Are other countries health systems really so scary?

(By Newsweek's Katie Connolly)

The New York Times reported yesterday on the thousands of people lining up for a free health clinic in L.A. Many came for routine medical care, like breast exams, TB tests, and pap smears.

Reading this report reminded me of a recent conversation I had with Karen Davis, president of The Commonwealth Fund. The Fund conducts a range of comparative analyses of First World health-care systems. Their findings are often surprising, and usually provide striking illustrations of the inadequacies of the American system.

I discussed with Davis the difficulties many Americans have with accessing primary care compared with international peers. Davis believes the problems can be accounted for, in large measure, by the type of physicians available to Americans.

"We have about the same number of doctors per capita as other countries, but a higher proportion of our doctors are specialists," she says. This shortage has led to a squeeze on other services, and a yawning gap in after-hours and weekend care.

In a 2008 survey, the Fund reports that 18 percent of Americans end up in the emergency room for a condition that could have been treated by their primary physician, if available. In Germany, only 7 percent of people end up in that predicament, and in the Netherlands it's 8 percent. Only Canada performed worse than the U.S. on this measure.

Similarly, only 40 percent of American primary-care physicians said they have arrangements for taking care of patients on nights and weekends, a much lower proportion than in other countries.

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