A rating of U.S medical health care system by a medical executive

Nearly one of every $5 spent in the United States goes to health care.

That’s almost $10,000 per person annually, roughly $2,000 more than second-place Switzerland and twice that of Canada.

Despite that spending, the U.S. generally lands at, or near, the bottom of health outcomes for its citizens when the Johns Hopkins Bloomberg School of Public Health releases rankings of the top industrialized nations in the world.

Dr. Thomas J. Foels has been among those in the regional health insurance industry with the task of pushing against those numbers.

“I think the health care system can still be very difficult to navigate at times,” said Foels, who retired this spring as executive vice president and chief medical officer of Independent Health.

Foels, 63, a North Tonawanda native who lives in Clarence, holds a master’s in medical management from Tulane University. He came back to Buffalo in the early 1980s to open a pediatric practice after medical school at the University of Rochester.

He started working part time at Independent Health in 1994 and jumped into health insurance full time three years later, when Dr. Michael W. Cropp, CEO of the region’s second largest health insurer, convinced Foels he could have a larger impact from such a perch.

His departure comes at an uncertain time for the American health care system.

He knows his former employer, and U.S. health care, must continue to change. That said, he is not a big fan of a single-payer health insurance system.

“The problem you’re trying to solve is to improve outcomes and quality, and to eliminate non-value-added services, which can be about 30% of our current spend,” Foels said.

He also worries that shifting politics may damage such a system, and believes the choice of doctors and services needs to be in patient hands.

“When you look at Medicare, there’s a sanctioned single-payer system,” he said, “and in this market, 50% of Medicare-eligible people have chosen an insurance company (Independent Health is among them) to manage their benefits, because they feel there’s more value there.”