Health Spending In The United States Compared.
Health Affairs, July/August 2005, Vol. 24, No. 4, recently published its annual comparison of healthcare spending trends among the thirty industrialized countries comprising the Organization for Economic Cooperation and Development (OECD). This year’s results compiled in the article by Anderson, Hussey, Trogner and Waters, “Health Spending In The United States and the Rest of The Industrialized World” notes again that the U.S. leads the world in 2002-2003 at $5,267.00 per capita. (Switzerland was second at $3,446.00 per capita.) The study this year undertook to analyze the role of two “usual suspects” in the high cost of U.S. medical care: 1) the absence of supply side constraints that exist in other countries and the cost of “out of control” malpractice litigation.
The surprise is that neither is that significant of a driver in American healthcare costs that might explain the cost levels. There is a prevailing image that other countries dampen demand for healthcare services by restricting supply — long waiting lines for non-emergent services. In fact, access in the U.S. to services is now below most of the countries in the survey as measured by hospital beds per capita, physicians and nurses per capita, and MRI and CT scanners per capita.
The study noted:
High technology medical equipment is frequently cited as the main driver of escalating health spending. Although the United States tends to be an early adopter of medical technologies, it does not require medical technology at high levels once the technology has diffused widely.
The effect of waiting lists fails to explain U.S. costs because even countries without significant waiting lists experience a cost structure substantially below that in the U.S.
Surely malpractice cases in the U.S. explain a big part of the differential ? The study reviewed malpractice claims against physicians and awards in 4 countries rooted in British law, the U.S., Canada, Australia and the U.K. No surprise here. The U.S. had 50% more malpractice claims filed per capita than in Australia and the U.K. and 350% more than in Canada. However, cases in the U.S. tend to be dropped or dismissed in favor of the defendant more often than in the other countries. In a comparison of total payments by total populations, the U.S. is higher ($16.00), but only slight over the U.K. ($12.00), Australia ($10.00) and Canada $4.00). The total cost of defense, insurance underwriting and claims payments was estimated to be 0.46 percent of total healthcare spending in the U.S. and 0.27 percent of total healthcare spending in Canada.
The conclusion: It is the price of care, not the amount of care in the U.S. that explains the difference. Unfortunately, the report indicates that the technical quality of healthcare in the U.S. does not significantly surpass that in many other countries and in many cases patient satisfaction in the U.S. is below that recorded elsewhere Meanwhile, higher prices in the U.S. are driving more and more Americans into foregoing health insurance and health services and pushing more stress on the uncompensated care provided by so-called “safety net” hospitals. . There appears to be no real governor on the healthcare engine in the U.S. and something will have to give in public sector healthcare with the advent of unprecedented budget deficits and the proposed Medicaid cuts, just when the demand of our aging population swings into full gear. Anybody see the looming intergenerational and class conflicts looming on the horizon?
..: posted by Greg Piche' :..
Lets not forget the 40 million Americans with no healthcare what so ever! |
