Americans like to brag that they have the finest healthcare system in the world, but a British research company says Switzerland is the best place to get care.
According to London-based MarketLine International, a research firm, Switzerland leads the world in health and healthcare provision, followed by Sweden, Austria and Japan.
The United States ranked No. 12 among 30 countries studied. Canada was No. 6, and the United Kingdom ranked No. 18.
Factors were per-capita health expenditure, number of doctors per capita, infant mortality, life expectancy, key causes of death and level of accessibility of healthcare services.
All four top-rated countries have long life expectancies and low infant mortality rates. Switzerland boasts high accessibility, short waiting lists and a well-developed hospital system, the company said.
North America spends the most, but the U.S. health system "provides poor value for money," the company said, leaving part of the population without access to care and suffering high infant mortality.
In his new suspense novel Contagion, Robin Cook, the John Grisham of the medical field, takes a swipe at managed care and for-profit healthcare organizations.
The plot kicks off when several patients at a hospital owned by a giant for-profit named National Health get infected with rare and fatal diseases. At one point, the novel's hero, Jack Stapleton, implies that National Health may have infected the patients because they already were suffering from chronic illnesses that cost the managed-care firm too much money to treat.
Elsewhere, Cook bemoans the demise of teaching hospitals, the dismal state of medical specialists, and the wave of downsizing and cost-cutting. Cook pines for the days when hospitals were run by people with medical training, characterizing the hospital's president as an "unctuous car salesman" more concerned with public relations than patients.
HMOs may be under attack for their hard-nosed approach to curbing inefficiencies, but Malik Hasan, M.D., chairman and chief executive officer of for-profit Health Systems International, isn't giving an inch.
As a panelist at a recent conference, he was asked, "What is the industry's responsibility to build alliances to cover the uninsured?"
Hasan responded, "You're not going to like my answer*.*.*.*I gave at the office." HSI paid $62.7 million in federal and state taxes in 1994, which covers its responsibility to the indigent, he said. Besides, HMOs have made insurance more affordable for those who would otherwise be uninsured, he said.
"I am not a heartless person," he later told Outliers. "But we are not in the business of social redistribution. We operate under a capitalistic system." It is the not-for-profits that "have a responsibility they have not fulfilled" and they should be doing more to care for the indigent, he said.
"Nobody comes out and says things frankly and candidly. Everybody starts giving pablum, mom and apple pie," he added.
People in Luzerne County, Pa., still remember the 1972 flood of the mighty Susquehanna River. So, when heavy rains swamped the snowbound valley Jan. 19, administrators at Mercy Hospital in Wilkes-Barre, Pa., didn't wait for the dikes to break.
As they made plans for evacuation, staff got an early warning of what was in store. Though the Susquehanna hadn't crested, a bridge at nearby Solomon's Creek collapsed, flooding Mercy's lobby area and the parking garage below. As water seeped in, Mercy employees scrambled to move the hospital's pharmacy operations out of the basement. Several hours later, nurses, medical staff and management began evacuating the facility, well in advance of a decision by the county's emergency management agency to mandate such a move.
Within nine hours, Mercy had discharged and transferred 160 patients. Nesbitt Memorial Hospital in Kingston, Pa., which is part of Wyoming Valley Health Care System, and several area nursing homes also evacuated their facilities.
"I was surprised at how smoothly it happened," said John Campos, executive vice president of Emergency Medical Services of Northeastern Pennsylvania, which coordinated the transfer of hospital and nursing home patients to other facilities.
Fortunately, the Susquehanna crested by 4 p.m. Jan. 20, and Mercy reopened at 7 a.m. on Jan. 22. But lost revenues, transportation expenses and equipment repairs will cost the hospital an estimated $1 million.
The induction of American Hospital Association officials is usually a tame affair, but when Gordon M. Sprenger was installed last month in Washington as 1996 chairman of the AHA board of trustees, Russia's problems in Chechnya indirectly intervened.
Sprenger, executive officer of Allina Health System in Minneapolis, was officially installed as AHA chairman in a Jan. 28 ceremony at the Washington Hilton, but a reception and dinner were scheduled at the Russian embassy. Attendees received a fax just days before the event, however, informing them that "due to an unforeseen civil disturbance in Russia" the social activities were being moved to the Smithsonian National Museum of American History. Hopefully, guests were more comfortable among the trappings of Western democracy than the relics of communism's dinosaurs.