Why does the health service in the United States cost so much and deliver so little?

I was born in Britain on 25 June 1948 so, except for 10 days of my life, I have benefited from a National Health Service – which is 70 years old today – that is publicly-funded and free at the point of use. ┬áBut the health model in the USA is very different, as I have been reminded by the book that I am currently reading: “Factfulness” by Hans Rosling.

Swedish Professor of International Health Rosling explains that the United States spends more than twice as much per capita on health care as other capitalist countries – around $9,400 compared to around $3,600 – and for that money its citizens can expect lives that are three years shorter. The USA spends more per capita on health care than any other country in the world, but 39 countries have longer life expectancies.

Why? Rosling refers to an OECD study which concludes that costs in the US health care system are higher across the board, but in particular costs of outpatient care and administration, and that this does not lead to better outcomes, because the system is not incentivising doctors to spend time with the patients most in need of care.


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