Health Care Worldwide: Is the U.S. the Best? — In Conversation with Peter Waziri

In the ongoing debate about U.S. health care, our system is often compared with other systems worldwide. Many are alarmed that the U.S. spends twice as much per person on health care than other countries, yet others maintain that high costs are the price we pay for the freedom to choose providers and avoid long waits for care.

How does our country’s health care system stack up against others around the world? We posed this question to Peter Waziri, a financial strategist and health care executive with a seasoned global perspective.

Peter, you’ve lived in three continents, Africa, Europe, and North America, and have experienced the health care system in each. What have you found?

My experience tells me that health outcomes ultimately depend on a country’s resources and how they are spent. Most African countries spend well below 5 percent of gross domestic product (GDP) on health care. Also, most facilities are government-owned and short on resources. There are private facilities, which tend to be better operated but not enough in scale to cover the mass population who are unable to afford to pay for care let alone have access to care. African countries also have a shortage of trained health care professionals.

While health care systems in western European countries have subtle differences, most maintain a welfare state model where everyone has equal access to basic health services at little or no cost. The average health care spend is in the 10 percent range with a sizable proportion funded by tax dollars. Typically, we see a hybrid system: one in which the government funds a type of universal health coverage through a single-payer design that effectively controls health insurance and health care providers through a socialized system; or a universal system that also maintains a privatized, regulated system, whereby employed citizens under a certain income threshold enroll in a public health insurance option and those making more purchase private insurance. The key benefit of European systems is that out-of-pocket costs are minimal and everyone has access to basic health services.

The U.S. is the only wealthy, free-trade country without universal health insurance. We’re widely hailed as having the best doctors and hospitals in the world. We attract human resources from other countries, primarily because of our leading-edge technologies. Capitalism has encouraged healthy competition and medical innovation among our researchers and hospital systems. We have the resources to channel into specialty care. Americans who have good coverage can usually see a doctor when they need one. For all these advantages, we spend approximately 20 percent of GDP on health care. But we have one of the lowest health outcomes among rich nations, along with coverage gaps and fast-rising costs.

Would the European model work in America?

I don’t think so. Our culture of individuality is too strong. We don’t tolerate long waits or high taxes, although some would argue we still have both. I believe America has the best system for those who can afford it. For those who can’t afford it, it’s not the best.

No health care system is without challenges. Each country has to design a system that works for its people. Given that the U.S. is young in comparison with most European countries, we can consider our health care system a work in progress.

Thank you, Peter, for sharing your experiences with us.

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A financial and health care leader with a global perspective, Peter Waziri has deep experience across several industries. He currently provides financial leadership for Parkland Community Health Plan’s operational and clinical management functions. Previous positions include CFO at Umpqua Health and also at Cascade Comprehensive Care, along with management positions at GE Capital, Ernst & Young, PNC, KeyCorp, and the Institute of European Finance in Great Britain.

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