There are 2 manner ins which I could have invested twice as much on doughnuts. I might have bought two times as many doughnutsI might have bought the exact same number of doughnuts however got really elegant ones and paid two times as much, or some mix thereof. Right? If we're spending two times as much as other high-income countries, we're accomplishing that by either doing two times as much health care, paying two times as much for the very same quantity of healthcare, or some mix.
Overall spending is quantity times cost. This notion that we're excessive using health care, that we're doing so much to our patients, we're providing a lot healthcare, that's why we invest a lot. All the policy stuff is about attempting to lower that overuse, our culture of overuse. I would state that much of the policy focus has been on the quantity side of things.
Let's take a look at the data. One hypothesis I often hear is, Mental Health Facility as an American culture, we fast to go the doctorat the drop of the hat, I get a little discomfort, Americans are off to see the physician. We first ask the concern, let's look at doctor check outs per capita (why is free health care bad).
This is physician gos to per capita in a given year: The mean is about 6. 6, and the United States has to do with 4. By the method, in Japan, the mean is 13. The typical Japanese sees their doctor more than once a month. For every 24-year-old who hasn't entered 4 years, there are people who are going every other week.
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6 and we're an excellent bit below that. We're not seeing the physician as much as these other nations. Then people take a look at that and state, "Ah, possibly the problem is not enough. Not enough avoidance, inadequate medical care, and it's all leading to a lot of hospitalizations. The issue is overuse of health centers.
We said, let's look at healthcare facility discharges per population. And here is the mean, right, 149 per thousand population. And here is the United States: a little bit below average. Surprisingly, Germany appears like a bit of the outlier, where hospitalizations per population are much, much greater. The other thingso this is just hospitalizations, right? Hospital discharges per populationanybody have a sense of how our lengths of stay compare to those of other nations, these other countries? We're way shorter, way shorter.
is? Yeah, three. In the Medicare population it's like four, 4 and a half, due to the fact that they're a little bit older, however in the three to four days. In Japan, about 14. Right? I remained in Japan a couple of years ago visiting a neighborhood hospital. It was exceptional to me. There were clients sitting around playing cards around a table.
Right? It resembles they got the four days of IV, then they switched to the oral, and now we're just observing them two days post-oral antibiotics, just making sure they're fine. It's interesting in regards to, if you think of it: less hospitalizations, shorter lengths of stay. And what you understand is we invest far less days in the health center than any other high-income country.
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The third, on this overutilization bit is that, the issue is we do a lot of tests and treatments. I put a little asterisk therein to remind myself to make a point, which is, of course, when you discuss we do a lot of tests and procedures, a huge part of that hypothesisa big part of the driving consider the policy world, and I'm pleased to get into more on thisis the sense that the issue is that the medical professionals in Americawe're just out there overtesting, overprocedurizing, charge for service.
So, let's take a look at some empirical data, and there's a little bit of assistance for some of this and not a lot for others, however let's appearance at the information. MRIs. MRIs, we are high. Sure, we have more MRIs per population than typical, however not some crazy outlier. Knee replacements, here we truly are top.
We have more weight problems than almost all of these nations, in fact, than any of these countries, so it's not an overall surprise that we're going to get more knee replacements. Hip replacements, I expected equivalent numbers on hip replacements. I said, "Oh, our knee replacements are high, our hip replacements are going to be high." Remarkably, not so much.
Meaning, once again, we see Germany showing up near the top, however we're really slightly below average. Coronary angioplasty, a treatment that has actually gotten a lot of attention for concerns about overuse. Sure enough, we're a bit on the high side, and here's Germany once again ... Again, what we see is we're a little high up on some things however not always others, and here's Germany on coronary angioplasty.
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healthcare expense is mainly about supplying too much care, about overutilization. Right? I don't see it. We have fewer hospitalizations, less medical professional check outs - which type of health care facility employs the most people in the u.s.?. Tests and treatments, I see as a mixed bag. Right? We do more MRIs, and knee replacements, and angioplasties. We do fewer hip replacements. The method I think of it is, when it concerns usage of health care services, we're above average on some things, we're listed below average on other things, and usually, we're quite averageon utilization.
Another quick one, I'm going to just show you this information and then keep going. Really, this is one I have actually even said publiclywithout information and it ends up I was wrongthe one concept that has come up over and over again is that all these countries are mainly main care, we're primarily experts, which the specialist-primary care physician mix is off.
Then the first time my colleaguesI remember they came into my workplace and they said here's the information on specialized mixand the information was that here was the mean across these countries, and here was the U.S., right in the middle. I didn't think it. I simply believed this can't be right.
The percentage of doctors who are main care, and on the right is Sweden and Denmark, where it's only 2233% in France, 54% of physicians are main carethe most significant challenge with this statistic is everyone calls it all various terms. Is it family doctors? Is it generalists? Is it medical care medical professionals? What we did was we stated, we do not care what you call it, let's speak about what people are actually performing in the workplace.
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And after that we went to both national stats offices of each of these countries along with three to 5 professionals from each country, and we revealed them their data (what is single payer health care). I keep in mind speaking to the people from Switzerland and saying, "Hey, we find that 48% of your physicians are medical care, based on this definition.
The 43% for the U.S. originates from the Kaiser Household Foundation, which is an exceptional source of data, utilizing the AMA Masterfile nationwide service. There are other studies and data from Rehabilitation Center the U.S. that put the number a little lower. We can have a debate about which number is best, however this is our finest at doing an apples-to-apples comparison. how much is health care per month.