How does the U.S. Health Care System Differ From Other OECD Countries

An interesting article written by Victor R. Fuchs titled “How and Why US Health Care Differs From That in Other OECD Countries” appears in JAMA, January 2, 2013,Vol 309, No. 1, pp. 33-34.  The article attempts to discuss the difference between the U.S. Healthcare system and other countries in the  Organization for Economic Co-operation and Development (OECD).

One way they differ is that the healthcare expenditures in the U.S. are twice as high. A second way they differ is that the share of expenditures funded by the U.S. government is lower. Most OECD countries have a tax-supported system healthcare system that is able to have lower administrative costs and is able to negotiate costs more aggressively with drug companies and physicians. Thirdly, there are differences in care with the U.S. being more technology intensive such as with MRIs.

The author then argues some reasons for the differences. He says that in the U.S. individuals appear more distrustful of government, and that this has a deeply historic cause. Of course the author points out that Medicare and Medicaid are an exemption to this. I find this argument hard to believe. For example, many Americans put money in a private bank, yet they want to make sure they have FDIC insurance which is backed by the government so that their money doesn’t evaporate if the bank goes out of business.

The author goes on to make the following argument

“Closely related to the weaker support for government action in the United States is a reluctance to achieve more equal  for the population through redistributive public policy. Although US individuals have always rejected European- style class distinctions that required deference and subservience, the declaration that “all men are created equal” did not carry any suggestion of equality of outcomes, such as in income or health.”

I’m not really sure I entirely buy this argument either, although the author later goes on to say that their is a sense of wanting to have redistributive public policy amongst homogenous groups such as with race, religion, and national origin.

The author later goes on to say

“Many observers attribute US failure to enact comprehensive health care reform to the opposition of “special interests,” such as pharmaceutical and device manufacturers, insurance companies, physicians (especially those in high-income specialties), and hospitals. But all countries have special interests; only in the United States have they been particularly successful in blocking comprehensive reform.”

I find it interesting that the author argues that U.S. individuals appear more distrustful of government as opposed to other special interests that have agendas that run counter to the best interests of U.S. individuals. Hence, it would seem that U.S. individuals should be more trusting of the government.

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