Health Care Elsewhere 2

“Hey, Curmudge, in our last posting I learned something about health care in other countries.”

“I did too, Julie.  And now we are going to try to reach some conclusions based on a few facts from a limited sample of the world’s health care systems.”

“That will be difficult.  Remember the old saying, ‘All generalizations are false, including this one.’  The most we can hope for is to find some recurring themes among the very diverse countries that we studied.  Here in a nutshell are two pieces of data for each country; the first number is population in millions, and the second number is physicians per 10,000 population.  Switzerland; 7.6 and 40.  UK: 61 and 21.  France: 64 and 37.  Singapore: 4.7 and 15.  And for comparison, Spain: 40.5 and 38, and U.S.: 314 and 24.3.”

“It appears to me that the doc-to-population ratio in developed countries isn’t too critical.  I wouldn’t hesitate to use the health care system in the UK, in fact Mrs. Curmudgeon and Doc Mack used it with success.”

“Curmudge, let’s look at our findings from the standpoint of our original premise—that health care is a complex system.  And not only is health care complex, the populations using the system may be demographically, linguistically, socially, and geographically complex.  If one overlays a highly complex health care system on a highly complex population, the result is apt to be chaos or at least a lot of unhappy patients and providers.  Fortunately, the people in the countries in Europe that we have studied aren’t as diverse as we are and don’t seem highly displeased with their health care.  It is almost as if the country’s health care system fits its personality.”

“Some of that might be due to their small size and the fact that much of the management of the national programs is done regionally.  Perhaps in those cases, one person might actually be able to grasp everything that is going on.”

“Here’s something that is going on, Curmudge, especially in Southern Europe.  Health care is only one of the countries’ social welfare programs, and because of that, whole countries are in financial trouble.  As Margaret Thatcher once said, ‘The problem with socialism is that eventually you run out of other people’s money.’  Other countries will ignore this lesson at their peril.”

“Staying with our concern about complexity, Julie, the United States might be viewed as the most complex of the democratic developed nations.  We have red states, blue states, northerners, southerners, people who think for themselves, people who think only about themselves, people who think it’s their duty to think for everyone else, and people who don’t seem to think at all.  Any one-size-fits-all solution to the health care problems of such a complex nation simply will not fit.”

“Curmudge!  At your salary grade you can’t make judgments like that.”

“Julie, if I had a salary grade I wouldn’t make judgments like that.  And besides, I’ve read it so often that I wouldn’t know whom to reference.”

“Okay, Senescent Sage, but instead of judgments, it might be safer to take a fling at suggestions.  As we said earlier, no one person can fully comprehend such a complex system; but one can offer a point of view and a suggested solution or two."

“Whatever that future subject is called, it will be our topic for next week.  See you then.”

Kaizen Curmudgeon