The developed world’s worst health care bargain
Posted on November 14, 2008 by: Bill Salganik | Category: Quality
The United States spends way more than other developed countries on health care, but gets results that are, in many cases, worse, according to a new study in the current issue of the respected policy journal Health Affairs. The study is based on data collected from its members by the Organization for Economic Cooperation and Development (OECD), which includes 30 developed countries. (Note: The link leads to a summary; the full article is available only to subscribers.)
Reviewing a number of studies comparing health outcomes, "despite the higher spending, the United State scored average or slightly worse than average on many quality-of care indicators," the authors wrote, "Perhaps even more troubling is that improvements in health status are occurring at a lower rate than in most OECD countries."
The authors are Gerard Anderson and Bianca Frogner of the public health school at Johns Hopkins. With various co-authors, Dr. Anderson has done such studies for a decade. That series of reports concluded the United State isn’t getting more care (as measured by such things as number of doctor visits and hospital days) or more resources (as measured by such things as hospital beds per capita or supply of advance MRI and CT scanners).
Rather, we simply pay more for what we get, a conclusion Dr. Anderson summarized as, "It’s the prices, stupid."
This study looked at life expectancy and health spending, both adjusted for per-capita income. The U.S. had by far the highest spending, and in (adjusted) life expectancy it beat only. Hungary among the 30 OECD countries. Besides the U.S., only two other countries - Belgium and Turkey - had both higher-than-expected spending and lower-than-expected life expectancy.
"Health reform efforts should focus on improving the value per dollar spent on health care," the authors concluded, "in addition to other reform goals of extending coverage to all and reducing unnecessary health care spending, so that American get the health care system they are already paying for."
