BMJ 2002;324:1332 ( 1 June )

Letters

Getting more for their dollar: Kaiser v the NHS

    Price adjustments falsify comparison
    Working knowledge would have been needed for comparison
    Use of OECD database has led to incorrect conclusions
    Kaiser may be model of American success or aberration
    United States is paying more and getting less
    Like should be compared with like
    Length of stay is not the problem
    Summary of responses

Price adjustments falsify comparison

The first 150 words of the full text of this article appear below.

EDITOR---The NHS is little cheaper than health care in the United States, according to Feachem et al.1 What's next on their agenda? War is peace? Freedom is slavery? The authors purport to show Kaiser's efficiency relative to the NHS. This task is hard, given two undisputed facts: firstly, the United Kingdom's per capita health expenditure is $1569, the United States's $4358; and secondly, Kaiser's casemix adjusted costs are about average for the United States. Undeterred, Feacham et al use an outrageous price adjustment, exclude many of Kaiser's costs, and ignore Kaiser's avoidance of the sickest and most expensive patients.

Feachem et al's price adjustment inflates NHS costs by 52%, assuming that the NHS plays no part in constraining drug prices, administrators' or specialists' incomes, etc. Conversely, the adjustment excuses the US system from responsibility for the world's highest drug costs and the billions wasted on healthcare executives and . . . [Full text of this article]
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This article has been cited by other articles:

  • Mainous, A. G III, Diaz, V. A, Saxena, S., Baker, R., Everett, C. J, Koopman, R. J, Majeed, A. (2006). Diabetes management in the USA and England: comparative analysis of national surveys. JRSM 99: 463-469 [Abstract] [Full text]  
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Rapid Responses:

Read all Rapid Responses

So where now?
Martin McKee
bmj.com, 31 May 2002 [Full text]
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