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US Healthcare on a Global Scale: How do we measure up? Med Times Copyright, All Rights Reserved, 2004-2005

By Jennifer Taylor

As the study of medicine in the United States marches boldly into the twenty-first century, the controversy over how best to establish and maintain a quality, cost-effective healthcare system for all of Americaís citizens still rages on. Although the U. S. continues to stand out as one of the most knowledgeable and technologically advanced nations in the field of medicine, we are yet to create a workable model for an extensive nationwide healthcare system.

The precedent for universal, yet affordable healthcare has long been set by such countries as Denmark, the Netherlands, New Zealand, Sweden, and Canada, while America trails far behind, caught in a tangled web of partisan politics and bureaucratic red tape.

We claim to be one of the most righteous, powerful, and compassionate nations in the world, and yet 16 percent of Americaís 273,000,000 inhabitants have no healthcare coverage at all (thatís close to 44 million people for all of my fellow mathematically challenged Anteaters out there!) How can we pride ourselves as a country founded on the principles of justice and equality for all when we canít even provide adequate healthcare for our most needy residents?

American healthcare today has almost completely abandoned the concept of personal, exhaustive care provided by a familiar, well-informed personal physician in favor of a more affordable, less comprehensive and compassionate version. Healthcare has become big business, and profit-oriented health maintenance organizations, more commonly referred to as HMOs, have taken the reins.

Granted, HMOs do provide some beneficial services, such as offering coverage at a much more affordable rate than the pay-per-visit system, but at what cost to the quality of care provided for the patient? In order to maintain affordability, the always cost-conscious HMO physician is discouraged from ordering extensive and costly tests-- a sure way to save money, and perhaps a more sure way to lose lives.

While under the care of an HMO, patients are finding it increasingly difficult to make appointments with specialists and are often unable to choose their own primary healthcare physician. In my personal experience with my former HMO, I found that I usually didnít even know who my doctor was, and I often received letters in the mail informing me that a new physician had been assigned to my file before I had even met the old one. This type of impersonal care coupled with an extensive waiting list for simple, yet necessary appointments remains a constant source of frustration for many Americans.

Itís fairly safe to say that the American healthcare system as it exists today is far from perfect, but is a model of perfect healthcare actually attainable? Many experts in the field of medicine would answer this question in one word: Sweden. Without a doubt, Sweden has undeniably surpassed America when it comes to the issue of quality of healthcare on a national level. Sweden has maintained a decentralized universal system of comprehensive healthcare that provides equal and affordable healthcare to all that reside within its boundaries. As a result of this superior level of health service, Sweden boasts one of the lowest infant mortality rates in the world (3.91 deaths per 1000 live births) as well as an average life expectancy rate of about 80 years (76.61 for men and 82.11 for women). It is important to note that Sweden has a population of about 8.5 million, however. This number is a very small fraction of the current American population. Is it possible to create and maintain a similar healthcare system of such a large scale as the one so desperately needed on American soil?

Sweden is not alone in its dedication to a universal system of healthcare. Other Western European countries have adopted similar healthcare policies, but they are now beginning to come to terms with the harsh reality of cost-control. In response to the severe strain placed on the economy in the attempt to provide unlimited healthcare coverage, nations such as Britain, France and Germany have been forced to make tough decisions and cut lots of corners. They have imposed massive health labor cuts and mandated drastic decreases in the amount and variety of prescribed drugs and other treatments.

To give you some idea of the cost of such extensive health coverage, Britain alone spends about 62 billion dollars on its universal system of healthcare annually, a fraction of what it would cost for the United States to follow Europeís example.

So, whatís stopping our mighty nation from offering full coverage to all of its loyal and devoted citizens? The bottom line is that the seemingly noble debate over healthcare reform in the U.S. comes down to nothing more than an issue of money. Taxpayers are not exactly jumping up and down to help pay for the enormous financial burden that would have to be assumed by the government in order to offer universal healthcare to a population 270 million strong and growing.

Could sweeping healthcare reform be in Americaís near future? Letís just say that passing a comprehensive healthcare reform bill through a partisan Congress whoís main objective is to get reelected at this point in time might take nothing short of an act of God.

Where does that leave us? Are we doomed to a future of ineffective and insufficient healthcare if we donít quite make the Forbes cut this year? Should we start looking into the real estate markets in Canada and Sweden? Not necessarily. Perhaps we can begin making some real progress on this issue if we start taking a little more personal responsibility when it comes to healthcare.

I know a lot of you must be asking yourselves what this has to do with you. The answer to your question is that this has everything to do with you. Many of us want to pursue careers in a health- related field, and it is vital that we are constantly aware of healthcare trends throughout the world in order to fully understand what our patients are faced with when they come to see us. Perhaps a more pressing cause for concern and attention to this issue is the fact that Mom and Dad are not going to protect you from the big bad world of healthcare issues under their plans forever. In order to avoid the many pitfalls associated with health coverage it is crucial that you stay informed about important healthcare related issues and that you do a little research into whatís available for you. When you read over the ballot come election time, keep in mind that healthcare reform is an issue that concerns all of us, and understand the consequences of what you are voting for. It is our responsibility as future healthcare providers, but more importantly as compassionate human beings to continue to fight for the best possible healthcare that America can offer.