Re: ‘Rather pay than wait’

By Andrew Brunskill | Apr 14, 2013


The comments by John Pierre on Health Care and costs April 11, are interesting.

We in the USA are spending much more per person health care results

than other countries.

I suggest reading the article  “Explaining High Health Care Spending in the United States: An international comparison

of Supply, Utilization, Prices, and Quality by David Squires (Commonwealth fund) on the internet.

Some people do visit the USA for HealthCare but many people from the USA who have the option leave the USA for healthcare as several other countries have medicines and tests we lack and more affordable costs.

Generally people in the US like to be smart shoppers.  They like to

obtain value, i.e. quality and cost.

This allows use your savings to buy other things.   Our present health care system does not seem to offer good value.

It is expensive, many people have not been covered and the quality and outcomes are not always good.  If you consider the UK NHS you should consider it as essentially a public service, like public transport.

It generally does a pretty good job to get you from one place to another but is not always convenient. You can access private health care beyond the public system if you wish to.

This is similar to taking a car into downtown Seattle.  Doing this is often a rather expensive option and may not always seem to be the best value compared to a bus.

Many people believe in increasing the availability of a public health care system, just as many people see that there may be advantages to public transport.

Some countries have very good public transport systems that many people in the USA might envy.

The term “socialized” is often used in these discussions but this is not very helpful.  For example the US education system might be considered highly “socialized” – as most people attend state rather than private schools. But this does not necessarily relate to value.

In several different areas – like provision of freeways, libraries, sanitation and the military the basic expenditures may have to be made at the national or community level to obtain value.

We could make every road a toll road but this may not always the best way. Looking ahead there are many opportunities to increase the value in our health care system and recent changes are moving in this direction.


Andrew Brunskill


Mr. Brunskill is an Edmonds resident and a physician with a postgraduate degree in Health Services from the University of Washington. He was the medical director of the state uniform medical plan for several years and was previously in clinical practice as a pediatrician.

His comments give great insight to the healthcare discussion from the “other side of the fence.” – Ed.

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