More noise on US healthcare as JP Morgan, Berkshire Hathaway and Amazon form a venture to look at lowering healthcare costs (Bloomberg article). I’ve been meaning to write a long series of pieces on health, given it is one of my specialties and I can talk about health for almost as many days as I can talk about theatre or investments and sustainability.

But, it’s hard to compress those thoughts succinctly.

So, I only wanted to point out 2 points. First, US healthcare spend is at around 16.6% GDP (in 2014; but close to 18% in 2017 and likely 20% in 2025!)  and now  vs UK at 9.9% (2014 adjusted) and Germany at close to 11% and China at about 6%.  (Noticeable for the UK its health spend is one of the lowest in the G7, on this measure although higher than the OECD average for now, it probably falls to average in next few years;  UK data here and more and world bank data here;  US govt analysis here)

These averages disguise a huge amount, which is a discussion for another time, but it is much larger than other developed nations and on balance the average health result in the US (again the mean and median disguising many items) are not as good as other developed nations, across many health measures (see a balanced view on key measures here from Kaiser    

I’ve also seen data where items such as socio-economic status, smoking, obesity and other key factors have been balances and US is still worse at the mean).

One of the problems in the US, is that there is no socio-political consensus that healthcare is a human right, in the same way it is in Europe.

Ultimately funding healthcare is as much (or if you follow Cambridge economist Ha-Joon Chang’s line of thinking, the politics is everything (23 Things They Don’t Tell You about Capitalism) political as economic. Some of the US population believes healthcare is a right and should be public funded, but others in the US do not believe it is a right.  Those others believe the healthy should not subsidise the unhealthy. This gives rise to the system the US has and there is the added difficulties of the healthcare economics  of risk pools, which is perhaps somewhat unique to healthcare.

So even as the economics of US health weigh even more heavily, I don’t see any easy way out for the country unless they can form a consensus on whether it is a right and settles once and for all if it should be privately or publicly funded or what the split should be and then perhaps  move towards a system like Singapore or Switzerland. Or can think about distributive justice.