IT Consulting from the Trenches

CITY HOSPITAL No. 17
The paradox of US healthcare & photos of a community hospital in post-Soviet Ukraine

There’s a paradox that illustrates why the healthcare system in the US needs to be reformed.

You may or may not know that the US spends more for healthcare than any other country in the world. That's significant. But it can be like visualizing a trillion; how large is that number?

How do we make that fact meaningful?

Well can we agree that a relationship exists between the amount spent on healthcare and life expectancy? In other words, can we expect that spending more for health and medical care will prolong the average life expectancy? If we agree, then we should expect that, up to a certain limit, more money spent on healthcare should prolong life expectancy.

Let’s see if the facts support that hypothesis. Compare the following countries. The data came from the World Health Organization (WHO). This is the agency of the United Nations whose mission is to “provide leadership on global health matters, shape the health research agenda, set norms and standards, articulate evidence-based policy options, provide technical support to countries and monitor and assess health trends.” I used the latest figures (2001 and 2002) available on their website [1].

United States
Per-capita expenditure = $4,887
Life expectancy, Male = 75 years old
Life expectancy, Female = 80 years old

Switzerland
Per-capita expenditure = $3,322
Life expectancy, Male = 78 years old
Life expectancy, Female = 83 years old

Cuba
Per-capita expenditure = $229
Life expectancy = 75 years old
Life expectancy, Female = 79 years old

Ukraine
Per-capita expenditure = $176
Life expectancy = 62 years old
Life expectancy, Female = 73 years old


Let’s take a moment to review these numbers.

The US spent nearly $4,900 per person in 2001 for healthcare. Switzerland, the next big-spender, spent $3,300. Yet the average life expectancy of an American man (75) is less than his Swiss counterpart. The same holds true for American women (80) and her Swiss counterpart (83). It appears that the additional $1,600 did not prolong American lives.

Incidentally, that per-capita figure, $4,900 (per individual in 2001) represents the total expenditure on healthcare by both the government and private sector (i.e., companies and individuals).

Let’s take Cuba now. Cuba was chosen for comparison and contrast. For comparison, note that its men live as long as American men. Its women live only one year less than American women. And for contrast, note how little was spent by Cubans for healthcare? Only $229! That’s $4,700 less than Americans spent and the life expectancy for both countries is very similar!

Now let’s move to Ukraine.

Ukraine spent only $176 per head and that’s less than Cuba. Its men have a life expectancy of only 62 years and its women, 73 years. Ahhh… Now we see a correlation. Less money spent shortens life expectancy.

The facts above support the notion that extra expenditure on healthcare does not extend life expectancy. So why is the US spending so much and what can be done to reform the system?

The solution is complicated and I’d like to cover that in another blog entry but for now, let me show you a typical Ukrainian community hospital.

These photos show the facade of City Hospital No. 17 in Dnipropetrovsk.

Dnipro (“Dnepro” in Russian) is the third largest city in the Ukraine. It has a number of interesting secrets. For example, the first artificial satellite, Sputnik, was developed in this city [2]. In fact, the manufacturing facility that actually developed it, Yuzhmash, became the heart of the Soviet space and missile programs [3].

Yuzhmash owns an Olympic-standard swimming pool complex beside it. Before you’re allowed to swim in it, you have to get a medical note that declares that you don’t have any skin-related diseases [4]. And you can get one at Hospital No. 17.

REFERENCES:

[1] Per capita total expenditure on health at international dollar rate & Life expectancy at birth. Retrieved January 24, 2009 from the WHO website at http://www.who.int/whr/2004/annex/country/.

[2] Sputnik, the world’s first artificial satellite. Retrieved January 21, 2009 from the NASA website at http://history.nasa.gov/sputnik/.

[3] The product line (!) of the State Enterprise called “Production Association Southern Machine-Building Plant named after A. M. Makarov.” Retrieved from the Yuzhmash website at http://www.yuzhmash.com/index_en.htm. Also Wikipedia’s entry notes that:
The company has been the key missile producer for Soviet ICBM and space exploration programs. Yuzhmash launch systems included:
• the R-5M - the Soviet Union's first nuclear armed missile
• the R-12 Dvina theatre ballistic missile
• the R-14 Chusovaya theatre ballistic missile
• the R-16 - the first Soviet ICBM
• the R-36 ICBM (converted to Dnepr rocket)

[4] The medical note is called a "spravka." Refer to this entry from a Christian medical missionary's blog.