Estados Unidos es un país capaz de las proezas más extraordinarias y de las miserias más incomprensibles. Se trata del estado con mayor gasto sanitario del mundo y, a la vez, del país desarrollado con la mayor tasa de mortalidad materna y la peor mortalidad infantil de los 20 países más ricos del planeta..

No, no es una cuestión de "nivel de vida". Los norteamericanos tienen un gasto medio de 9.403 dólares por persona al año y no deja de crecer. Solo en 2016, el gasto norteamericano creció un 17,8% frente al resto de países que tuvieron un crecimiento entre el 9,6 y el 12,4%. Por ejemplo, Alemania gasta 5.182 dólares, Holanda unos 5.202 y España, 4.003. Es más, si calculamos la media de los diez países más ricos del mundo, el hecho es que EEUU gasta el doble que ellos.

Entonces, ¿qué está pasando?:Un estudio recién publicado señala que hay tres 'culpables': EEUU gasta más en farmaceúticos, en procedimientos quirúrgicos, en imágenes para diagnóstico y en trámites administrativos. Esas cuatro cosas explican más del 70 por ciento de sobrecosto médico en norteamerica.

Money, money: Da igual el procedimiento quirúrgico (reemplazo de rodilla o cadera, derivaciones coronarias, angioplástias, etc..), los americanos gastan entre 2 y 6 veces más que en cualquier país homologable. No sólo es que haya el doble de cesáreas per capita que en Países Bajos; es que el gasto anual es de 62 dólares frente los 9 dólares de Holanda.

La sanidad americana es un pozo sin fondo. Es de locos. 752 por habitante y año en gestiones administrativas frente a los 232 de Alemania. 220 dólares en imágenes para el diagnóstico (resonancias, TACs, radiografías...) frente a los 23 de Holanda. 1443 en gasto farmacéutico frente a los 566 de los suecos. Sin embargo, el gasto en personal es comparable al resto: los médicos cobran más, sí; pero son muy pocos.

Un problema sin solución. Al menos, no una sencilla. La reforma sanitaria, pese a los datos que muestran el fracaso continuado del sistema actual, sigue siendo un tema ridículamente polémico. Algo incomprensible cuando pequeños cambios (reforzar el poder de negociación, racionalizar el uso de pruebas innecesarias o ponerle coto a la sobremedicación) podrían reducir el gasto sanitario sensiblemente.

ENLACE ORIGINAL

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