U.S. Health Care Costs More Than ‘Socialized’ European Medicine

Rendezvous.blogs.nytimes - A sobering statistic emerged on Thursday as the United States Supreme Court prepared to deliver its judgment on Obamacare.

It confirmed that the U.S. spends more per capita on publicly funded health care than almost every other country in the developed world. And that includes countries that provide free health care to all their citizens.

Figures published on Thursday by the Organization for Economic Co-operation and Development, a 34-nation grouping of advanced economies, showed that less than half of health spending in the U.S. was publicly financed compared with an O.E.C.D. average of 72.2 percent.

"However, the overall level of health spending in the United States is so high that public (i.e. government) spending on health per capita is still greater than in all other OECD countries, except Norway and the Netherlands," according to the Paris-based organization's Health Data 2012 report.

Combined public and private spending on health care in the U.S. came to $8,233 per person in 2010, more than twice as much as relatively rich European countries such as France, Sweden and Britain that provide universal health care.

Are Americans healthier as a result? The U.S. has fewer doctors per capita than comparable countries, and fewer hospital beds. But more is spent on advanced diagnostic equipment and health tests.

Life expectancy has risen in line with that in other developed countries, but the average American life span of 78.7 years in 2010 was below the O.E.C.D. average. Obesity in the U.S. was the highest in the 34-nation survey.

"Obesity's growing prevalence foreshadows increases in the occurrence of health problems (such as diabetes and cardiovascular diseases), and higher health care costs in the future," the O.E.C.D. said.

An earlier survey found that U.S. health care was overpriced and not always better than in comparable countries. "Sometimes treatments are provided which are unnecessary, or even undesirable," the organization said in a 2011 report on comparative health indicators.

"It does a lot of elective surgery," the survey said of the U.S. health care system, "the sort of activities where it is not always clear-cut about whether a particular intervention is necessary or not."

Advocates of state-funded universal health care might use such statistics to show free health care for all is not only fairer but also cheaper.

In defense of a Canadian health care system maligned during the Obamacare debate as "an inefficient socialistic enterprise," Tim Shufelt of Canada's Financial Post wrote: "Canadians pay much less per capita on health care than do Americans, while ranking higher among the most common measures of human health."

Canada's embrace of universal health care reflects sentiment in most countries where free treatment is regarded as a right.

"In Europe...the right of access to health care for all is considered normal," Pierre-Yves Dugua wrote in a Figaro blog, "as is a financing system based on compulsory contributions."

The economic arguments in favor of European-style systems have been evident in the domestic U.S. debate on Obamacare.

Commenting on the latest O.E.C.D. figures, an editorial in Gannett's The Advertiser noted: "America pays big-time money for health care and gets Third World results."

"The greatest public good comes from universal access to care that emphasizes prevention and health education," according to article. "The European systems, often socialized or with health insurers forced to offer basic plans to everyone, can do that. Ours doesn't."

Where in the world can you get universal health care?

Edition.cnn - The U.S. Supreme Court upheld President Barack Obama's sweeping health care legislation Thursday in a narrow 5-4 ruling that Obama says will provide up to 30 million additional Americans with health care.

America doesn't have universal health care coverage -- what the World Health Organization (WHO) calls "a widely shared political aim of most countries" -- but neither do most other countries.

Nearly 50 countries have attained universal or near-universal health coverage by 2008, according to the International Labor Organization. Several well-known examples exist like the UK, which has the National Health Service, and the Canadian public health care system.

Here are more examples of countries have implemented near-universal health care.

Brazil

Free health care coverage is recognized as a citizen's right in Brazil.

Brazilians have both a private and public health care system, which was overhauled in 1988. The Sistema Único de Saúde, a nationalized program, provides primary health care, while a network of public and contracted hospitals delivers specialist care.

About 80 percent of Brazil's population relies on public care, while the wealthiest 20% can afford private health care, according to a Center for Strategic and International Studies report.

Since the 1990s, Brazil has also provided universal access to HIV/AIDS drugs.

During the three decades since the nation's major health care changes, infant mortality decreased and life expectancy increased by 10.6 years, according to a 2011 article in medical journal The Lancet.

