In June 2017, the United States Senate rejected a third attempt under President Donald Trump to repeal the Affordable Care Act. This failure was the latest development in the US’s slow move towards socialized healthcare. But in fact, the United States has long had one of the worst balances between what healthcare costs each citizen, and what benefit they get out of it.
In the rest of the world, citizens pay much less, or nothing, and often receive higher quality care, with higher life expectancy and lower rates of disease.
So, we wanted to know, which countries get Whicthe most out of their healthcare?
Well, since 2012, the Bloomberg Health-Care Efficiency Index has measured exactly this balance. As of 2016-2017 one of the top three ranking countries was Spain.
Spain is an above average representation of healthcare in OECD countries and spends roughly twenty-six hundred dollars per person with an average life expectancy of nearly 84 years. About ten percent of the country’s GDP goes towards healthcare costs, which are largely subsidized by the government.
This system of socialized medicine is globally known as “single-payer”, and most citizens see no out-of-pocket expenses when they visit public hospitals. In fact, the right to healthcare is guaranteed in Spain’s constitution. However, this system also leads to complaints about delays in seeing doctors beyond primary care or getting specialized surgeries.
Ranking Second on the Efficiency-Index is another country with universal healthcare, Singapore.
Unlike Spain, Singapore requires that care is NEVER provided for free, in order to avoid wasteful use of the system. Instead, healthcare costs are kept artificially low through government subsidies, which compared to Spain, only use 1.6% of Singapore’s GDP.
In addition to implementing price controls on medical care and medication, the country uses a system known as Medisave. This is a medical savings account, where up to 9 percent of employee salaries are required to be deducted and set aside and can be used for personal or family care. This combination means that costs are low, while the quality of care is one of the highest in the world.
But overall, the best, and most efficient healthcare system is reportedly in the autonomous territory of Hong Kong.
1. Hong Kong
Interestingly, the territory uses a combination of private and public care, with one of the highest life expectancies in the world, costing just $2000 dollars per citizen, and comprising just 3% of the GDP.
However, Hong Kong’s high ranking healthcare may not be exactly what it seems at first glance. First of all, while public healthcare plans can be purchased at low costs, the wait to see specialists or to get certain surgeries can be excessive, with some sources claiming 5-year wait lists.
On the other hand, private hospitals are reportedly speedy but very expensive. This combination of low-cost care for routine visits and medication, with high priced elective or specialized care, makes Hong Kong’s system incredibly efficient, and difficult to overburden, thereby avoiding raising costs for everyone.
While these three countries get the most bang for their buck, with very high standards of care and life expectancy, they are also difficult to apply broadly around the world.
Singapore and Hong Kong have populations of under ten million people, meaning that most health factors are uniform throughout the region and population. By comparison, the United States is enormous, with a population of over 320 million, making centralized, or single payer healthcare more difficult to implement without serious complications.
Nonetheless, US healthcare costs are astronomical, with medical bills being the number one cause of bankruptcy for Americans.
Why is US healthcare so incredibly expensive?
Healthcare in the United States is very different from healthcare in the rest of the world.
1. The US is one of the only developed countries without universal healthcare for its citizens. Often times, care is treated as a commodity, rather than a necessity.
2. Instead of prices being set by procedure cost, hospitals and insurance companies negotiate for prices that are based on bargaining power. Meanwhile, patients have almost no influence on the cost, considering that there is often no alternative to being treated. But some have pointed out that unlike other commodities, healthcare costs tend to rise without ever going down, leading to a perpetually increasing price point.
3. One of the reasons for this is that hospitals are responsible for treating uninsured patients. The cost of their treatment is passed on to insured patients and is tacked onto their care.
4. Additionally, US hospitals spend considerably more than any other country on administrative costs.
5. Doctors also earn much more for the same procedures than in other countries. Even drug costs are higher, as the US does not negotiate drug purchases in bulk.
From top to bottom, healthcare suppliers charge Americans more money.