U.S. Health Care System: Worst in the world?

Multiple news sources have reported on a study released on June 23, 2010 by the Commonwealth Fund, a New York-based private foundation focused on health, concluding that American healthcare ranks highest in cost and last in performance among seven industrialized nations. The above headline comes from one of those stories that was published on June 24, 2010 in “The Week”.

A June 23, 2010 Reuters news story starts off with the ominous statement, “Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system.” The Commonwealth Fund’s president, Karen Davis PhD., stated, “On many measures of health system performance, the U.S. has a long way to go to perform as well as other countries that spend far less than we do on healthcare, yet cover everyone. It is disappointing, but not surprising, that despite our significant investment in health care, the U.S. continues to lag behind other countries.”

The factors looked at in the Commonwealth report were quality, efficiency, access to care, equity and the ability to lead long, healthy, productive lives. The study noted that Americans spend $7,290 per person for healthcare which is twice as much as any other country studied in the survey conducted in 2007. The study reported that New Zealanders spent the least at $2,454 per person, while in the other 5 countries the amount spent on healthcare per person was $3,357 for Australians, $3,895 for Canadians, $3,588 for Germans, $3,837 for the Dutch and $2,992 for the British.

According to a June 23, 2010 Wall Street Journal article on the report, there are several key findings that need improving. They are:

  • The U.S. ranked last in measures of safe care (an indicator of quality), cost-related access problems, efficiency, equity and the long, healthy lives measure.
  • A full 54% of U.S. adults with chronic health conditions said they didn’t fill or complete a prescription, get a recommended test or treatment or visit a doctor when needed due to cost.
  • Of those same adults with chronic problems, 19% said they’d visited an ER for something that a regular doctor could have handled had one been available. In Germany and the Netherlands, that rate was 6%.
  • The U.S. has the highest “mortality amenable to health care” rate (from 2002-03), at 110 per 100,000 population. Australia was lowest, with 71 per 100,000. (That rate refers to the number of deaths before age 75 from ischemic heart disease, diabetes, stroke and bacterial infections.)
  • We ranked no higher than fourth on anything — for effective care and patient-centered care.

In the Commonwealth study executive summary, the authors clearly state the problems with the US healthcare system when they say, “The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance. Among the seven nations studied—Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States—the U.S. ranks last overall, as it did in the 2007, 2006, and 2004 reports.”

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