When it comes to health system reform, these days all eyes seemed to be focused on India and China.
From the booming growth of their biotechnology, pharmaceutical and medical-device industries to their rapid expansion of health insurance programs and care sites, healthcare policy experts from around the world are looking to these emerging markets for hints about what can be done to improve health outcomes, expand access and lower costs in their own countries. According to a Health Affairs briefing at the National Press Club in Washington this week, the U.S. could learn a lot by paying attention to both the successes and missteps of China and India as they struggle to develop first-class healthcare systems.
Many of the challenges these nations face are surprisingly similar to our own, said Health Affairs Editor-in-Chief Susan Dentzer during the briefing. Aging populations, rising rates of obesity and the HIV/AIDS epidemic are among the common challenges that Dentzer cited and that the healthcare policy journal addresses in its July/August issue. Central to the collective messages of the 23 articles focused on China and India is that creating a high-functioning, easily accessible network of providers, payers and appropriate technology has implications far beyond wellness. This isnt just about improving health; its about protecting people from financial catastrophe, said Phil Musgrove, the journals deputy editor.
That reality is certainly one Americans can relate to. In 2001, medical expenses were responsible for more than half of all personal bankruptcies in this country, according to a study published in the Feb. 2, 2005 issue of Health Affairs. And though China, India and the U.S. may be operating with different political and economic realitiesthe former two countries are experiencing rapid growth of their middle class while the U.S. is trying to save its from extinction, for exampletheir healthcare realities are undeniably parallel, according the briefing participants. Both the U.S. and China, for example, are struggling to close healthcare disparity gaps. Thirty-seven percent of Americans didnt see a doctor when sick, skipped a recommended treatment or test or didnt fill a prescription due to cost issues in 2007, according to a Commonwealth Fund study. Likewise, nearly half of Chinese citizens reporting an illness in 2003 didnt seek care due to expense concerns, according to one of the Health Affairs articles.
The shared concerns continue, according to the briefing participants. Both China and India face concerns over how to deal with an aging population that will soon outnumber the working population that pays for the two countries growing healthcare systems. By 2030, older adults are expected to account for two-thirds of the disease burden in China and nearly half of the disease burden in India. Here in the U.S., lawmakers and healthcare providers are struggling to keep the countries overburdened Medicare program from fiscal collapse. And, as China and India grow their influence and participation in developing life-saving drugs and medical devices, both countries also find themselves working to identify which technologies and advances deliver the best medical outcomes. They are also struggling to limit the influence of drug companies and devicemakers on the delivery of patient care.
Like the U.S., both countries are working to determine how to incentivize providers to provide good and appropriate care to patients, Musgrove said.
While the U.S. has long been the country many have looked to for accessing the highest standard of care, when it comes to revamping our basic healthcare infrastructure, looking eastward could provide some helpful signposts.
Reporter Shawn Rhea, based in New York, covers international healthcare, among other issues. She can be reached at [email protected]