Health care consumers in search of value

As an international student studying global health in the U.S., I often compare the health care system here to those of other countries in terms of quality and affordability. It is widely accepted that US health care system provide relatively “high quality” care but “high cost” limits access to the care. I believe it is partly true, but still doubt whether the US system really save “quality” while sacrificing “equity” in their health care.

Suppose you were diagnosed with late stage breast cancer. You might be desperately looking for some innovative treatments that can save your life. And soon you will find you are lucky to be in the United States. You can see world-class oncologists without long waiting times and can be treated with the most recently proved cancer therapy that might save or at least extend your life. That can be something you can only dream of if you are in some other countries. According to a recent report by Deloitte,  400,000 non-U.S. residents came from abroad in 2008 seeking for high quality care. Nobody doubts the U.S. is home to the finest medical facilities, technologies, innovations, treatment, and human talent.

However, the story turns into reality only when you have an expensive insurance plan with special coverage or you can afford more than $100,000/year for a medication. If you don’t, you will end up with wrestling with mortality and your insurance company simultaneously. That is many other American patients are doing now, knowing that the medication needed to save your life was only a few feet away, but isn’t available to them.


In this globalized world, with free market system, consumers keep comparing the quality and price of the product they need. Although the market economy doesn’t necessarily work perfectly, it reveals the relative strength and weakness of a country’s product and the production system. Health care system is not an exception. The recent increase in US consumers to travel abroad seeking for better and affordable care is worth receiving attention in this sense. More and more US patients choose to travel because they can get same quality of care with less than 50% of cost.  

The same report by Deloitte shows that 750,000 American patients, almost twice as much as incoming patients, went to abroad seeking for affordable care in 2007. The number will be expected to increase to 15.75 million in 2017. The fast growth in medical tourism reveals that the health care cost in the U.S. is too high to protect its own people’s health need.

Embedded in a private market competition, the health care in the U.S. has sacrificed average American’s access to an affordable care for a “high quality” care. American health care is relying on insurance companies whose business model is based on accepting premiums from healthy people and devising ways to exclude from coverage those who most desperately need medical care. Although recently passed reform bill dealt with the problem of the uninsured by mandating an individual health insurance and prohibiting insurance company’s denial of coverage, exceptionally high cost still remains as a major weakness in American health care system.


Moreover, the recent studies show that American superiority in quality of care is a mixed bag. The U.S. is doing relatively well in some areas like cancer cares but less well in others such as mortality from treatable and preventable conditions. It is widely known that the U.S. ranks 37th in infant mortality and 34th in maternal mortality in WHO statistics. According to a recent report by Robert Wood Johnson Foundation, the U.S. is the worst among 19 developed countries in avoiding “preventable deaths,” such as those where a disease could be cured or forestalled.


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