Thread: U.S. Health Care Ranks Low Among Developed Nations

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U.S. Health Care Ranks Low Among Developed Nations: Report
Despite high cost, it delivers too little to patients, Commonwealth Fund says

By Steven Reinberg
HealthDay Reporter
Lifestyle

WEDNESDAY, June 23 (HealthDay News) -- Compared with six other industrialized nations, the United States ranks last when it comes to many measures of quality health care, a new report concludes.

Despite having the costliest health care system in the world, the United States is last or next-to-last in quality, efficiency, access to care, equity and the ability of its citizens to lead long, healthy, productive lives, according to a new report from the Commonwealth Fund, a Washington, D.C.-based private foundation focused on improving health care.

"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," the Commonwealth Fund's president, Karen Davis, said during a Tuesday morning teleconference.

"It is disappointing, but not surprising, that despite our significant investment in health care, the U.S. continues to lag behind other countries," she added.

However, Davis believes new health care reform legislation -- when fully enacted in 2014 -- will go a long way to improving the current system. "Our hope and expectation is that when the law is fully enacted, we will match and even exceed the performance of other countries," she said.

The report compares the performance of the American health care system with those of Australia, Canada, Germany, the Netherlands, New Zealand and the United Kingdom.

According to 2007 data included in the report, the U.S. spends the most on health care, at $7,290 per capita per year. That's almost twice the amount spent in Canada and nearly three times the rate of New Zealand, which spends the least.

The Netherlands, which has the highest-ranked health care system on the Commonwealth Fund list, spends only $3,837 per capita.

Despite higher spending, the U.S. ranks last or next to last in all categories, Davis said, and scored "particularly poorly on measures of access, efficiency, equity and long, healthy and productive lives."

The U.S. ranks in the middle of the pack in measures of effective and patient-centered care, she added.

Overall, the Netherlands came in first on the list, followed by the United Kingdom and Australia. Canada and the United States ranked sixth and seventh, Davis noted.

Speaking at the teleconference, Cathy Schoen, senior vice president at the Commonwealth Fund, pointed out that in 2008, 14 percent of U.S. patients with chronic conditions had been given the wrong medication or the wrong dose. That's twice the error rate observed in Germany and the Netherlands, she noted.

"Adults in the United States [also] reported delays in being notified about abnormal test results or given the wrong results at relatively high rates," Schoen said. "Indeed, the rates were three times higher than in Germany and the Netherlands."

"As a result we rank last in safety and do poorly on several dimensions of quality," Schoen said.

In addition, many Americans are still going without medical care because of cost, she said. "We also do surprisingly poorly on access to primary care and access to after hours care given our overall resources and spending," Schoen said.

In fact, 54 percent of people with chronic conditions reported going without needed care in 2008, compared with 13 percent in Great Britain and 7 percent in the Netherlands, she said.

The United States also ranked last in efficiency, Schoen said. There are too many duplicate tests, too much paperwork, high administrative costs and too many patients using emergency rooms as doctor's offices. In addition, poverty appears to be a big factor in whether Americans have access to care, the report found.

The United States also performed worst in terms of the number of people who die early, in levels of infant mortality, and for healthy life expectancy among older adults, Schoen said.

Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine, commented that "as a physician and public health practitioner, I have routinely spoken out in favor of health care reform in the U.S. The responses evoked have not always been kind. Prominent among the counterarguments has been: 'You should see what health care is like in other countries.'"

"This report utterly belies the notion that the former status quo for health care delivery in the U.S. was as good as it gets. Others have been doing better and we can, and should, too," he said.

However, at least one expert doesn't believe that health care reform, as it now stands, will solve these problems.

Dr. Steffie Woolhandler, a professor of medicine at Harvard Medical School and co-founder of Physicians for a National Health Program, said that "the U.S. has the worst health care system among the seven countries studied, and arguably the worst in the developed world."

"Unfortunately, the U.S. will almost certainly continue in last place, since the recently passed health reform will leave 23 million Americans without coverage while enlarging the role of the private insurance industry, which obstructs care and drives up costs," she said.

SOURCES: Steffie Woolhandler, M.D., M.P.H., professor of medicine, Harvard Medical School, Boston, co-founder, Physicians for a National Health Program; David L. Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; June 22, 2010, teleconference with Karen Davis, Ph.D, president, and Cathy Schoen, M.S., senior vice president, both at the Commonwealth Fund; June 23, 2010, report, Mirror Mirror On The Wall: How the Performance of the U.S. Health Care System Compares Internationally, 2010 Update.

If our health care is so bad why do people flock from all these countries to here to get treated.

But hey, our malpractice lawyers can afford great health care.

Propaganda bull. Who you gonna believe, the media?

I believe people that I know from those nations - like Canada, England and Turkey for example. They say their healthcare is better and cheaper. They schedule annual trips home to have all their medical needs met despite living and working here and the U.S. and having good quality insurance here.

The medical/Big Pharma lobby is huge and a for profit system and until you become ill you may have no idea how insidiously they have been eating away at true healthcare and true knowledge for years. I think that this year I can see that doctors are coming to the realization that they cannot just be pimps for Big Pharma anymore. If you just look at the ads on TV for drugs and listen to the potential side effects you can know part of why. Plus the fact that the costs are going up phenomenally. My husbands' insulin went from $3.50 to $350 this year - literally and we have been unable to afford it. His very life is dependent on being able to maintain a vehicle and a telephone to go and get insulin samples from the doctor every week. I have contacted all kinds of media and government officials - we cannot be the only ones - but nobody helps and no media prints the story.

