One American health statistic that is strikingly above average:

Life expectancy for Americans who have already reached the age of 65. At that point, they can expect to live longer than the average in industrialized countries.

That's because Americans above age 65 actually have universal health care coverage: Medicare. Suddenly, a diverse population with pockets of poverty is no longer such a drawback.

Nicholas Kristoff, NYT

Well……maybe we pay more to get better around the clock service

Surely we get better quality, access and outcomes…….

4

Coronary Bypass Proceduresper 100,000 Population, 2006

145

8782 78 75

7061 57 54

4334

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25

50

75

100

125

150

US** CAN* DEN* GER NZ AUS* OECD Median

NETH* SWED UK SWITZ

*2005**2004Data: OECD Health Data 2008 (June 2008).

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Potential Years of Life Lost Due to Diabetes per 100,000 Population, 2006

242529

35363739

56

65

99

0

20

40

60

80

100

US* NZ** CAN** NETH OECDMedian

SWED** GER FRA* UK* SWITZ*

*2005**2004Data: OECD Health Data 2008 (June 2008).

• We rank 37th in infant mortality (partly because of many premature births) and 34th in maternal mortality

• A child in the United States is two-and-a-half times as likely to die by age 5 as in Singapore or Sweden, and

• An American woman is 11 times as likely to die in childbirth as a woman in Ireland

• An African-American in New Orleans has a shorter life expectancy than the average person in Vietnam or Honduras.

• Canadians live longer than Americans do after kidney transplants and after dialysis

Got any more encouraging/upbeat facts?

Even when we know what works…..we fail to follow it….

Time for some positive news

Readmissions are a problem in the USThere is something we are not doing

But with all the vaunted hospitals, medical schools and physicians in the NYC region, surely……….

The study's lead author, Dr. David Goodman, suggests that the range in practice is linked to variations among physician and hospitals. "The care that patients receive has less to do with what they want and need and more to do with the hospitals they happen to seek care from," he said, adding, "Geography is destiny."

  Dartmouth Atlas report on “Quality of End of

Life Cancer Care”, November 2010

Nearly 1 of every 4 Medicare admits would need to be eliminated to achieve national practice standards

Doing the “Right Thing” for our community… could be very beneficial to our finances

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TotalCost

LI CostNYC CostSF Cost

arbitrage opportunity

Solutions abound

The will to change, on the other hand….

Medicine is remarkably conservative to the point of being properly

characterized as sclerotic, even ossified.

“Eric Topol, “The Creative Destruction of Medicine”

“There are risks and costs to action.

But they are far less than the risks and costs of comfortable inaction.”

– John F. Kennedy