But the system hasn't been without problems, according to the Center for Strategic and International Studies report, which alluded to gaps in the quality of care between various Brazilian regions.

Rwanda

Since establishing a national health plan in 1999, Rwanda has insured about 91% of its population with health care -- a greater percentage than the United States.

Rwanda has been dubbed "Africa's Singapore" by The Economist for its transformation since a devastating genocide in 1994.

Watch Fareed Zakaria talk with Rwanda's president

The country has three health insurance plans, one for government employees, another for the military, and the third for the remaining population. The country commits about 20% of its annual spending to health, which is funded by tax revenues, insurance premiums and financial support from international donations, according to a WHO report.

Since introducing health insurance, Rwanda has seen lower childhood mortality rates; more people are also receiving medical attention. But the country faces challenges from an increase in health services and making contributions more affordable for its poorest citizens, according to a WHO report.

Thailand

By law, Thailand requires all patients to be covered by health insurance, regardless of their ability to pay.

The WHO uses Thailand as an example of a low- or middle-income country that has been able to extend health coverage to all citizens.

Introduced in 2002 as the "30-bhat scheme," (which is less than $1), the plan added about 14 million previously uninsured people to the Thai system.

Prescription drugs, hospitalizations and services like chemotherapy, surgery and emergency care are free to patients, according to a WHO report.

But the addition of millions of people to a health care system strained the existing structures, prompting criticisms of long waits, poor quality of service and shortage of service.

South Korea

South Korea passed a law in 1977, mandating health insurance for industrial workers. During its rapid economic growth, health care became a priority for the government, which created the National Health Insurance. The system extended to universal coverage by 1989.

The government merged more than 300 individual insurers into a single national fund, according to a WHO report.

Korea's single-payer program has "been successful in mobilizing resources for health care, rapidly extending population coverage, effectively pooling public and private resources to purchase health care for the entire population, and containing health care expenditure," according to a report published in Health Policy Plan.

But another report published in Health Affairs said that the public funding is limited, leaving "beneficiaries with relatively high payments." South Korea's expenditure on health care is 6.3% of the country's gross domestic product, compared with 18% in the United States.

Moldova

The Eastern European country became independent with the fall of the Soviet Union in 1991. By 2004, it began a mandatory health insurance program with the aim of providing the entire population with basic health care.

Employed Moldovans chip in a portion of their income through a payroll tax or a flat-rate contribution. Others who are unemployed or not working are insured by the government.

Its National Health Insurance Company is the sole buyer of health care services and organizes emergency, primary and secondary care locally, according to a report by the European Observatory on Health Systems and Policies, a joint partnership between European governments and the World Health Organization.

Kuwait

Kuwait's level of health care is comparable to average European standards, according to the WHO's profile of the Middle Eastern country.

The country began building up its health care system as it gained wealth from oil revenues. By the 1950s, the government implemented free comprehensive health care. This resulted in declines in general mortality and infant deaths, the report said. "Free health care was so extensive that it even included veterinary medicine," according to a local WHO report.

Kuwait faces an aging population as well as an epidemic of diabetes, heart disease and obesity-related complications that place great demands on its health care system.

Chile

The Chilean constitution guarantees rights to health protection.

Chileans can opt for public care or get coverage from private health insurance companies. Wealthier citizens can buy insurance from the Instituciones de Salud Previsional or obtain coverage through their employer. A 7% income tax funds the public health care system, the Fondo Nacional de Salud, according to an analysis of health care reform in Chile.

Public care includes free medical, dental and midwifery services, which are run locally. Private insurance tends to focus on specialist treatment.

The existence of both public-private insurance has created inequities of care, prompting reform efforts in 2000 to increase equality across the country.

Chile has guaranteed universal access to quality treatment for some conditions including certain cancers, HIV/AIDS, pneumonia, depression and dental care, which has improved care for the poor, according to the WHO.

China

China announced an overhaul of its health system in 2009 to bring safe, affordable basic health services to all residents -- a tall order for a country containing 1.3 billion people.

The government committed about $126 billion to reform the quality and efficiency of its health care, and ensure affordable and quality medication.

