by Nick Jacobs

Last month, I was invited to speak for the American Hospital Association in Phoenix, Arizona. One of the speakers who preceded me, Ian Coulter, PhD of the Samueli Institute and RAND Corporation provided a compelling analysis of healthcare around the world. He described his countrymen from Scotland as “Unarmed Americans with health insurance.”

Even more chilling was the fact that, “America is the only major economic power where, if you lose your job, you literally can fall into medical oblivion without health insurance until the age of sixty five.”

Another major problem identified by Dr. Coulter is that the food producers of America provide enough food products for every adult to consume 4000 calories each and every day. Unfortunately, we only need about 2000 calories per day. The more is not better theory works here as well as we overeat, become morbidly obese, develop diabetes, high blood pressure and high cholesterol.

Interestingly, in the rest of the industrialized world, the ratio of specialists to primary care physicians is approximately 40 percent specialists to 60 percent primary care. In the United States, that ratio is exactly the opposite; 60 percent specialists to 40 percent primary care physicians. This fact was very interesting as well. In the United Kingdom, primary care physicians earn approximately 130,000 pounds a year or nearly $260,000, significantly more than primary care physicians in the U.S. There is also a 30 percent pay for performance opportunity in the U.K. compared to a 6 percent pay for performance opportunity in the United States. Our primary care physicians are under incentivized while we may have too many specialists in some areas of the country.

Dr Coulter also corrected a previous set of facts that we have all read numerous times; 30 percent of all healthcare dollars are not spent on the last thirty days of life. Thirty percent of all Medicare dollars are spent on the last thirty days of life. What is not stated is that these expenditures typically do not improve the quality of those last thirty days of life.

If you aren’t too tired of facts and figures yet, how about this one from his presentation? Two thirds of Republicans and only one third of Democrats think that we have the best health system in the world, and 58 percent of Republicans and only 20 percent of Democrats are satisfied with the quality of our health care. These statistics may indicate that money does influence your perception of what you can buy in the health care system.

Finally, 20 percent of all American are consumers of complimentary and alternative medicines. On the other hand, 40 percent of the population or nearly 120,000,000 people are fully open to trying integrative medicine alternatives. Unfortunately, only about 30 percent of physicians embrace the various modalities offered through these alternative medicine approaches.

In closing, maybe we should consider this very broad interpretation of health as stated by the World Health Organization’s, "Health is relatively simple; if you feel better, that is health.”