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> US public health infrastructure is less resilient than most of europe, capacity is lower

these parts



Europe, in general, has more hospital beds per capita than the US. Hospital beds per capita seems to be a reasonable heuristic.

https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp...


Also more physicians per capita. US is around 25 per 10k, most Western European countries are around 35, some up to 50.


In the US, "physicians" might be less numerous, but there are a lot of highly-skilled intermediary roles that fill the gap -- Physician Assistants, Nurse Practitioners, etc, all perform routine treatment performed by "physicians" in other countries.

US physician training is honestly excessively long, complicated, and expensive (although there are justifications for making it this way), but it's a simplification to point out that there aren't as many doctors, without noting all the other doctor-esque roles with significant overlap.


> it's a simplification to point out that there aren't as many doctors, without noting all the other doctor-esque roles with significant overlap.

Comparing the number of doctors in the US to other countries is not a good measure of anything. But noting that americans spend more per capita and get worse health outcomes is pretty significant.


I'm definitely not trying to make any greater point, only that the 25 vs 50/10k is not a meaningful measure of healthcare quality or capacity.


This is possibly the worst metric as it can mean so many things.

Here [1] we have more numbers.

Most importantly the # of beds seems to correlate strongly to the 'average time in hospital' eg. Japan has 3x beds but stays are 3x longer. That stays are shorter is not an indication of poorer quality.

The US has fewer doctors, about the same nurses, but 3x more MRIs per capita, and probably similar inventories of other kinds of equipment.

As for respirators? Who knows. But The US is a major exporter of medicine, equipment, and they spend considerably more. Just like in every major war there's a 'key weapons system' that wins the day while the underlying economy wins the war ... the US might be in a decent position with enough equipment, and a resilient enough economy and populace to fight coronavirus.

Don't be fooled by Trump's shenanigans, Americans are not fools. When they decide to do whatever they do it in a way that few can match. FYI I'm not American.

There will be ugly issues for those without insurance but I suggest that states will take over there with emergency solutions or else they'll all be voted out of office instantly and they know it. Even Trump isn't stupid enough to fail to recognize that people dying en masse on TV will make him look, in his own terminology 'really, really, really bad'.

Also, thankfully, once again, North America seems to be a tiny bit isolated from the 'rest of the world' and has just enough time to see what's happening in Italy and can possibly act a little sooner on some things.

I expect lock-downs and social distancing measures to take effect earlier in America on an per-capita-infected-basis.

[1] https://www.healthsystemtracker.org/chart-collection/u-s-hea...


I don't think simple comparisons between Japan and US are meaningful. Japan has a universal health care system so everyone is covered by health insurance. There is little incentive to leave hospitals prematurely.

One of our children spent a week in hospital and the out of pocket cost was 500yen (about $5USD)[1] plus food. My mother in law joked that it was cheaper then childcare.

Hospitals are also not incentivized to mess around with trying to extract the most from billing because its prescribed.

A friend from Australia needed stitches while in Japan and didn't have travel insurance. We went to the local doctor explained the situation and they refereed us to a hospital. They didn't charge us for the consultation because "they didn't do anything, only gave a referral". At the hospital we explained the situation and the bill was less then the excess they would have payed in Australia. My impression is that they didn't feel the need to extract every dollar because they were getting full payment from everyone else.

These are exceptional cases and the usually out of pocket is more like $30~$50 for a consultation.

1. Where we are children cost a flat rate of 500yen for a consultation and as the hospital stay was a result of the consultation that was also covered.


Every other nation on the list has socialized medicine and they leave have considerably shorter hospital stays. Japan is an outlier for their quite long avg. hospital stays.


The question is do longer stays result from worse care or economic incentives.

In the case of our child, we choose a 7 day inpatient treatment that could have been done as a more risky outpatent treatment.


Hospital beds are healthcare infrastructure.

Public health isn't quite healthcare.

(they overlap, but they are not the same thing)




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