US Health Care System: Poor Outcomes, Higher Costs Compared to Developed World

Commonwealth Fund report, 2008

Executive Summary

Every family wants the best care for an ill or injured family member. Most are grateful for the care and attention received. Yet, evidence in the National Scorecard on U.S. Health System Performance, 2008, shows that care typically falls far short of what is achievable. Quality of care is highly variable, and opportunities are routinely missed to prevent disease, disability, hospitalization, and mortality. Across 37 indicators of performance, the U.S. achieves an overall score of 65 out of a possible 100 when comparing national averages with benchmarks of best performance achieved internationally and within the United States.

Even more troubling, the U.S. health system is on the wrong track. Overall, performance has not improved since the first National Scorecard was issued in 2006. Of greatest concern, access to health care has significantly declined. As of 2007, more than 75 million adults—42 percent of all adults ages 19 to 64—were either uninsured during the year or underinsured, up from 35 percent in 2003. At the same time, the U.S. failed to keep pace with gains in health outcomes achieved by the leading countries. The U.S. now ranks last out of 19 countries on a measure of mortality amenable to medical care, falling from 15th as other countries raised the bar on performance. Up to 101,000 fewer people would die prematurely if the U.S. could achieve leading, benchmark country rates.

2013, Fox News

In one of the most comprehensive studies of its kind, researchers from the Institute for Health Metrics and Evaluation (IHME) found that in nearly every major cause of premature death – from heart disease to interpersonal violence – the U.S. fares worse than its economic peers.

Published in the Journal of the American Medical Association, the report analyzed all data and scientific literature – both in the United States and 34 countries across the globe – available for 291 diseases, conditions and injuries that cause death and disability.

Utilizing a team of global researchers, the study highlighted the impact of premature deaths in children and young adults on each nation, as well as the overall effects of disabling conditions such as lower back pain and major depression.  The researchers also examined 67 known health risk factors associated with both fatal and non-fatal health disorders. …

While the United States has made strides in some major areas – such as preventing premature deaths from stroke and breast cancer – the country has fallen behind most nations in regards to deaths from many other conditions….

Out of its 34 economic peer countries in Europe, Asia and North America, the U.S. ranked 27th in disease burden brought on by dietary factors, 27th on high body mass index (BMI) and 29th in blood sugar levels.

2013, MedPage Today

Health outcomes in the U.S. lag behind those of other countries even as the cost of healthcare continued to rise, according to health policy experts.

“Despite the increases in resources devoted to healthcare, multiple health metrics, including life expectancy at birth and survival with many diseases, shows the United States trailing peer nations,” Hamilton Moses III, MD, of the Alerion Institute in North Garden, Va., and colleagues wrote online Tuesday in the Journal of the American Medical Association.

People in the U.S. also are sicker than their counterparts in other countries belonging to the Organization for Economic Cooperation and Development (OECD), they continued, with cardiovascular disease, perinatal disorders, respiratory diseases, and infectious diseases such as HIV accounting for 75% of the deviation.

Although the U.S. lags on these indicators, in 2011 healthcare expenditures stood at $2.7 trillion, or 17.9% of GDP — double the percentage in 1980 and 4.2% more than the average for the other members of the OECD. Overall healthcare costs increased 2.9% a year between 2000 and 2010 and prices of hospital care, healthcare provider services, drugs and devices, and administrative costs accounted for 91% of those cost increases, rather than increases in demand or the aging population, the authors noted.

2000, World Health Organization (pdf)

See pdf report. The US (which by far outspends Canada in GDP health care expenditures) ranks 37th in overall health system performance, while Canada ranks 30th.

So Canada’s govt run system would appear to be producing superior outcomes with far lower expenditure.

2003, New England Journal of Medicine

“In 1999, health administration costs totaled … $1,059 per capita [in the United States], as compared with $307 per capital in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in teh United States and 16.7 percent fo health care expenditures in Canada. Canada’s national health insurance program had overhead of 1.3 percent”

“The gap between US and Canadian spending on health care administration has grown to $752 per capita. A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system.”

2012, NYTimes, on myth of private sector efficiency

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