Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

The Worst Healthcare System In The World

The worst healthcare system in the world is the United States, of course. Oh no, wait — it’s Canada. Actually, it could be Germany. Geez, now I think it might be the UK.

You could go on and on like this, but you know what? No matter how good or bad your healthcare system is, there are certain universal truths. Here are four of them that might make you look at global healthcare a little differently:

First, healthcare is getting more expensive, all over the world. A new study by the global consultant, Towers Watson (disclosure: Towers Watson is a Best Doctors client) found that the average medical cost trend around the world will be 10.5 percent in 2011. In the advanced economies costs will rise by an average of 9.3 percent. While Americans tend to think of rising medical costs as a uniquely American problem (they’ll rise by 9.9 percent here), it’s just not true. Canadian costs will rise by 13.3 percent. In the UK and Switzerland, they will increase by 9.5 percent, and in France by 8.4 percent.

Why is it happening? As ever, the main drivers are the increasing availability of new medical therapies — and inappropriate use of care. We see the same phenomenon at Best Doctors in our global experience. Across the world, our data for 2010 showed that just over 20 percent of patients had an incorrect diagnosis, and about half were pursuing inappropriate treatment plans. Read more »

*This blog post was originally published at See First Blog*

Does Group Health’s “Medical Home” Leave The Poor Behind?

Group Health has published two papers recently, one in Health Affairs and the other in JAMA, both extolling the virtues of its Medical Home. These follow their brief report last fall in the NEJM and the lengthy description of their model in the American Journal of Managed Care. Their model has been promoted by the Commonwealth Fund, and it is cited in the currrent issue of Lancet.

The big news is that costs were a full 2% lower than conventional care, hardly a great success –- it wasn’t even statistically significant. But was even this small difference due to the Medical Home, or was it because the Medical Home patients were less likely to consume care? Read more »

*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*

The U.S. Should Focus on Primary Care


A new study conducted by the Commonwealth Fund was published by Health Affairs and it showed that the U.S. lagged behind other nations in some very important ways that affect health and access to quality health care. The study surveryed over 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States. The study found that:

  • The vast majority (69 percent) of U.S. respondents report that their practices have no provisions for after-hours care, leaving their patients no choice but the emergency room. The U.S. was behind every other country surveyed on this finding.

Read more »

*This blog post was originally published at EverythingHealth*

Counter Point: American Healthcare Is Not The Best In The World

Let’s get honest, OK? America does not have the best health care in the world. Europeans and Canadians are not flocking to our borders to get to our health care. It is time we realize that we can learn from our neighbors and we don’t have to claim we are the “best” at everything. It makes us look really stupid in the eyes of the world.

Here are some facts. We do spend the most money on health care in the world. We do spend the highest percentage of Gross National Product (GDP) on health care and we do spend more dollars per capita than any other country on Earth.

The claim that the United States has the best health care in the world has been proven false by every broad metric used. The World Health Organization and the nonpartisan Commonwealth Fund rankings rate the U.S. last of the Western industrialized countries. The WHO ranks us 37th of all measured countries.

The Commonwealth Fund says, “Among the six nations studied—Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2006 and 2004. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last on dimensions of access, patient safety, efficiency, and equity. The 2007 edition includes data from the six countries and incorporates patients’ and physicians’ survey results on care experiences and ratings on various dimensions of care.”

The U.S. also lags in information technology. (We have been awaiting a robust electronic medical record for 10 years) and in coordination of care and in measured quality outcomes.

One of the ways we improve in health care is when we face the brutal truth. How can you make improvements if you don’t know where you are starting from? If you truly believe you are the best in the world…there would be no need for health care reform.

Perhaps that is why these myths and lies are being propagated.

*This blog post was originally published at EverythingHealth*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

Read more »

Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

Read more »

“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

Read more »

Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

Read more »

See all book reviews »