In your posting of October 6, Robert Garrett asked about a report ranking healthcare systems, possibly from the WHO. I think he was probably referring to this widely cited report which ranked the United States thirty-seventh?
The ranking used “five indicators: overall level of population health; health inequalities …; overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts); distribution of responsiveness within the population…; and the distribution of the health system’s financial burden within the population (who pays the costs).” On some, nations were measured against what should be achievable with the available resources. So even though technical capabilities here are great, the large numbers of people excluded and the great inequalities in our system undermined the US ranking.
The rankings drew heated criticism from some quarters and pressure on the WHO to change its methods:
I hope this is helpful!
This is excellent. Thanks for the references. You’re right to point out that even with a big modern engine of technology and state-of-the-art training, we should still be given crucial demerit points for excluding huge segments of our population from adequate healthcare. I still maintain, however, that by definition, quality is difficult to study and difficult to compare.
Do you know why “individual and spouse” healthcare coverage is many times more expensive than individual healthcare coverage on its own?
For example, I have individual healthcare coverage through my workplace; it costs $76 a month. However, if my husband wants to be covered by my plan, the cost will be $262 a month, which is more than three times the cost of individual health coverage!
I would understand the price increase if it doubled, but tripled? Shouldn’t health insurance companies be offering discounted rates, or at least equally priced rates, to customers’ spouses or their families?
RHEA A. VAFLOR
They absolutely should provide reasonable spousal coverage. The tiers of rates you cite are a function of the current trend in insurance coverage. Costs are transferred from the insurance company to the employer who, in turn, transfers them to the employee. This goes on just below the radar (though recently the trend has been reported in the Wall Street Journal and the New York Times). The employers can easily maintain that they are not responsible for a spouse, which then lets the insurance company off the hook. Meanwhile, one of the central purposes of this kind of insurance is to provide family coverage. The person not working for the firm may well be the one getting sick, or having a child, for example. I’m not sure what the solution is. But clearly this is an example of why we need some form of universal coverage. Perhaps patients need a strong union together with their doctors.