Normally, the focus of this blog is healthcare in Southeast Asia and, of course, China in particular. In this post, however, I’m going to shift the focus to the United States and discuss some very disturbing new statistics in maternal mortality that have just been released.
One of the paradoxes of United States’ healthcare is that despite spending more per person on healthcare than any other country in the world, the United States suffers from appallingly poor performance in many healthcare indices. An excellent source of healthcare data is the OECD, Organization of Economic Cooperation and Development, a voluntary data gathering organization to which 34 countries subscribe and provide data in a host of different areas – healthcare being one. With a few exceptions, the 35 countries comprise pretty much the entire world’s industrialized and developed countries. If you are a statistics geek, the OECD’s annual reports are fascinating reading. Did you know, for example, that Chinese males are the heaviest smokers in the world and Chinese females are the lightest smokers in the world? If you’re interested, all of the annual reports including the health report can be found at stats.oecd.org.
The OECD reports have long pointed out just how poor the United States’ performance is in the healthcare area; particularly when compared to other developed countries who spend far, far less on healthcare. Just a couple of examples to make this point:
Infant mortality per 1,000 live births: 30 countries have lower infant mortality rates than the United States. Only Chile, Mexico, Turkey and China in the OECD data have higher infant mortality rates than the United States.
Mortality rates for communicable diseases per 100,000 population: 22 countries have lower mortality rates than the United States. Even such relatively undeveloped countries as Estonia, Slovenia and the Slovak Republic have lower mortality rates from communicable diseases than the United States.
There are a number of other examples but let’s talk about a particularly disturbing one, maternal mortality. A recent article in the New York Times (http://www.nytimes.com/2016/09/22/health/maternal-mortality.html) focused on this issue:
“One of the biggest worldwide public health triumphs in recent years has been maternal mortality. Global death rates fell by more than a third from 2000 to 2015. The United States, however, is one of the few countries in the world that have gone against the grain, new data show. Its maternal mortality rate has risen (emphasis added) despite improvements in health care and an overwhelming global trend in the other direction.”
Defined as deaths due to complications from pregnancy or childbirth, maternal deaths numbered 28 per 100,000 births in the United States in 2013, up from 23 per 100,000 in the prior year. For sake of comparison, The New York Times points out that this rate is more than triple Canada’s rate. Modern Healthcare in a recent article (http://www.modernhealthcare.com/article/20150506/NEWS/150509941) ranks the United States as last among developed countries and 33rd among all of the countries in the world in maternal mortality.
Out of curiosity, what do you think China’s maternal death rate was in 2015? If you thought it would be higher than the United States, think again. It was 25 deaths per 100,000 – lower than the United States.
What is the purpose of this discussion? Well, other than a general lament about how undeserved the United States’ reputation for having an excellent healthcare system might be, there is a strong point here: It’s not how much you spend on healthcare as it is how you spend it.
China does an excellent job of focusing on public health and using its limited funds on the things that ultimately really matter in healthcare. It may not be pretty with its poorly maintained facilities, long lines, abbreviated physician visits and over-utilization of pharmaceuticals but considering their huge population and limited resources for healthcare, they’re doing a pretty good job. If you are an international company thinking of bringing your healthcare product to China think first about whether your product is really needed to address the primary healthcare issues of the country or is it simply a fringe product that might work in the United States but isn’t really that appealing or meaningful in China.
One final note: If you’re scratching your head and wondering ‘how in the world can this be happening?’ consider for a moment the impact on the data results if you divide the United States data into two categories of its citizens: black and ‘all other’. If you do this, the care received by the ‘all other’ category ranks consistently in the top five countries in the world while the care received by the black population of the United States ranks in the lowest third of countries in the OECD.