Most of the European health care systems provide about the same care as the US at about half the cost. This is extraordinary when you think about it, especially because we in the US pride ourselves on innovation and cost effectiveness. What’s up with this? Still not at all clear to me, but I think a major part of our problem is our … freedom to choose combined with our political spending craziness. When you ask people about allocating risks they tend to very foolishly think we should have “no risks” or at the least always be working to reduce risks. This is not rational – we should actually be increasing some risks in our health care system when this increase in risk would lower the costs. For example rather than spending a huge sum on care for a patient in a coma with a very low chance of recovery we should allocate the money to improving inner city ambulance service times. These types of decisions should be practical / institutional / cost driven and not left to stressed individuals in hospital settings as we tend to do in USA. It’ll take a lot more research to figure out the answer to my question however, which is how in the heck we can spend so much to get the same outcomes!
Here’s a nice article from Kaiser about the spiralling costs of US care, indicating that half the costs are now from hospital care: http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358
In France the pharmacy can prescribe antibiotics and other medications from easy to diagnose conditions. This is a great cost innovation and I’m looking into why we don’t do this here, forcing patients to involve a high cost doctor when this is not needed at all for many ailments.