Wednesday, January 23, 2008

ECHCI: Analyzing European Health Care Systems

Jane Sarasohn-Kahn at Health Populi once again delivers the goods as she examines the latest version of the Euro-Canadian Health Care Index (ECHCI) and its findings on the subject of consumer-centric health care systems:

The concept of consumerism in health care has migrated to Europe. The Health Consumer Powerhouse, a self-described "do-tank" (as opposed to "think-tank") based in Brussels and Stockholm, innovated and perennially updates the ECHCI. This year, the Powerhouse has added sister-nation Canada to the mix, and the results are fascinating. A key objective for the Index is to promote transparency across health systems in Europe; transparency is a major initiative in the European Union.

The Powerhouse points out that the top 5 countries all have "Bismarckian" health systems; that is, they were founded on the principles of social insurance where many health plans compete in markets and are also independent of the delivery system. This is in marked contrast to a system such as the UK's National Health Service, founded on "Beveridge" principles where financing and delivery are organized within one system (that would include Canada).
She correctly observes that a large amount of context is required to properly interpret the indexes, Still, it's useful to deconstruct them in order to gain insights into our current situation.

The Index is calculated using a "pentathalon" of five measurements: Patient rights and information, treatment waiting times, outcomes, generosity, and pharmaceuticals. These metrics lead directly to Ms. Sarasohn-Kahn's "Hot Points:"
When I ponder the five components of the ECHCI's pentathlon of consumer-friendly measures, the one that is most surprising from the US perspective is "generosity." I peeked under the hood of generosity and found the following metrics: cataract operations per 100,000 citizens; infant disease vaccination rates; kidney donations per million people; and, dental care as part of the public health offerings.

What is consumer-centrism in American health care? Is it "generosity?" To a colleague with whom I met yesterday, consumer-centrism was being seen on-time at a physician appointment. To me at my daughter's last visit to her pediatrician, it was spending sufficient time discussing the health challenges of a tween girl in 2008. When it's about you, the consumer, it's the micro-details of your experience with health providers, payors, products.
I heartily advise reading her complete post; it offers a number of useful insights into new ways of looking at health care delivery here in the U.S. In Health Care Reform Now!, George Halvorson stresses that we should look to other existing systems for ideas while crafting a health care model that is unique to our nation. Every industrialized nation has found a path to universal coverage. The U.S. must do the same, but along that path we can find elements of the systems in use elsewhere that can either be integrated into our approach or inspire new approaches.

SOURCE: " Consumers and health care through the Euro-lens" 01/23/08
photo courtesy of Albertane, used under this Creative Commons license

1 comment:

  1. Kathleen O'ConnorJanuary 25, 2008 at 11:36 AM

    we are starting to look at other health systems here at CodeBlueNow! since I have to teach a class on them. I have not yet read George's book, but am pleased to hear that he does not have a specific model in mind yet. I would encourage people to read our findings from Iowa on what people value in a health care system. We just completed the same survey in Washington state and the findings are virtually identical between these two states.

    We are waiting for the final report to post those findings. They should be up sometime next week.

    What we have found is that more consensus exists than the pundits and the parties would lead us to believe, and even where there is not agreement--people are more neutral than negative on an issue.

    All the more reason to get health care out of the hands of politicians and back to the hands of the people.

    You can see the findings on our website:

    Cheers and more later. Kathleen


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