International Health Care Data and Comparisons

By Clive Riddle

With this election year, health care is a central topic of discussion for Presidential and Congressional candidates. Inevitably, references are made inferring either superior or inferior performance of the U.S. health care system compared to various other countries.
So just what kind of current data is out there reflecting various attributes of international health care? Below is collection of selected international health care factoids, compiled by Global Health Resources this year:

Health Spending And Insurance Systems in Seven Countries, 2007

Australia Canada Germany Netherlands New Zealand United Kingdom United States National health spending Per capita (U.S. $PPP)* $3,128 $3,326 $3,287 $3,094 $2,343 $2,724 $6,697 Percent of GDP* 9.5% 9.8% 10.7% 9.2% 9.0% 8.3% 16.0% Percent of primary care practices with: Any financial incentive for quality 72% 41% 43% 58% 79% 95% 30% Electronic medical records 79% 23% 42% 98% 92% 89% 28% Percent uninsured 0% 0% <1% <2% 0% 0% 16% *PPP is purchasing power parity. GDP is gross domestic product Source: Toward Higher-Performance Health Systems: Adults’ Health Care Experiences In Seven Countries, 2007 Health Affairs, October 2007 http://content.healthaffairs.org/cgi/content/full/26/6/w717

Cost of Medical Procedures: United States and Abroad (in US dollars)

Procedure United States Costa Rica Mexico Korea Heart bypass $130,000 $24,000 $22,000 $34,150 Heart-valve replacement $160,000 $15,000 $18,000 $29,500 Angioplasty $57,000 $9,000 $13,800 $19,600 Hip replacement $43,000 $12,000 $14,000 $11,400 Hysterectomy $20,000 $4,000 $6,000 $12,700 Knee replacement $40,000 $11,000 $12,000 $24,100 Spinal fusion $62,000 $25,000 N/A $3,311 Source: Medical Tourism Association, 2007 Survey

Procedure United States Costa Rica Mexico Korea Heart bypass $130,000 $24,000 $22,000 $34,150 Heart-valve replacement $160,000 $15,000 $18,000 $29,500 Angioplasty $57,000 $9,000 $13,800 $19,600 Hip replacement $43,000 $12,000 $14,000 $11,400 Hysterectomy $20,000 $4,000 $6,000 $12,700 Knee replacement $40,000 $11,000 $12,000 $24,100 Spinal fusion $62,000 $25,000 N/A $3,311 Source: Medical Tourism Association, 2007 Survey

The Cost of Medical Procedures in Selected Countries (in US dollars)

Procedure US Retail Price* US Insurers' Cost* India** Thailand** Singapore** Angioplasty $98,618 $44,268 $11,000 $13,000 $13,000 Heart bypass $210,842 $94,277 $10,000 $12,000 $20,000 Heart-valve replacement (single) $274,395 $122,969 $9,500 $10,500 $13,000 Hip replacement $75,399 $31,485 $9,000 $12,000 $12,000 Knee replacement $69,991 $30,358 $8,500 $10,000 $13,000 Gastric bypass $82,646 $47,735 $11,000 $15,000 $15,000 Spinal fusion $108,127 $43,576 $5,500 $7,000 $9,000 Mastectomy $40,832 $16,833 $7,500 $9,000 $12,400 * Retail price and insurers' costs represent the mid-point between low and high ranges ** US rates include at least one day of hospitalization; international rates include airfare, hospital and hotel Source: Medical Tourism: Global Competition in Health Care, National Center for Policy Analysis, November 2007 http://www.ncpa.org/pub/st/st304/st304.pdf

Wait Time to get an Appointment in Seven Countries

Percent of adults who waited 6+ days for an appointment to see regular medical doctor Canada 30% United States 20% Germany 20% United Kingdom 12% Australia 10% Netherlands 5% New Zealand 4% Source: Fixing the Foundation: An Update on Primary Health Care and Home Care Renewal in Canada, January 2008 http://www.healthcouncilcanada.ca/docs/rpts/2008/phc/HCC_PHC_Main_web_E.pdf

Percent of adults who waited 6+ days for an appointment to see regular medical doctor Canada 30% United States 20% Germany 20% United Kingdom 12% Australia 10% Netherlands 5% New Zealand 4% Source: Fixing the Foundation: An Update on Primary Health Care and Home Care Renewal in Canada, January 2008 http://www.healthcouncilcanada.ca/docs/rpts/2008/phc/HCC_PHC_Main_web_E.pdf

Access to “Medical home”* Among Adults in Seven Countries, 2007

Australia Canada Germany Netherlands New Zealand United Kingdom US 59% 48% 45% 47% 61% 47% 50% *Medical Home: Has a regular doctor or place that is very/somewhat easy to contact by phone, always/often knows medical history, and always/often helps coordinate care Source: Toward Higher-Performance Health Systems: Adults’ Health Care Experiences In Seven Countries, 2007 Health Affairs, October 2007 http://content.healthaffairs.org/cgi/content/full/26/6/w717

Out-of-Pocket Expenses for Medical Bills in the Past Year in Seven Countries

(in U.S. $ equivalent) Australia Canada Germany Netherlands New Zealand United Kingdom United States None 13% 21% 9% 38% 12% 52% 10% $1-$100 11% 17% 17% 15% 17% 12% 9% More than $1,000 19% 12% 10% 5% 10% 4% 30% Source: Toward Higher-Performance Health Systems: Adults’ Health Care Experiences In Seven Countries, 2007 Health Affairs, October 2007 http://content.healthaffairs.org/cgi/content/full/26/6/w717

Mortality Amenable to Health Care in Selected Countries*

Deaths per 100,000 population Country 1997-98 2002-03 France 76 65 Japan 81 71 Spain 84 74 Australia 88 71 Sweden 88 82 Italy 89 74 Canada 89 77 Netherlands 97 82 Greece 97 84 Norway 99 80 Germany 106 90 Austria 109 84 Denmark 113 101 New Zealand 115 96 United States 115 110 Finland 116 93 Portugal 128 104 United Kingdom 130 103 Ireland 134 103 *Deaths from certain causes before age 75 that are potentially preventable with timely and effective health care. Source: Measuring the Health of Nations: Updating an Earlier Analysis, The Commonwealth Fund, January 2008 http://www.commonwealthfund.org/usr_doc/1090_Nolte_measuring_hlt_of_nations_ HA_01-2008_ITL(web).pdf?section=4039

Cost-Related Access Problems in Seven Countries, 2007

Australia Canada Germany Netherlands New Zealand United Kingdom United States Percent in past year due to cost: Did not fill prescription or skipped doses 13% 8% 11% 2% 10% 5% 23% Had a medical problem but did not visit doctor 13 4 12 1 19 2 25 Skipped test, treatment or follow-up 17 5 8 2 13 3 23 Percent who said yes to at least one of the above 26 12 21 5 25 8 37 Source: Health Care: Solutions Without Borders, The Commonwealth Fund http://www.commonwealthfund.org/aboutus/aboutus_show.htm?doc_id=597055

For More Information:

Global Health Resource
www.globalhealthresources.com