Book: "Which Country Has the World's Best Health Care?"

We rank everything; top universities, top running backs, and top hospitals. Ranking health care is more complicated. It’s subjective and surprisingly polarizing and politicized. It is also subjective as we often won't agree on the criteria and if we should index for access to advanced health care and technologies (“If I had cancer, there’s no place I would rather live than here!”), or other measures, like access to care and affordability (“Does everyone have the same access to quality care?”). I am sure I have already alienated someone just by asking the question.

I am reading Zeke Emanuel’s new book, “Which Country Has The World’s Best Health Care?”. To be clear, I am not a fan of single payer health care systems, but I think we should understand how other countries spend less and get more for their health care spend. Most models are not single payor. I will not agree with all of Emanuel’s opinions, but it’s hard to argue the basic point of his book; the U.S. system is broken and the U.S. does not rank among the top 10 in most any category. Sadly, these stats only got worse since I first read T.R. Reid’s 2010 book, “The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care”. 

The U.S. spends more on health care than other countries, about 18% of our GDP compared to 9% to 11% in other wealthy countries. We are an outlier in the world. The U.S. is only 4.25% of the world’s population, yet we account for nearly half of the world’s drug spend. This is just one example. It’s important to dig in and do the important homework needed to understand and solve this problem. 

Once again, I am writing this LinkedIn post with my industry friends and colleagues in mind. I haven't posted on this topic since 2017. This book got me worked up again. In many ways, I am preaching to the choir. Many of you are passionate warriors on the health care policy, innovation, delivery or payor/distribution side of our business. Many of my friends work on the insurance side and in many ways, closest to the health care consumers who directly feel the pain of our busted system. I am eager to hear your thoughts, especially if you are reading this, or related books. 

Thoughts and comments are my own, although my employer (Oscar Health) is not shy about highlighting these problems, and aiming to solve many health care pain points for our customers.