At the June 1-2 International Hospital Federation Meeting in Chicago, presentations from worldwide experts helped shed light on some of the world’s problems (and approaches) to healthcare. A presentation from the head of the Health Industry Investment Policy of the World Bank Group, Alexander Preker, focused on how much is being spent on healthcare worldwide. The stunning number was that the United States annual expenditure on health care of $2.7 trillion is approximately one-half of all worldwide expenditures ($5.5 trillion) in healthcare. A conversation with the Canadian Healthcare President, Pamela Fralick, discussed the irony to the U.S. approach of adding an additional 32 million onto its insured roles, because that number is roughly equivalent to the entire population of our northern neighbor. Fralick and Pan American Health Organization’s Ciro Ugarte both expressed a concern that the United States’ demand for additional practitioners may consume some of our neighbor’s trained healthcare human resources as they are lured over the borders to more lucrative positions.
George Porignon, Health Policy Expert at the World Health Organization, presented a healthcare model that focused around primary care practitioners, and not around the acute care hospital. What was fascinating was the discussion that followed by Indonesia’s Muki Reksoprodjo, who stated that although his country was as large as the U.S., it consists of two-thirds water, making logistical access to primary care resources difficult. Pan American Health Organization’s Ciro Ugarte talked about the difficulty in treating patients with limited primary care resources, who then come to the acute care facility for access.
AHA’s President Rich Umbdenstock discussed U.S .approaches and the difficulty of turning the massive system around to primary care, but provided examples of how primary-care centric organizations work in the U.S. Richard deFilipppi, a trustee at Cambridge (MA) Health Alliance and the Board Chair of the AHA discussed the Massachusetts system. Erick DeRoodenbeke, the Executive Director of the International Hospital Federation, nicely summed up the discussion….that more and more, the movement to Primary Care-centric practice is being led by state, regional, and local organizations, as legislating policy from a national body is hard to implement due to local variation. Lastly, a side conversation with the German Hospital Federation Chief Executive Georg Baum focused on how Germany controlled costs, especially drug costs, by having pharmaceutical organizations come in front of a panel and justify prices based on efficacy and value.
The perspective gleaned from discussions with international healthcare leaders served to broaden my view of things….removing some of my American myopia. Almost all nations are struggling with issues; most are not as fortunate as the United States to have our deep resources. More than once, representatives commented to me that it is hard to believe that the richest, most powerful country has so many uninsured. I tried to explain why, and the history that led up to where we are now, and that the answer was not easy. I was not sure if it was the language barrier or the shortcomings of our system that left my explanation somewhat lacking.
The Romanian Hospital Association’s First Vice President, Dr. Mircea Oltenu, stated to me that along with the recession, healthcare costs are crippling his country. Healthcare’s significant consumption of resources on each nation’s productivity, no matter what system is in place, is a common characteristic. As I left the meeting, my thoughts drifted to a hope that a cure for cancer, Alzheimer’s, and diabetes may be the only solution to solving the world’s healthcare issues. The eradication of these diseases could result in the same “dividend” that the eradication of polio in the 1950s and 1960s had for society, with its concurrent impact on lowering the need for iron lungs, long term care, human caregivers, and family’s resources. From a world-wide perspective, only miracles of cures for major diseases seem like the best hope.
