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[…] my complete post over at the World Health Care Blog. Posted in WorldHealthCareBlog, Globalization, […]

The recent Commonwealth Fund report on spending versus performance/outcomes clearly repeated prior report wherein the US is spending at almost twice the rate of European countries and NOT achieving the same results. The message was exactly what you are suggesting…..we/the United States can learn much how other countries are addressing healthcare issues. At the same time globalizing healthcare is not easy. The insurance sector tried to “export” its managed care business in the late 80’s/early 90’s and it was a disaster. More recently DM companies are also finding resistance for a number of reasons but also because we do not have a very good track record at the moment in the public sector. Notwithstanding US hospital still benefit from thousands of patient from other countries seek out the John’s Hopkins, Sloan Kettering’s, Mayo Clinic’s, etc. If we are to lead with our expertise perhaps it should be via more academic approachs or with centers of excellence.

Given increase in co-pays, uninsured, etc. we are apt to see a large surge in medical tourism in the next decade. If one looks at the credentials of the doctors in countries like India, Singapore, Brazil, Thailand, etc….you will find lots of US trained physicians. I would ask how can we attract more Americans into the medical profession. I fear that if we do not there may be no ceiling to the medical tourism trend.

My fellow co-founder of the disease management movement in America, Warren Todd, is absolutely correct. Based on my own experience in starting disease management initiatives on four continents, I can tell you that the health care systems of other countries have generally been more receptive to that new way of managing care than has been the American system.

Why should other OECD countries look to America as a “model” when, as Warren points out from the recent Commonwealth Fund study, our system costs twice as much per capita with (generally) worse overall health results?
The fact is that America has much more to learn from other countries, than what they have to learn from us.

Thank you very much Dr. Couch and Mr. Todd for your comments. So how do we improve the awareness of the global nature of health care? I guess I am of the school that tries to find the sweet spot that avoids both the denial of our achievements or self-serving oversell. Maybe this presidential campaign will offer the country a collective “learning moment” . The question will be , how do we take advange of the opportunity?

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