US Health Care Still Among Least Efficient in the World

According to the 2014 Bloomberg Health Care Efficiency Index, the U.S. was near the bottom of the list of 55 countries rated for their Health Care. This index compiles data from the World Bank, World Health Care Organization, and a few other sources which take into account life expectancy and the cost of Health Care per capita of each nation. America ranked 50th on the index, with costs per person averaging $9403, which is 17.1% of GDP for 2009, the most recent year data has been available. Life Expectancy was at 78.9, also lower than most of the nations listed. Singapore and Hong Kong are the top two countries on the list with life spans averaging 83 years. These two governments have taken a stronger role in providing Health Care through tougher regulation but spending only $2300 per capita on average. Since the index was created in 2012, The U.S. has consistently lagged behind with only five countries ranking lower. 

Health Care Spending and Life Expectancies
According to Paul Ginsburg, Professor at the University of Southern California, the U.S. is largely a private run health care system with less government oversight. This can make for a less organized system that can lead to inefficiencies such as the high-cost per capita spending of $9403. This may explain the low ranking on the index, but Americans still have a relatively high life expectancy of 79 years.

For the first time, the index has reflected the U.S. Affordable Care Act, or Obamacare as it is commonly known, which took effect January 2014. Obamacare makes health insurance more accessible as well as affordable, by allowing subsidies for lower income people. However, it's full impact on Americans health and longevity will take a while. 

It's easy to conclude that more spending on health care will lead to higher life expectancies, but this is not always the case. Countries like Sweden and Saudi Arabia fell more than 20 points on the index. This is despite the increased spending per capita that grew by 50 to 80 percent. To make it more confusing, Greece moved up to 13th position on the index despite the devastating economic crisis it has had to endure. Greece's life expectancy rose, while health care spending fell sharply.

Public versus Private Health Care
There has been a long-standing debate concerning the merits of public versus private health care systems, and which does better for a population's longevity. Some question the apparent inefficiencies of public care compared to private care. Others worry that privatization of care would lead to unfair inequalities favoring those who can afford treatments. 

One country with a public healthcare system is Canada, where life expectancy is about 82 years. Canada ranks 16 on the Bloomberg index with a cost per capita of over $5000 USD compared to the U.S with $9403. Under this system, all individuals are provided equal access to medical services regardless of their income. On the other hand, America has a private healthcare system that has been augmented with the Affordable Care Act. Also called Obamacare, it is designed to lower the cost of private run health insurance as well as making it easier for more people to qualify for Medicaid. It may be many years yet to determine what effects this will have on American longevity, as well as health costs per individual. Some analysts are predicting that over time Obamacare could increase government spending even further.

One of the ways to measure how effective health care systems in each country are working is to look at the average life expectancies, says Jon Oberlander Professor at the University of North Carolina, but it is not the only thing that influences longevity. There are many factors like diet, lifestyle, social inequality, and poverty will have an impact on a population's health. Using the Bloomberg Index as a reference is not at all clear-cut when it comes to health care spending and longevity.