What can countries learn from each other?

Having spent the past week at conferences in Amsterdam and Grenoble with several of my London-based colleagues from Xerox/ACS, I had an excellent opportunity to gauge the current status of three top-rated health systems that are commonly cited as models for the U.S. to emulate.  Ironically, I discovered that policy-makers in the Netherlands, France, and Great Britain are looking to us for solutions just as much as we are looking to them.  Our respective systems for financing and delivering care are facing the same problems, in spite of significantly different organizational characteristics.

The costs of health care have exceeded available economic resources in these three top-rated European countries.  American health policy analysts might look to them as models for universal coverage, but their economic challenges are no different than ours.  These countries are slashing providers’ budgets on a scale comparable to the cuts that Democrats in Congress recently imposed to pass insurance overhaul “reforms.”  So much for political promises that the United States could maintain accustomed levels of service and move toward European-style universal coverage!

The extent of covered benefits is also declining in these health systems that presumably provide more health care for their citizens.  Residents of all three countries told me that many services traditionally included in the universal plans are now only covered under supplemental plans that require the individual to pay an additional premium.  Further, the role of private providers is growing perceptibly in state-directed systems that many American liberals would have us emulate.


Those of you who follow my commentaries on health care will not be surprised that the principle themes of my speeches at last week’s European conferences were efficiency and effectiveness—that is, eliminating waste in health care delivery.  Perhaps I should not be surprised by the strong, positive audience responses to my message.  Indeed, a French study just concluded that more than 30% of all hospital stays there are inutile (useless).  The world’s top-rated health systems are suddenly realizing that they must harness medical expenditures that do not contribute to the health of individual citizens or national populations.    

The United States does not have a top-rated national health system, but I proudly believe our best providers are global leaders in applying performance improvement to health care.  Americans can still learn from European countries that produce healthier populations with lower shares of GDP, but we can teach them a thing or two about lowering costs (efficiency) and improving quality (effectiveness).  Some of our providers and payers have developed world-class solutions that will solve problems in Europe and elsewhere.  I expect more Americans will be asked to speak at international conferences in the future.