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Monday, September 30, 2019

How the US Healthcare System Compares to Other Large Democracies


Comparison of Large Democracy Health Systems
Continuing the informed conversation on health systems from the previous post[1], this table shows how the US compares to several large democracies with national healthcare systems which include private insurance and clinics.

Criteria
France
Germany
Australia
USA
National mandate for healthcare access and insurance protection
Insurance is provided to up to 99% of residents; hospitals are owned by the government; clinics can be public or private; health insurance is required, through three government run companies; workers pay up to 8% of income and employers pay 13% as a wage tax
Insurance is mandated for all and residents pay up to 8% of gross income into the nonprofit state-run insurance program;employers and employees contribute to a comprehensive health, long term care, and accident protection program; insurance may be either public or private; group healthcare was standardized here in 1883
Has a national healthcare system called Social Security, which provides hospital coverage, but not  all of outpatient care; financed by 1.5% tax on gross income (2.5% if you lack private supplemental insurance)

Hodge podge system, VA and private insurance varies widely by region; medical insurance was mandated under the PPACA but was reversed by Trump; Medicare is paid by a 1.45% payroll tax on workers and employers; lack of hospital price transparency
Public versus private care hospital overview
62% are Public 24% are private nonprofit and 12% are for-profit hospitals
50% are Public hospitals and the rest are a mix of nonprofit and for profit
 66% are public hospitals, 33% private; public hospital care is free to residents
20.% government owned hospitals, 58.5% are nonprofit and 21.3% are for profit
Specialty care is readily available
Yes, doctors even make house calls
Yes
Yes, in western Australia, less so elsewhere
Yes, if you have the money to pay
Hospital bill per discharge
$11,149
$6,122
$10,874
$21,186
Private insurance is available
Yes
Yes 
Yes
Yes, and is a must if you want care
Cost of healthcare per capita
$4,600
$5,551
$4,708
$9,892
Cost of care born by government
86%
85%
69%
51%
Average cost of health care paid by residents per month
10 or $11, very small co-payments; referrals may be required for specialists in order to get max benefits
Germany limits cost-sharing to a 2% max of income, which is a little over $100 per month; All Germans contribute to the healthplan, roughly 400€ or $500 
$167/person is the average cost for private insurance/person; co-payments are limited to $25
CMS estimates Americans spend $267 in out of pocket expenses and over $500 for insurance premiums
Per capita spend for insurance administration
$272
$255
$123
$787

Conclusions
The American people pay a much higher percentage of total health system costs than residents in the other democracies. And residents of the US are not getting better quality care for that huge disparity. Considering the average cost for unreimbursed care and the typical insurance contribution born by an American worker, totals $9,200 per year, this money could be invested for a healthy retirement savings or to purchase a home. Voters of millennial-age are realizing this rip-off, which is why they support transformation in the government through Bernie Sanders and Elizabeth Warren. It has taken a few decades but the majority of Americans are finally realizing the current system of healthcare in the US is failing them.
And this is the healthpolicymaven signing off, encouraging you NOT to sign blanket releases when you have inpatient procedures done, do indicate that for which you consent and that for which you decline. If you are intimidated by medical jargon and administration procedures, bring an advocate.


References


Institute for Quality and Efficiency in Health Care. (2018). Health Care in Germany; The German Health Care System. NCBI, NLM,National Institutes of Health.gov. Informed Healthcare.org. Retrieved September 30, 2019, from https://www.ncbi.nlm.nih.gov/books/NBK298834/
Petersen-Kaiser Health System Tracker. (2019, September 30). Petersen-Kaiser Health System Tracker. Retrieved from Henry J. Kaiser Foundation.org: https://www.healthsystemtracker.org/indicator/access-affordability/percent-insured/
The Commonwealth Fund.org. (2019, September 30). International Health Care System Profiles. Retrieved from The Commonwealth Fund.org: https://international.commonwealthfund.org/countries/
Tikkanen, R. (2019, September 30). Multinational Comparison of Health Systems Data, 2017. Retrieved from Commonwealth Fund.org: https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_chartbook_2017_multinational_comparisons_of_health_systems_data_2017_rtikkanen_pdf.pdf
Transferwise.com. (2019, September 30). Healthcare in France: A Guide to the French Healthcare System. Retrieved from Transferwise.com: https://transferwise.com/us/blog/healthcare-system-in-france







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