Category Archives: Broken in the USA

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Healthcare Revisited – Relative Quality of Life

Healthcare Revisited – Relative Quality of Life

More important than longevity is the length of time that we experience “quality” life experience. The following chart again shows how we compare to other countries.
Following was taken from


Health attainment, level, and distribution in all Member States
Disability-adjusted life expectancy at birth (years) Adjusted for years spent in disability. When compared to longevity, the chart is revealing. It indicates that the last ten years of life are not pleasant (on average) and also likely very expensive.
 Rank  Country                Total      Male     Female
1       Japan                                   74.5            71.9            77.2
2       Australia                              73.2            70.8            75.5
3       France                                  73.1            69.3            76.9
4       Sweden                                73.0            71.2            74.9
5       Spain                                    72.8            69.8            75.7
6       Italy                                      72.7            70.0            75.4
7       Greece                                 72.5            70.5            74.6
8       Switzerland                         72.5            69.5            75.5
9       Monaco                               72.4            68.5            76.3
10    Andorra                                72.3            69.3            75.2
11    San Marino                          72.3            69.5            75.0
12    Canada                                 72.0            70.0            74.0
13    Netherlands                        72.0            69.6            74.4
14    United Kingdom                 71.7            69.7            73.7
15    Norway                                71.7            68.8            74.6
16    Belgium                               71.6            68.7            74.6
17    Austria                                 71.6            68.8            74.4
18    Luxembourg                       71.1            68.0            74.2
19    Iceland                                70.8            69.2            72.3
20    Finland                                70.5            67.2            73.7
21    Malta                                   70.5            68.4            72.5
22    Germany                             70.4            67.4            73.5
23    Israel                                    70.4            69.2            71.6
24    United States                     7 0.0            67.5            72.6

It is interesting to note that all of the five baseline countries rank well above the United States and 3 of the five rank in the top 5: Japan, France & Spain.

Healthcare Revisited – Hospital Costs

Healthcare Revisited – Hospital Costs


Total health care spending in America was approximately $3.5-trillion in 2017, and about 32% of that amount — or $1.1-trillion — is spent on hospital services.”

Hospitals are an area where our costs are completely out of whack! I have no idea why we are so out of line with the other countries.

There are numerous documented examples of hospital financial abuse in this country. Overcharges for OTC medications, overprescribed testing, and phantom charges are among these examples. In the U.S. we pay more for hospital services than in all other countries. Do we receive superior care in exchange? Considering where we rank in terms of quality of care, it is doubtful.

This area cries out for some serious baselining. I have not been able to locate the cost of a hospital day for all of the baseline countries. But there is little doubt that they all have a lower per day cost than the U.S.

I am reprinting this chart to illustrate the issue. It contains the numbers for a couple of baseline countries, France and Spain.

Healthcare Revisited -Legal Factors in Healthcare Costs (con’t)

Healthcare Revisited –Legal Factors in Healthcare Costs (con’t)

The following is a list of some of the largest settlements reached between the United States Department of Justice and pharmaceutical companies from 1991 to 2012, ordered by the size of the total settlement.”

YearCompanySettlementViolation(s)Product(s)Laws allegedly violated
(if applicable)
2012GlaxoSmithKline[1][6]$3 billion ($1B criminal, $2B civil)Criminal: Off-label promotion, failure to disclose safety data.Avandia (not providing safety data), Wellbutrin,False Claims Act/FDCA
Civil: paying kickbacks to physicians, making false and misleadingPaxil (promotion of paediatric use), Advair,
statements concerning the safety of Avandia, reporting false bestLamictal, Zofran,
prices and underpaying rebates owed under the Medicaid Drug Rebate ProgramImitrex, Lotronex,
 Flovent, Valtrex;
2009Pfizer[2]$2.3 billionOff-label promotion/kickbacksBextra/Geodon/False Claims Act/FDCA
2013Johnson & Johnson[7]$2.2 billionOff-label promotion/kickbacksRisperdal/Invega/False Claims Act/FDCA
2012Abbott Laboratories[8]$1.5 billionOff-label promotionDepakoteFalse Claims Act/FDCA
2009Eli Lilly[9]$1.4 billionOff-label promotionZyprexaFalse Claims Act/FDCA
2001TAP Pharmaceutical Products[10]$875 millionMedicare fraud/kickbacksLupronFalse Claims Act/
Prescription Drug Marketing Act
2012Amgen[11]$762 millionOff-label promotion/kickbacksAranespFalse Claims Act/FDCA
2010GlaxoSmithKline[12]$750 millionPoor manufacturing practicesKytril/Bactroban/False Claims Act/FDCA
Paxil CR/Avandamet
2005Serono[13]$704 millionOff-label promotion/SerostimFalse Claims Act
kickbacks/monopoly practices

The Largest drug-related class action settlement was in 2000

“Fen-Phen diet drugs $3.8 billion

In 2000, a federal judge in Philadelphia approved a $3.75 billion settlement over a diet drug known as fen-phen that had been associated with potentially fatal heart valve damage. Six million people reportedly used fen-phen, sold by American Home Products, before it was pulled from the market in 1997. The settlement provides up to $1.5 million to users, depending on their injuries and how long they used the drug.”

“News flash, just announced by far the largest settlement offer to date and this is for only one drug and one company involved in the Opioid Crisis:                             The maker of OxyContin, Purdue Pharma, and its owners, the Sackler family, are offering to settle more than 2,000 lawsuits against the company for $10 billion to $12 billion. The potential deal was part of confidential conversations and discussed by Purdue’s lawyers at a meeting in Cleveland last Tuesday, Aug. 20, (2019), according to two people familiar with the mediation.

Brought by states, cities, and counties, the lawsuits — some of which have been combined into one m massive caseallege the company and the Sackler family are responsible for starting and sustaining the opioid crisis.

Additional Update: In November 2019 it was announced that the current offer to settle the Opioid Class action was now at $50 Billion for the two largest manufacturers of the product!

The point is that in the long run all of these costs end up being passed along to the consumer in the form of higher prices (you might say an added tax).