US healthcare - the highs and lows

The US spends twice as much on health care per capita than most other industrialised nations but ranks lower than those nations on a number of criteria, according to a report released on Thursday by the Commonwealth Fund, the New York Times reports (Abelson, New York Times, 7/17). For the report, Cathy Schoen, senior vice president of the Commonwealth Fund, and colleagues ranked the health care systems of the US and several other industrialised nations based on 37 criteria.

The US health care system received an overall score of 65 out of 100, a decrease of two points from 2006. In addition, the US received a score of 58 out of 100 for access to care, a decrease of nine points from 2006. The US received a score of 53 out of 100 for health care efficiency, in part because of lack of adoption of electronic health records among physicians. According to the report, 28% of US physicians had adopted EHRs in 2006, compared with 98% in the Netherlands and 42% in Germany (Cooley, CQ HealthBeat, 7/17).

The report also found that, although the rate of preventable deaths among US residents younger than age 75 decreased from 115 per 100,000 in 2001 to 110 deaths in 2006, the US ranked last among all industrialised nations because other nations had larger improvements (New York Times, 7/17). The report cited "wide opportunities to improve care" in the US that could save 100,000 lives and $100 billion.

Comments

Schoen said, "Whenever you look outside the US, one of the core differences you see is everyone is in the health care system." In a statement, Schoen said, "We now have 75 million Americans who are uninsured or underinsured. Poor access pulls down quality and drives up costs of care," adding, "The US leads the world on health care spending -- we should expect a far better return on our investment." She said that efforts to improve quality and access to care will require a "top-down" approach by the federal government (CQ HealthBeat, 7/17).

Karen Davis, president of the Commonwealth Fund, said, "It's harder to keep deluding yourself or be complacent that we don't have areas that need improvement" in health care. The "central finding" of the report is that access to care has "deteriorated" in the US, she said (New York Times, 7/17).

James Mongan, chair of Commonwealth's Commission on a High Performance Health System and CEO of Partners HealthCare, said, "While there are pockets of improvement and excellence, it is clear that we need strong leadership and concerted public and private efforts to achieve and raise standards of performance nationwide and ensure that significant progress occurs in the future" (CQ HealthBeat, 7/17).

The report is available online.

Article courtesy of http://www.kaisernetwork.org/firstedition