Catastrophic Care

Catastrophic Care: Why Everything We Think We Know about Health Care Is Wrong is a book by David Goldhill about the American healthcare system.

Their healthcare is comparable to that provided by the NHS. However we rank better because we spend only a third of the money the US does. Someone told me they spend more tax money than we do, even before the insurance costs, though I do not have a source for that.

Goldhill points out a number of problems, some common across all healthcare systems, others specific to America:

  • Holistic care, phsycholical factors in recovery and control of infections are often overlooked – for example making the ward look nice, keeping records electronically and emptying the bins before they overflow.
  • Insurance systems do not make sense because healthcare is not a risk, it is an inevitability.
  • There are incentives to take medication – you can take statins to lower your blood pressure, or you can lead a healthy and active lifestyle. Your insurance pays for the former but not the latter.
  • There is little focus on cost in insurance-based systems.
  • 68% of hospital beds in America are provided by non-profit hospitals, yet they do not produce better results than for-profit ones.
  • Medical errors, hospital-acquired infection and over-treatment kill as many people as many major medical conditions

His solution is to crap the insurance system and replace it with a loan based system. A typical American will spend around $1,300,000 on healthcare over their life-system so Goldhill suggests giving them that as fund, with a small insurance system for catastrophic conditions that cost more (though he argues nobody would charge more in a market-based system).

On a tangent, he also talks about how state assistance to buy a house actually helps rich home-owners rather than first-time buyers. I blogged about this in June.

Reading it, it made me glad we have the NHS. Of course, it may be a case of the grass is always greener where you live (which is now a thing) as the NHS is proving highly ineffective for me at the moment. Overall, as I said at the start though, we probably get the better deal spending far less on health care for a slightly better life expectancy.

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This entry was posted on Saturday, May 16th, 2015 at 10:30 am and is filed under Books. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.