A recent study by the Commonwealth Fund ranking healthcare systems in eleven advanced countries found the United States in last place. And while we languished at the bottom the study, which ranked healthcare delivery on such metrics as quality of care, access, efficiency and healthy outcomes, rated the United Kingdom at number one (take that, Fox News know-nothings). Just to add insult to injury, the UK spends $3,405 per capita on health (second lowest behind New Zealand) while we spend a whopping $8,508, the most of any in the study by a country mile.
Unsurprisingly, we fared poorest in categories associated with access and equity thanks to our lack of universal insurance coverage, and in efficiency where we are burdened with such deficiencies as excessive insurance company administrative overhead, medical duplication and overuse of emergency room treatment.
We also performed the worst in healthy outcomes as measured by infant mortality, healthy life expectancy, and mortality amenable to medical care (i.e. unnecessary or avoidable deaths).
As if this study wasn’t bad enough, we also have the International Federation of Health Plans 2013 Comparative Price Report which annually measures the cost of medical procedures and drugs among selected countries. Guess who regularly emerges as the most expensive? Even Switzerland (where a hamburger meal can cost $50) is way cheaper. As Ezra Klein noted about the iFHP 2012 price report in the Washington Post:
This is the fundamental fact of American health care: We pay much, much more than other countries do for the exact same things. For a detailed explanation of why, see this article. But this post isn’t about the why. It’s about the prices, and the graphs.
One note: Prices in the United States are expressed as a range. There’s a reason for that. In other countries, prices are set centrally and most everyone, no matter their region or insurance arrangement, pays pretty close to the same amount. In the United States, each insurer negotiates its own prices, and different insurers end up paying wildly different amounts.
So the US healthcare system is definitely ailing. But relief may be at hand. In noting the results of the Commonwealth Fund report, a New York Times editorial states:
The poor results for the United States reflect the high cost of its medical care and the absence of universal health insurance, a situation being addressed by the Affordable Care Act. The federal law is already increasing the number of Americans with health coverage and will substantially cut the number of uninsured in coming years. Other advanced nations are far ahead in the game because they have long had universal health coverage and promoted strong ties between patients and doctors.
Already the ACA’s beneficial effects on the rate of uninsured are being felt, particularly in states that embraced it wholeheartedly, as this piece about Minnesota from Jonathan Cohn in the New Republic shows.
So, despite the best efforts of Republicans to keep us mired in a rotten system that is inefficient, inequitable, prohibitively expensive, and too often lacking in overall effectiveness, there is hope that the future will be significantly brighter for American healthcare, thanks to Obamacare.