Monday, 19 May 2014

Bandages for Buck: Healthcare Resourcing in the G8 + Australia + Singapore

The Australian Government in its 2014 budget is looking to reduce expenditure on health care. This would only make sense if there were opportunities to increase efficiency. That is, provide the same level of service for less. Health systems fall quite neatly within national boundaries. So a quick international comparison can show if Australia is allocating its health dollars optimally.

There's no use comparing Australia with developing nations, so I'll use the peers she wishes she had, namely, the G8. Unfortunately the data contains many gaps and is not particularly current. But the nations involved do not see too much variation from year to year. Even though Australia is in the bottom end of the G20, it spends more on healthcare than all but one of the G8.
Data from 2008-2010 Source: WHO

There are many aspects to healthcare, but I concentrate on three: Physician density, Hospital Beds, and Price of drugs.
Data from 2008-2010 Source: WHO
One would expect resources to be proportional to expenditure. Australia does not do too badly in physician density, although Italy, Germany and France have comparable or better results for less. Where Australia fares poorly is hospital beds. A developing nation like Singapore can be excused for being able to deliver more beds per population, but not countries synonymous with bureaucracy like the UK.

Before jumping to (more) conclusions, perhaps it is blowouts in the delivery of other health services that make beds and doctors seem so much more costly in Australia. And so we turn to prescription medication.

Alas, the WHO do not keep indicators on drug prices. But an excellent source is Australia's national Pharmaceutical Benefits Scheme.

Total expenditure on pharmaceuticals and other medical non-durables 2011%Total expenditure on health per capitaUS$ purchasing power parity per capita
Australia14.7541
Canada17732
France16.1632
Germany14.9629
NewZealand9.5279
United Kingdomn.a.n.a.
United States12.2977
It is good to see that Australia seems to pay less for medicine than other countries, although I am unsure what justifies the drastic price differences.

Further good news is that Australia can look to plenty of examples for how to more efficiently manage their health system. That is, all of the G8, its neighbours New Zealand and Singapore, but not the U.S.

Other interesting links:
International Federation of Health Plans - Price Report

Data Table
WHO 2008-2010 Annual DataGovernment Health Expenditure Per Capita (US$)Total Health Expenditure Per Capita (US$)Private Health Expenditure Per Capita (US$)Hospital beds (per 10 000 population)Physicians density (per 1000 population)
United States of America$4,126.14$8,895.12$4,768.98302.452
United Kingdom$3,009.36$3,647.47$638.11332.79
Singapore$912.09$2,426.07$1,513.98311.921
Russian Federation$540.89$886.88$345.9997No data
Japan$3,919.58$4,751.61$832.031372.297
Italy$2,370.54$3,032.49$661.95364.092
Germany$3,572.32$4,683.18$1,110.86823.806
France$3,608.72$4,689.99$1,081.27693.18
Canada$4,021.61$5,740.70$1,719.09322.068
Australia$4,108.40$6,140.04$2,031.64383.273

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