In Search Of The Perfect Health System - Book Review

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Mark Britnell has traveled to over 60 countries as a healthcare management consultant and held senior positions in the NHS and Australia for more than two decades. Summarizing his experiences in "In Search Of The Perfect Health System", Britnell offers a fascinating top-level assessment of healthcare systems, policies and outcomes around the world.

Healthcare is a unique industry, for a variety of reasons. Biologically, people function the same all accross the world. As a result, health technology, know-how and science travels mostly uninhibited from country to country. However, local availability of skilled services, socio-economic factors, culture, wealth, climate, and history all vary greatly from one country to another, with great consequences for their respective health systems.

Britnells book offers some astonishing facts and stories: In 1985, Russia had around four times the doctors and hospital beds per capita as the US. Today, a third of Russian hospitals still lack hot water. And something that truly shocked me while reading: The disparity between male and female life expectancy in Russia is the highest in the world at 65 and 76 years respectively (this is mostly attributed to alcoholism and risky life style).

Speaking of life style: Japan has an obesity rate of 3.3 percent, 10x lower than in the US. The US, another example of a very unique health system, spends 17.1 per cent of GDP on healthcare (the highest per-capita spending in the world), yet its health system delivers a disappointing life expectancy of 78.9 years - a whopping one and a half years less than the OECD average of 80.2 years.

For countries operating a mature, highly regulated, yet not very innovative health system - such as, in my view, Switzerland - the book also offers countless success stories of how to improve health systems despite significant resource constraints. Community health and patient empowerment initiatives, for example, have been a tremendeous source for improving healthcare in a number of poor countries, but sadly lack traction in many developed nations. Smart organizational design combined with technology and process innovation can improve both outcomes AND economic viability, as a number of examples in the book show. And by breaking down the wall between the insurer and the health maintenance organization, a number of institutions (i. e. Kaiser Permanente in the US, or Clalit in Israel) are looking to challenge fragementation and siloing. It will be fascinating to see how their efforts will progress.

By offering each countrys health system a few pages, Mark Britnell strikes a perfect balance between "fun facts" that stick and background information on history, policy and other factors he deems responsible for creating such stark differences between todays healthcare systems.

Finally, Britnell offers a compelling case for a variety of trends, such as universal coverage, patient empowerment, or adequate use of technology to leverage skills, combining his vast experience with data and a personal, passionate and empathic assessment of challenges in the health systems around the world. For healthcare innovation enthusiasts – like myself - "In search of the perfect health system" is a true page-turner.

(Link to book on Amazon:

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