Americans spend more on health and get poorer care: Report

By Dr. Ananya Mandal, MDJun 23 2010

According to a Commonwealth Fund report released this Wednesday, Americans spend nearly twice as much as people from other developed countries on healthcare but get lower quality of care, less efficiency and have the least equitable health care system. The comparison was drawn with six other countries, Britain, Canada, Germany, Netherlands, Australia and New Zealand, and the United States ranked last. The report collected data from nationally representative patient and physician surveys in these seven countries in 2007, 2008, and 2009.

The nonprofit Commonwealth Fund has made reports earlier on healthcare performance and has sometimes helped bring about policy changes in the healthcare  system. Commonwealth Fund President Karen Davis rued, “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.” She hoped that health reform legislation passed in March would follow previous examples and heed this report to make amends.

• 2007 expenditure on health was $7,290 per person in the United States compared to $3,357 in Australia, $3,895 in Canada, $3,588 in Germany, $3,837 in Netherlands, $2,992 in Britain and $2,454 in New Zealand.
• Last survey of the Fund showed an expenditure of $6,697 per capita on healthcare in 2005 in the US.

If high costs would mean better healthcare all would be well say experts. But this report that studied quality, efficiency, access to care, equity and the ability to lead long, healthy, productive lives, showed otherwise in the US.

Schoen said, “We rank last on safety and do poorly on several dimensions of quality…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.”

With regards to quality of healthcare Britain ranked first and Netherlands ranked first overall across all measures.

Experts feel that this new report card on the US healthcare system needs to be acted upon. It says, “The findings demonstrate the need to quickly implement provisions in the new health reform law.” The report also points out that while the other systems cover all citizens US leaves out 46 million Americans or 15 percent of the population without health insurance. “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. However on the brighter side the report says, “Health reform legislation recently signed into law by President Barack Obama should begin to improve the affordability of insurance and access to care when fully implemented in 2014.”

There are some loop holes too in the findings claim some critics. Europeans and Australians are claimed to be healthier than Americans. The latter population has maximum obesity say some critics. Davis also countered these arguments saying that smoking rates were higher in other countries compared to the US and Germany has a large elderly population. She said that once all factor are considered no population can be healthier than others.