Despite high cost, it delivers too little to patients,
Commonwealth Fund says
By Steven Reinberg
HealthDay Reporter
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.
Posted by Dr. Troy Dreiling
www.thevancouverchiropractor.com
