There are 2 manner ins which I could have invested two times as much on doughnuts. I might have bought two times as lots of doughnutsI might have purchased the same variety of doughnuts but got actually expensive ones and paid two times as much, or some mix thereof. Right? If we're spending two times as much as other high-income nations, we're accomplishing that by either doing twice as much health care, paying twice as much for the very same amount of healthcare, or some combination.
Overall costs is amount times price. This concept that we're excessive using healthcare, that we're doing so much to our patients, we're delivering so much health care, that's why we spend so much. All the policy things has to do with trying to decrease that overuse, our culture of overuse. I would say that much of the policy focus has actually been on the quantity side of things.
Let's take an appearance at the data. One hypothesis I often hear is, as an American culture, we are quick to go the doctorat the drop of the Rehabilitation Center hat, I get a little discomfort, Americans are off to see the doctor. We initially ask the concern, let's look at medical professional gos to per capita (how is canadian health care funded).
This is physician visits per capita in a given year: The mean has to do with 6. 6, and the United States is about four. By the method, in Japan, the mean is 13. The average Japanese sees their physician more than as soon as a month. For each 24-year-old who hasn't entered four years, there are people who are going every other week.
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6 and we're an excellent bit listed below that. We're not seeing the medical professional as much as these other nations. Then individuals take a look at that and state, "Ah, perhaps the problem is not enough. Inadequate prevention, insufficient main care, and it's all causing a lot of hospitalizations. The problem is overuse of health centers.
We said, let's look at hospital discharges per population. And here is the mean, right, 149 per thousand population. And here is the United States: a little bit below par. Remarkably, Germany appears like a little bit of the outlier, where hospitalizations per population are much, much greater. The other thingso this is just hospitalizations, right? Medical facility discharges per populationanybody have a sense of how our lengths of stay compare to those of other countries, these other countries? We're method shorter, way much shorter.
is? Yeah, 3. In the Medicare population it's like four, four and a half, because they're a little bit older, but in the 3 to four days. In Japan, about 14. Right? I remained in Japan a few years ago visiting a neighborhood health center. It was remarkable to me. There were patients relaxing playing cards around a table.
Right? It resembles they got the 4 days of IV, then they changed to the oral, and now we're just observing them two days post-oral antibiotics, simply ensuring they're great. It's fascinating in regards to, if you consider it: less hospitalizations, shorter lengths of stay. And what you understand is we invest far fewer days in the health center than any other high-income country.
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The 3rd, on this overutilization bit is that, the problem is we do a lot of tests and procedures. I put a little asterisk therein to advise myself to make a point, which is, obviously, when you discuss we do too lots of tests and treatments, a big part of that hypothesisa big part of the driving consider the policy world, and I more than happy to enter into more on thisis the sense that the issue is that the doctors in Americawe're just out there overtesting, overprocedurizing, fee for service.
So, let's take a look at some empirical information, and there's a little bit of support for some of this and not a lot for others, but let's take a look at the data. MRIs. MRIs, we are high. Sure, we have more MRIs per population than average, but not some crazy outlier. Knee replacements, here we truly are number one.
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 comparable numbers on hip replacements. I said, "Oh, our knee replacements are high, our hip replacements are going to be high." Surprisingly, not a lot.
Significance, again, we see Germany appearing near the top, but we're actually a little second-rate. 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 again ... Once again, what we see is we're a little high up on some things however not necessarily others, and here's Germany on coronary angioplasty.
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healthcare expense is mostly about offering excessive care, about overutilization. Right? I do not see it. We have fewer hospitalizations, less physician sees - which of the following are characteristics of the medical care determinants of health?. Tests and procedures, Browse around this site I view as a combined bag. Right? We do more MRIs, and knee replacements, and angioplasties. We do less hip replacements. The way I consider it is, when it comes to utilization of healthcare services, https://beckettnqpq671.my-free.website/blog/post/445081/unknown-facts-about-how-much-does-medicare-pay-for-in-home-health-care we're above average on some things, we're below average on other things, and on average, we're pretty averageon utilization.
Another quick one, I'm going to just reveal you this data and then keep going. Really, this is one I've even stated publiclywithout data and it turns out I was wrongthe one concept that has actually come up over and over once again is that all these nations are mainly medical care, we're mainly professionals, which the specialist-primary care physician mix is off.
Then the very first time my colleaguesI remember they came into my office and they said here's the data on specialty mixand the data 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 just thought this can't be right.
The proportion of doctors who are main care, and on the right is Sweden and Denmark, where it's just 2233% in France, 54% of physicians are primary carethe greatest challenge with this figure is everyone calls it all different terms. Is it general specialists? Is it generalists? Is it main care physicians? What we did was we stated, we do not care what you call it, let's talk about what people are in fact carrying out in the office.
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And after that we went to both nationwide data offices of each of these nations as well as three to five experts from each nation, and we showed them their data (what is a health care delivery system). I keep in mind talking to the guys from Switzerland and stating, "Hey, we find that 48% of your doctors are medical care, based upon this definition.
The 43% for the U.S. originates from the Kaiser Family Foundation, which is an exceptional source of information, utilizing the AMA Masterfile national service. There are other surveys and information from the U.S. that put the number a little lower. We can have a debate about which number is best, but this is our best at doing an apples-to-apples comparison. which of the following is not a result of the commodification of health care?.