But the issue of equity in health care persists. "There are still significant disparities in health status between regions, urban and rural areas, and among population groups," according to the WHO.

China has seen increased life expectancy and reductions in infant deaths, but health observers stated in the WHO report the need to improve delivery of care.

Rio + 20 declares health key to sustainable development

Pharmpro.com - The United Nations Conference on Sustainable Development (Rio+20) has adopted a series of measures that have the potential to contribute to a more equitable, cleaner, greener, and more prosperous world - and recognizes the important linkages between health and development.

"The Future We Want" conference outcome document, agreed upon by member states attending the 20-22 June conference, highlights the fact that better health is a "precondition for, an outcome of, and an indicator of sustainable development".

"This focus on the links between health and sustainable development is critical," said Dr Margaret Chan, Director-General of the World Health Organization WHO. "Healthy people are better able to learn, be productive and contribute to their communities. At the same time, a healthy environment is a prerequisite for good health."

The outcome document also emphasizes the importance of universal health coverage to enhancing health, social cohesion and sustainable human and economic development. And it acknowledges that the global burden and threat of non-communicable diseases (NCDs) constitutes one of the major sustainable development challenges of the 21st century.

The document states: "We are convinced that action on the social and environmental determinants of health, both for the poor and the vulnerable and the entire population, is important to create inclusive, equitable, economically productive and healthy societies. We call for the full realization of the right to the enjoyment of the highest attainable standard of physical and mental health".

Health-related development issues covered in detail in the outcome document include:

- Access to better energy services including sustainable cooking and heating solutions, which can significantly reduce childhood pneumonia and adult cardiopulmonary disease deaths from indoor air pollution;

- Greater focus on urban planning measures including more sustainable, energy-efficient housing and transport - which can significantly reduce many NCD risks, e.g. cardiopulmonary diseases from air pollution, health risks from physical inactivity and traffic injury;

- Better sanitation in cities and villages to protect against the spread of communicable diseases;

- Sustainable food systems that combat hunger and contribute to better health and nutrition;

- More sustainable water usage, meeting basic needs for safe drinking-water and stewardship of water supplies to grow food;

- Assurance that all jobs and workplaces meet minimum safety and health standards to reduce cancer, chronic lung diseases, injuries and early deaths.

Rio+20 also underlined the vital need for universal health coverage (including policies to prevent, protect and promote public health). Currently, 150 million people worldwide suffer severe financial hardship each year because they fall ill and cannot afford to pay for the services or medicines they need to recover. Universal health coverage can therefore fight poverty and build more resilient and prosperous communities.

An outcome of the 1992 Rio Conference (The 1992 UN Conference on Environment and Development) was Agenda 21, a comprehensive plan for global and local action.

Chapter Six of this document focused on 'Protecting and Promoting Human Health'. Over the past 20 years, WHO has worked in the five areas outlined in that chapter: meeting primary health care needs particularly in rural areas; control of communicable diseases; protecting vulnerable groups; meeting the urban health challenge; and reducing environmental health risks, which are often exacerbated by unsustainable development. The Organization will continue this work and scale up efforts to help countries aiming to achieve universal health coverage and prevent and treat noncommunicable diseases.

WHO concerned over rising number of Congo fever cases

tribune.com.pk - ISLAMABAD: The World Health Organization (WHO) has expressed concern over the recent outbreak of measles and Crimean-Congo haemorrhagic fever (CCHF), commonly known as Congo fever, in some parts of the country.

According to WHO Weekly Epidemiological Bulletin, 22 suspected cases of CCHF were reported throughout the country, out of which 15 cases were confirmed, leading to five deaths this year. Out of 15 cases reported from Balochistan, 13 cases were in Quetta.

Disease Early Warning System (DEWS) Senior Surveillance Officer at WHO, Dr Musa Rahim, said, "Currently, the situation is not alarming but it is worrisome and immediate measures need to be taken to control these outbreaks, which spread rapidly."

"Cases of Congo fever are being reported from Balochistan and the victims are workers who work in farmhouses or are associated with the leather business," he added.

The WHO DEWS team is working in close coordination with the health department to control the outbreak of Congo fever.

