How Health Care Systems Stack Up
By THE EDITORIAL BOARD
JUNE 16, 2014
nytimes.com
Britain and Switzerland were top scorers in a study examining the quality and efficiency of health care systems in 11 advanced nations by a leading American research organization. As usual, the United States finished last over all and last on several important measures of cost and health outcomes, despite having the most costly system in the world.
The analysis was performed by the Commonwealth Fund, a nonprofit institution that specializes in health care issues. It is based on three international surveys conducted in 2011, 2012 and 2013 of how doctors and patients view medical practices in their health systems and on data gathered by the World Health Organization and the Organization for Economic Cooperation and Development.
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.
The United States ranked last on measures involving the cost of care, the efficiency of delivering it (too many duplicate tests, avoidable emergency room visits, and administrative hassles), and the fairness of its system (lower-income Americans go without care more often than their counterparts in other countries). It also ranked last on indicators of healthy lives as measured by infant mortality, healthy life expectancy at age 60 and deaths that might have been avoided through medical care.
In this category, Britain also did poorly; France, Sweden and Switzerland led the pack. The best American showing was third in delivering preventive care and providing recommended tests and treatments for the chronically ill.
The other 10 countries spend much less than the United States on health care per person and as a percent of gross domestic product, yet achieve better value for it. Britain, the leader in the rankings, spent only $3,405 per capita in 2011, while the United States, last in the rankings, spent $8,508 per capita. The Affordable Care Act, if left to accomplish its goals by Congressional Republicans, is the best way to alleviate the cost and quality issues for most Americans. |