Unfortunately our entire legal/medical/employer system only supports the Big Pharma type of medicine and not the healthier alternatives which are usually more time-consuming and require more time off work - but the result is true healing and a shot at long-term health as opposed to a high probability of permanent damage from Rx and slash and burn style of medicine.

We all have multi-tiered medical systems which is why people from other nations come here. It is also true that wait times in some areas can be horrendous for example in Canada - but that is also true for some areas in the U.S. People in England tell me that the problems they did have are resolved although I read reports to the contrary. I do read and hear of innovation coming from nations with socialized medicine so that argument no longer washes with me. There is much money to be made in U.S. healthcare and they have spent huge dollars maintaining their lies and pushing propaganda.

I don't know how attorneys determine which drugs to have class action lawsuits on - but there are many more problems than what they actually pursue and if you take a look you will find that most states' statute of limitations is so short that if the patient lives - by the time they figure out what happened they will no longer have the option of pursuing. Most patients who have these negative side effects from pharmaceuticals get dumped over and over and over by doctors who do not wish to risk their license or their careers telling the truth against a pharmaceutical company. This patient dumping is not relegated to the uninsured - it happens to highly insured and multiply insured people. It drives up the cost of healthcare and the cost to society when so many citizens become disabled from Rx.

This is why I say we still need healthcare reform. There is much that is still unknown - but there is also much that is known and certain tests should be run before ever writing any prescription for anybody. Yes that will drive up the cost of healthcare but over the long term the individual who cannot tolerate various Rx will be able to live and work a productive life rather than becoming disabled so the long term cost is what I care about.

The Mecha Mexicans call us a frail people. Well if they stick around for U.S. medicine they will also find themselves becoming inexplicably frail. They would do well to expand on traditional medicines and market them to us - we are hungry for alternatives that will not kill or disable us.

Originally Posted by IndianaJones

Propaganda bull. Who you gonna believe, the media?

I am certainly not going to believe FOX news and their propaganda. Like sarum, I have friends living in other countries like England and Canada, and their system is much better. Don't let the media fool you.

I can't complain about the healthcare I purchase (well I can but why bother?). It's a big expense but I buy it and follow the requirements. There are rules because it is a business, a money making business. Otherwise I can privately pay and get cheaper care or hope I don't get any major illneses. But if I do, there are ways to get assistance in this country, help is out there. All of us have donated to charities and charities help the needy. Nanny state, cradle to the grave oversight is not my thing. Waiting lists and reviewers 'deciding' when and if...no thanks.
I also know many people from all around the world and they do not tell me their heathcare is better. I have lived briefly outside of the US as well. And I did find myself in need of care and experienced the care for myself. I believe what I know to be true. It's my opinion from my experience.

http://www.reuters.com/article/idUSTRE6 ... mesticNews

U.S. scores dead last again in healthcare study
Maggie Fox, Health and Science Editor
WASHINGTON
Wed Jun 23, 2010 4:48pm EDT
Related News

Credit: Reuters/Jessica Rinaldi

WASHINGTON (Reuters) - 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, according to a report released on Wednesday.

The United States ranked last when compared to six other countries -- Britain, Canada, Germany, Netherlands, Australia and New Zealand, the Commonwealth Fund report found.

"As an American it just bothers me that with all of our know-how, all of our wealth, that we are not assuring that people who need healthcare can get it," Commonwealth Fund president Karen Davis told reporters in a telephone briefing.

Previous reports by the nonprofit fund, which conducts research into healthcare performance and promotes changes in the U.S. system, have been heavily used by policymakers and politicians pressing for healthcare reform.

Davis said she hoped health reform legislation passed in March would lead to improvements.

The current report uses data from nationally representative patient and physician surveys in seven countries in 2007, 2008, and 2009. It is available here

In 2007, health spending was $7,290 per person in the United States, more than double that of any other country in the survey.

Australians spent $3,357, Canadians $3,895, Germans $3,588, the Netherlands $3,837 and Britons spent $2,992 per capita on health in 2007. New Zealand spent the least at $2,454.

This is a big rise from the Fund's last similar survey, in 2007, which found Americans spent $6,697 per capita on healthcare in 2005, or 16 percent of gross domestic product.

"We rank last on safety and do poorly on several dimensions of quality," Schoen told reporters. "We do particularly poorly on going without care because of cost. And we also do surprisingly poorly on access to primary care and after-hours care."

NETHERLANDS RANKED FIRST OVERALL

The report looks at five measures of healthcare -- quality, efficiency, access to care, equity and the ability to lead long, healthy, productive lives.

Britain, whose nationalized healthcare system was widely derided by opponents of U.S. healthcare reform, ranks first in quality while the Netherlands ranked first overall on all scores, the Commonwealth team found.

U.S. patients with chronic conditions were the most likely to say they gotten the wrong drug or had to wait to learn of abnormal test results.

"The findings demonstrate the need to quickly implement provisions in the new health reform law," the report reads.

Critics of reports that show Europeans or Australians are healthier than Americans point to the U.S. lifestyle as a bigger factor than healthcare. Americans have higher rates of obesity than other developed countries, for instance.

"On the other hand, the other countries have higher rates of smoking," Davis countered. And Germany, for instance, has a much older population more prone to chronic disease.

Every other system covers all its citizens, the report noted and said the U.S. system, which leaves 46 million Americans or 15 percent of the population without health insurance, is the most unfair.

"The lower the performance score for equity, the lower the performance on other measures. This suggests that, when a country fails to meet the needs of the most vulnerable, it also fails to meet the needs of the average citizen," the report reads.