The district health department has planned a door-to-door distribution of flyers in Quetta to raise awareness on the hazards of exposure to ticks and fresh blood when animals are butchered.

Measles, too, is becoming a cause of concern. This year, 5,663 cases of measles were reported. Of these 77 children died.

Dr Rahim said the reason behind the outbreak of measles is the suboptimal coverage of vaccination in some parts of the country. "Some places were inaccessible to the teams, while in other instances families refused vaccination."

Is India becoming the world's capital for poor health?

timesofindia.indiatimes.com - According to the World Health Organisation, chronic diseases in India account for 53% of all deaths, which is estimated to increase by a sharp 8 million by 2020.

An interesting fact is that these numbers not only highlight the rural population, but also the city-based - a population that doesn't suffer from malnutrition and other poverty driven health issues. Today, we take a look at the top five diseases that are effectively making India the world's capital for poor health.

Cardiovascular diseases. Two of the most common types of cardiovascular diseases in India are coronary heart diseases (leading to heart attack) and cerebrovascular diseases (leading to stroke).

According to an estimate by WHO, by 2020 deaths from cardiovascular diseases will estimate for around 5 million. The major causes of heart disease in India are tobacco use, physical inactivity, and an unhealthy diet.

It is also believed that 80% of premature heart disease, stroke and diabetes can be prevented by following lifestyle modifications such as eating healthy and exercising regularly.

Respiratory diseases. The World Health Organisation (WHO) estimates that around 1.34 million premature deaths from respiratory diseases and cancers were caused due to polluted air. Lack of clean air is the main reason why respiratory problems are prevalent in India.

It is believed that the rise in SUVs (sports utility vehicles), cars and two-wheelers in Indian cities is the main reason behind respiratory disorders. Other than this, small scale manufacturers and other industries, burning biomass and coal for cooking and heating, are the reasons why respiratory disorders are on a rise.

Diabetes. By now it is a matter of common knowledge that India has the world's highest number of diabetic cases, classifying India as the diabetes capital of the world (as mentioned in the International Journal of Diabetes in Developing Countries). The foundation estimated that, "the number of diabetic patients in India more than doubled from 19 million in 1995 to 40.9 million in 2007 and is projected to increase to 69.9 million by 2025".

At present, 11 percent of India's urban population and 3 percent of India's rural population, above the age of 15, have diabetes. The reason behind such a rise in diabetic cases can be attributed to lack of physical activity, stress, sedentary lifestyle and a diet rich in sugar, fats and calories.

The study also states that, "the most prevalent is the Type 2 diabetes, which constitutes 95 per cent of the diabetic population in the country." Type 2 diabetes is caused by lifestyle, as opposed to any genetic predisposition.

Hypertension. Hypertension is present in 25% of urban Indians and 10% of rural Indians. Among cities in India, Mumbai has the highest rates of hypertension - 44% of men and 45% of women silently suffering from high BP as compared to 30% and 33% for men and women from Delhi and 24% and 17% among men and women in Kolkata.

The count of "hypertensive" individuals is expected to rise from 118 million in 2000 to 214 million in 2025. According to the highlights of India's largest clinic-based survey, Screening India's Twin Epidemic (SITE), to assess the prevalence of hypertension, 60%, or three out of every five Indians, have either diabetes or hypertension or both.

People not monitoring their sugar or blood pressure regularly is the main reason why hypertension is such a deadly disease in India. For more information on hypertension, read here.

Oral cancer. In India, over 700,000 to one million Indians die due to consumption of tobacco, every year, mostly due to mouth cancer (Food Safety and Standards Authority of India). India has the highest number of oral cancer cases in the world out of which 90 per cent are due to tobacco consumption (World Health Organization Survey Report).

When it comes to oral health problems, tobacco use becomes a primary cause. The increase in the use of tobacco in various forms like lime, raw with betel leaf, betel nut, pan masala, gutka and smoking has led to a rise in the cancer cases. Smokers or smokeless tobacco users are also at a much higher risk of developing cancers of the lips, mouth, cheeks, tongue and throat as well as problems relating to periodontal, or gum, diseases. For more information on oral cancer, read here.