United States Spends Most On Health, But France No. 1 In Treatment
Controversial Study Finds France Has World's Best Health-Care System
The French healthcare system has been in place and has continued to
evolve ... and was classified the "best health system in the world" by
the World Health Organization.
By Lauran Neergaard, Associated Press, 6/20/2000
WA****NGTON (AP) The United States spends more per person on health
care than any other country, yet in overall quality its care ranks
37th in the world, says a World Health Organization analysis. It
concluded that France provides the globe's best health care.
Italy ranked No. 2, says the World Health Re****t, being published
Wednesday a highly contentious first attempt to compare the world's
health systems.
Tiny countries with few patients to care for San Marino, Andorra,
Malta crowd onto the World Health Organization's surprising best list.
Singa****e, Spain, Oman, Austria and Japan round out the top-10.
That doesn't mean the French and Italians are the world's healthiest
people. Japan actually won that distinction.
Instead, the WHO re****t basically measures bang for the buck:
comparing a population's health with how effectively governments spend
their money on health, how well the public health system prevents
illness instead of just treating it and how fairly the poor,
minorities and other special populations are treated.
When each country's measurements were added together, even study co-
author Dr. Christopher Murray, a Harvard health economist and the
health organization's chief of health policy evidence, was surprised.
He had expected Scandinavian countries or Canada to be the world's
best, because they're always presented as models.
Instead, Norway hit No. 11, Canada 30.
Britain, with its much-debated free national health service, came in
18th.
The re****t sparked immediate controversy.
''Any set of rankings that puts Finland at 31 and Italy at 2, or even
France at No. 1, raises questions,'' said Nick Bosanquet, health
policy professor at London University's Imperial College, noting that
previous studies have been highly critical of Italy.
''They are obviously getting an olive oil effect,'' he added,
referring to the famed Mediterranean diet.
Italians themselves have expressed dissatisfaction with health care,
said a surprised E. Richard Brown, director of the University of
California, Los Angeles, Center for Health Policy Research.
It's long been clear ''the U.S. is woefully lacking,'' Brown said.
Proof, he said, is in the 40 million uninsured Americans amid a
patchwork of different quality private insurance and government
programs.
While good at expensive, heroic care, Americans are very poor at the
low-cost preventive care that keeps Europeans healthy, said Princeton
University health economist Uwe Reinhardt. Take prenatal care, vital
to a healthy start in life. Reinhardt called France the world's role
model, while many poor Americans never get prenatal care.
Regardless of debate over rankings and what criteria to use, the World
Health Organization won wide praise for establi****ng a way countries'
improvement, or worsening, can be measured.
The United States spends a stunning $3,724 per person on health each
year. But measuring how long people live in good health not just how
long they live the Japanese beat Americans by 4=BD years, and the French
lived three more healthy years. Yet Japan spends just $1,759 per
person on health and France $2,125.
''That's a pretty big gap,'' noted Murray. ''For the money we're
spending, we should be able to do a lot better.''
How did Oman, which spends just $334 per person on health care, rate
No. 8?
Previous analyses have looked just at how healthy people are, ''and
you're left with the image that the rich (countries) do well because
they're rich,'' said study co-author Dr. Julio Frenk. This new
analysis praises health systems ''that utilize few resources very
well.''
Twenty years ago, one in four children in Oman died before their fifth
birthday. Today that has plummeted to 15 deaths per 1,000 children,
Frenk said. He also cited 24-hour clinics and a new tax-funded
universal care system.
Indeed, who pays the cost of health care, and how fair payments are,
are im****tant to WHO's rankings. In most of the world the poor pay a
dispro****tionate share, particularly in ''out-of-pocket'' expenses
that drive families into bankruptcy just when someone's sick, the
re****t said.
No country that spends less than $60 a person on health care does
well, the re****t added. Yet 42 countries spent less than that like
Somalia, at $11.
Many of the worst-faring countries are in sub-Saharan Africa. Largely
because of the AIDS epidemic, healthy life expectancy for babies born
this year in many of those nations has dropped to 40 years or less,
WHO said.
Worst in the 191-country ranking: Sierra Leone, Myanmar, Central
African Republic, Democratic Republic of the Congo and Nigeria.
WHO recommended that countries extend health insurance to as many
people as possible. That doesn't mean endorsing government-run
insurance, Frenk stressed. He said countries with good mixes of
private and public programs do well.
But ''the worst way to pay for care is out of pocket at the time of
illness,'' he said.
http://cthealth.server101.com/Old%20Universal%20Health%20Care/united_states=
_spends_most_on_health,_but_france_no__1_in_treatment.htm
|
