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PubMed2005

National healthcare spending in the U.S. and Japan: national economic policy and implications for neurosurgery.

Growth of national healthcare spending is a problem confronting national governments of all industrially advanced countries. Healthcare spending in the U.S. reached 13.9% of the Gross Domestic Product (GDP) in 2003, compared to only 8% in Japan. In the U.S., health insurance is voluntary, with 15% of the population uninsured. In Japan, health insurance is mandatory and virtually universal, with growth in national health costs about half the rate of growth in the U.S. U.S. healthcare costs are projected to reach 18.4% of GDP 2013. The predicted growth in health care costs is expected to cause strain on the federal budget and a growing inability of employers and employees to pay for private insurance. Different national policies are the reason for different national health care costs in the U.S. and Japan. The U.S. has higher healthcare prices for salaries, equipment, supplies, and pharmaceuticals as compared to Japan. Higher prices, higher service intensity and volume during hospitalization create higher total cost in the U.S. Price controls in Japan kept medical inflation low at 0.46%/yr from 1980-2000. Market-pricing mechanisms in the U.S. have proven ineffective in controlling national healthcare costs, while Japan's national fee and price control policies have kept national costs among the lowest within the Organization for Economic Cooperation and Development. To guide insurance coverage policy, neurosurgery and other highly technical specialties should better define the comparative health benefit of high price technical services by prospective outcome studies.

Health Care Costs↗
PubMedDate not supplied

How do patents and economic policies affect access to essential medicines in developing countries?

This paper studies the relationship between patents and access to essential medicines. It finds that in sixty-five low- and middle-income countries, where four billion people live, patenting is rare for 319 products on the World Health Organization's Model List of Essential Medicines. Only seventeen essential medicines are patentable, although usually not actually patented, so that overall patent incidence is low (1.4 percent) and concentrated in larger markets. This and other results shed light on the policy dialogue among public health activists, the pharmaceutical industry, and governments that is often based on mistaken premises about how patents affect corporate revenues or the health of the world's poorest. Pragmatism and greater flexibility are urged, so that policy may better concentrate on the greater causes of epidemic mortality, which now pose unprecedented threats to global peace and security.

Developing Countries↗
PubMed1995

Canadians pay for harsh economic policies with their health, physicians warn.

Canada's fiscal policies are damaging the health of Canadians, two physicians told a conference that examined globalization's impact on the country. Near-record unemployment levels and the recent recession have forced 41% of families in which the parents are 30 or younger to live below the poverty level; more than 21% of Canadian children are also considered to live in poverty. The impact tight fiscal policies have on health and well-being are enormous, say the dean of medicine at the University of Western Ontario and the chair of the Canadian Institute of Child Health.

Adult↗