 85 Grenada, 86 Antigua and Barbuda, 87 Libya, 88 Bangladesh, 89 Macedonia, 90 Bosnia-Herzegovina, 91 Lebanon, 92 Indonesia, 93 Iran, 94 Bahamas, 95 Panama, 96 Fiji, 97 Benin, 98 Nauru, 99 Romania, 100 Saint Kitts and Nevis, 101 Moldova, 102 Bulgaria, 103 Iraq, 104 Armenia, 105 Latvia, 106 Yugoslavia, 107 Cook Islands, 108 Syria, 109 Azerbaijan, 110 Suriname, 111 Ecuador, 112 India, 113 Cape Verde, 114 Georgia, 115 El Salvador, 116 Tonga, 117 Uzbekistan, 118 Comoros, 119 Samoa, 120 Yemen, 121 Niue, 122 Pakistan, 123 Micronesia, 124 Bhutan, 125 Brazil, 126 Bolivia, 127 Vanuatu, 128 Guyana, 129 Peru, 130 Russia, 131 Honduras, 132 Burkina Faso, 133 Sao Tome and Principe, 134 Sudan, 135 Ghana, 136 Tuvalu, 137 Ivory Coast, 138 Haiti, 139 Gabon, 140 Kenya, 141 Marshall Islands, 142 Kiribati, 143 Burundi, 144 China, 145 Mongolia, 146 Gambia, 147 Maldives, 148 Papua New Guinea, 149 Uganda, 150 Nepal, 151 Kyrgystan, 152 Togo, 153 Turkmenistan, 154 Tajikistan, 155 Zimbabwe, 156 Tanzania, 157 Djibouti, 158 Eritrea, 159 Madagascar, 160 Vietnam, 161 Guinea, 162 Mauritania, 163 Mali, 164 Cameroon, 165 Laos, 166 Congo, 167 North Korea, 168 Namibia, 169 Botswana, 170 Niger, 171 Equatorial Guinea, 172 Rwanda, 173 Afghanistan, 174 Cambodia, 175 South Africa, 176 Guinea-Bissau, 177 Swaziland, 178 Chad, 179 Somalia, 180 Ethiopia, 181 Angola, 182 Zambia, 183 Lesotho, 184 Mozambique, 185 Malawi, 186 Liberia, 187 Nigeria, 188 Democratic Republic of the Congo, 189 Central African Republic, 190 Myanmar --- Regards, Walt Schmidt

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