10/23/2009 Aaron Katz, MPH Principal Lecturer of Global Health (adjunct) and Health Services

1. !" # ! $
% & & &
' ( )* +

2. New
Australia Canada Germany Zealand UK US
OVERALL RANKING (2007) 3.5 5 2 3.5 1 6
Quality Care 4 6 2.5 2.5 1 5
Right Care 5 6 3 4 2 1
Safe Care 4 5 1 3 2 6
Coordinated Care 3 6 4 2 1 5
Patient-Centered Care 3 6 2 1 4 5
Access 3 5 1 2 4 6
Efficiency 4 5 3 2 1 6
Equity 2 5 4 3 1 6
Long, Healthy, and Productive Lives 1 3 2 4.5 4.5 6
Health Expenditures/cap, 2004 $2,876* $3,165 $3,005* $2,083 $2,546 $6,102
!
Source: Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American
Health Care, The Commonwealth Fund, 2007.

3. ! ! " # $ %
%
&

4. ' (
)
European
US Banks
Banks
$10 Billion
African
Governments

5. *+
" !, - . /

6. 0 ( 12
Population Health Care Spending
United
States
United
5%
States Rest of
39% the
Rest of World
the World 61%
95%
Source: Organization for Economic Cooperation and Development, 2006

7. " & 3 !1 5
4 67-
" ! 4 $
/
5 6 3
* 78
10% ,- 0
./ 0 1-
20% - 30
2- /
,- 0
./ 0 1-
20% - / 2,-
29 1 23
.
; <
;
>
- 3
:- 9 1
/
50%
?
!
3 -1 ;<
- 3 :- 9 1
/ =<
Sources: Centers for Disease Control and Prevention, University of California at San Francisco, Institute for the Future.
Reprinted from Advances: The Robert Wood Johnson Foundation Quarterly Newsletter, 2000, Issue 1, supplement, page 1

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13. 0 )
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14. - G<B
Washingtonians in Families with High Health Care Costs
Percent
Share of pre-tax income on health 2000 2008 Insured
care (2008)
923,000 1,333,000
> 10% (17.5%) (23.6%) 84.4%
254,000 386,000
> 25% 78.5%
(4.8%) (6.8%)
Source: Too Great a Burden: Washington’s Families at Risk, Families USA, December 2007

15. ( : 6
9 <> !
2003 2008 2015 2020
$30,000
26,730
$25,000 23,842
21,009
19,731
$20,000 17,599
15,508
$15,000 13,788
12,298
10,837 10,748
9,249
$10,000 7,866
$5,000
1
$0
U.S. average Lowest state Highest state

16. - G B
Capacity and Use Rates for Selected OECD Countries, 1999/2000
Acute Admissions Average Acute
beds per per 1000 length of hospital
1000 pop pop hospital days per
stay (days) capita
Canada 3.3 99 7.1 1.0
France 4.2 204 5.5 1.1
Germany 6.4 205 9.6 1.9
Switzerland 4.1 136 9.3 1.3
US 3.0 118 5.9 0.7
Source: Anderson, GF, et al., Health Affairs, May/June 2003

17. - G B
%
( <
<
; < & <
*
+ < * <
& * <
Spending & < <
per capita * <
as % of US = <
<
<
( <
<
A 0 4 " B
Source: Organization for Economic Cooperation and Development, 2006

18. - ! 5 ! !( 6
( 3
+ 7< A ?
= A
25%
Medicare
20% Private Health Insurance
Premiums
15%
10%
5%
0%
70
72
74
76
78
80
82
84
86
88
90
92
94
96
98
00
02
04
06
19
19
19
19
19
19
19
19
19
19
19
19
19
19
19
20
20
20
20

19. 15 !! +
4 6
:
Coverage with skilled birth attendance in poorest quintile by type of
provider, according to overall level of skilled birth attendance (%)
All countries with DHS surveys analyzed by WB PHN
70
65
60
50
Percentage of births (%)
40
30
23
20
13
10
4 2 3 4
0
0
<10% 10-19.9% 20-39.9% 40-100%
(% )Births attended by public providers (% )Births attended by private providers

20. & ; 6
0 15
4
( ( + ( ;
- " ) + 6 & 6
;; & 6
; + 6
+
: !4
;6 ( 6
* ( 6 ( 6
+
/4 4 +(
6 +6 ;=
6 &=
6
! 4 ( 6
( ( 6
(* ( 6 6
Source: 1993, 1997 RWJF Washington Family Health Insurance Survey; 1998, 2000
Washington State Population Survey.

22. - & 3 7
$ %
% )
Gov Public
Investment
Health
7%
3%
Hospital
21%
Prof
Services
All Admin 19%
36%
NH/ HH
Rx +
6%
Products
9%
Source: Rough calculations based on CMS 2007 reports and estimates of administrative
expenditures by UW Health Policy Analysis Program, 1990

23. 6 (
&
11
10
9
(constant 1995 prices)
E & (
8
7
as a % of GDP
6
5
4
70
72
74
76
78
80
82
84
86
88
90
92
94
96
98
00
19
19
19
19
19
19
19
19
19
19
19
19
19
19
19
20
Source: Everhart and Sumlinski
Simple average Weighted average
From: Fiscal Space for Public Investment, UNDP, Sept 2006

24. " ( 8 ;$ ! ;
- $ %
% 5 !
2004 46% 44% 10%
Private
2000 57% 43%
Public
1980 60% 40% Tax
subsidy
1960 79% 21%
0% 20% 40% 60% 80% 100%
Source: US Department of Health and Human Services, 2006; Katz estimate

25. + $ %!
% 6 -
- ! "
US
UK
1995
Spain
Japan 1990
Canada
Australia
0 50 00 50 00 50 00 50 00 50 00 50 00 50 00 50 00
2 5 7 10 12 15 17 20 22 25 27 30 32 35 37 40
MRIs / Million Population
Source: Organization for Economic Cooperation and Development, 1999

26. - G)B " # "
$ " $" % %
A 9! 1
" & %
THE WALL STREET JOURNAL
September 21, 2009

27. ( H 5
! ! # '1
# $ %
& ' () *
+, $-
.
. !

28. '%() *B
5 ! ! 5 ! !
1986 2006
Health
Public Health Public
Care and
Schools Care and Schools
All Other 39.5%
45.7% All Other
38.4%
49.9%
Higher
Higher
Ed
Ed
10.6%
15.8%
Source: Washington State Office of Financial Management, 2008

29. - G> +
B
" %
The Impact of Quality-Reporting Programs on
Hospital Operations
September/October 2006
Health Affairs, Vol. 25, No. 5

30. Health Care Market Trends and the Evolution
of Hospitalist Use and Roles
February 2005
Journal of General Internal Medicine, Vol.
20, Issue No. 1

31. Health Benefits in 2005: Premium Increases Slow
Down, Coverage Continues to Erode
The Average Cost of Family Coverage Now Exceeds the
Average Yearly Income of Minimum-Wage Americans
September/October 2005 Health Affairs, Vol. 24, No. 5

32. ! B( - 0 ! 5
0 ! : ?- #
3 6
8 <) 97
*, %
% $
%
%
,
* Kaiser Daily Health Policy Report, November 14, 2008

33. I ;
+ 5 6
6 6 J 6 ?
! !
K 6 L 5 F
5 !
$ %
% M 55 6
3 5 ! ! 7

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