U.S.
Health-Care System Gets a “D”
By Catherine
ArnstThu
Sep 21, 3:08 AM ET
The U.S.
health-care system is doing poorly by virtually every measure.
That’s the conclusion of a national report card on the U.S.
health-care system, released Sept. 20. Although there are
pockets of excellence, the report, commissioned by the
non-profit and non-partisan Commonwealth Fund, gave the U.S.
system low grades on outcomes, quality of care, access to care,
and efficiency, compared to other industrialized nations or
generally accepted standards of care. Bottom line: U.S. health
care barely passes with an overall grade of 66 out of 100.
The survey was
carried out by 18 academic and private-sector health-care
leaders, who rate the system on 37 different measures. The poor
grade is particularly discomfiting, the researchers note,
because the U.S. spends more on medicine, by far, than any other
country. Approximately 16% of the nation’s gross domestic
product (GDP) is devoted to health care, compared with 10% or
less in other industrialized nations.
Health care is
also responsible for most new job creation, according to
BusinessWeek’s Sept. 25 cover story (see BusinessWeek.com,
9/25/06, “What’s Really Propping Up The Economy”). Yet the U.S.
ranks 15th out of 19 countries in terms of the number
of deaths that could have been prevented. The study estimates
that each year 115 out of 100,000 U.S. deaths could have been
avoided with timely and appropriate medical attention. Only
Ireland, Britain, and Portugal scored worse in this category,
while France scored the best, with 75 preventable deaths per
100,000.
Below
Potential. The U.S. ranks at the bottom among industrialized
countries for life expectancy both at birth and at age 60. It is
also last on infant mortality, with 7 deaths per 1,000 live
births, compared with 2.7 in the top three countries. There are
dramatic gaps within the U.S. as well, according to the study.
The average disability rate for all Americans is 25% worse than
the rate for the best five states alone, as is the rate of
children missing 11 or more days of school.
The report
found that quality of care and access to care varied widely
across the country, and it noted substantial gaps between
national averages and pockets of excellence. The authors
concluded that, if the U.S. improved and standardized
health-care performance and access, approximately 100,000 to
150,000 lives could be saved annually, along with $50 billion to
$100 billion a year.
The
Commonwealth Fund, which studies health-care issues,
commissioned the report last year as part of an effort to come
up with solutions to the nation’s troubled health-care system.
The report “tells us that overall we are performing far below
our national potential,” says Dr. James J. Mongan, chairman of
the team that pulled together the study and chief executive
officer of Partners Healthcare in Boston. “We can do much better
and we need to do much better,” he says.
Among the
reports’ findings:
·
• Only 49% of
U.S. adults receive the recommended preventive and screening
tests for their age and sex.
·
• Only half of
patients with congestive heart failure receive written discharge
instructions regarding care following hospitalization.
·
• Nationwide,
preventable hospital admissions for patients with chronic health
conditions such as diabetes and asthma were twice as high as the
level achieved by the best performing states.
·
• Hospital
30-day re-admission rates for Medicare patients ranged from 14%
to 22% across regions.
·
• One-third of
all adults under 65 have problems paying their medical bills or
have medical debt they are paying over time.
·
• Only 17% of
U.S. doctors use electronic medical records, compared with 80%
in the top three countries.
·
• On multiple
measures across quality of care and access to care, there is a
wide gap between low income and the uninsured, and those with
higher incomes and insurance. On average, measures for low
income and uninsured people in these areas would have to improve
by one-third to close the gap.
·
• As a share
of total health expenditures, insurance administrative costs in
the U.S. were more than three times the rate in countries with
integrated payment systems.
Copyright © 2006
BusinessWeek Online. All rights reserved.
Fear not, the
politicians get a "D" too. But theirs stands for the
millions of Dollars in campaign contributions they've
received from the health care industry to leave our highly
inefficient and profitable system in place.
