Tuesday, June 17, 2014

Best Healthcare in the World, My Ass....

The Commonwealth Fund has released its latest report on how the healthcare system in the United States compares to other industrialized countries. It's not good. In fact, its terrible.

Executive Summary
The United States health care system is the most expensive in the world, but this report and prior editions consistently show the U.S. underperforms relative to other countries on most dimensions of performance. Among the 11 nations studied in this report—Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2010, 2007, 2006, and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last or near last on dimensions of access, efficiency, and equity. In this edition of Mirror, Mirror, the United Kingdom ranks first, followed closely by Switzerland (Exhibit ES-1).
Expanding from the seven countries included in 2010, the 2014 edition includes data from 11 countries. It incorporates patients’ and physicians’ survey results on care experiences and ratings on various dimensions of care. It includes information from the most recent three Commonwealth Fund international surveys of patients and primary care physicians about medical practices and views of their countries’ health systems (2011–2013). It also includes information on health care outcomes featured in The Commonwealth Fund’s most recent (2011) national health system scorecard, and from the World Health Organization (WHO) and the Organization for Economic Cooperation and Development (OECD).
It's hard to fathom just how poorly our system works, especially given the sky-high price we all pay for less than full access and questionable results. Ranking worst out of the eleven countries reviewed in 6 of the 12 categories considered. (Cost-related issues re: access, efficiency, equity, healthy lives, health expenditures per capita and  overall ranking.)

In the other categories, (quality care: effective care, safe care, patient centered care and access: timeliness of care) we ranked in the middle somewhere.

In no category did the US rank in the top two.

Who came in first?

The NHS from the United Kingdom, which is socialized medicine.

Conservatives in America will likely point to the report as reason to move toward a more "free market/less government involvement" style of health care delivery. While such a response has far more to do with politics than it does with sound, evidence based delivery of health care, it also defies common sense.

The US system is a blend of free market private and/or employer based health insurance combined with a social safety net combination of medicare for people 65 and older and medicaid for the disabled, children, pregnant women and the very, very poor.

None of the countries in the report has as small an amount of government involvement as the US does. Put another way, all of the countries in the report - who all fared batter than the US does - have a higher level of government interaction in their HC delivery than we do.

The answer to our health care issues is not less government involvement. We need more.The rest of the world has figured this out. Except us.

Before anyone accuses me of being a socialist or anti-american, we should be copying our friends in Europe and Asia who have devised an effective system of a strong, comprehensive government provided or administered system that covers all citizens for basic health care needs. Complimenting that foundation is a robust private market that competes for consumer dollars by offering supplemental and additional levels of insurance and benefits.

As the report indicates, the data used for this study do not yet take the effect of the Affordable Care Act into consideration. Going forward, its expected the United States will perform better in areas like access.

Unless, of course, a Republican President and Republican controlled Congress would repeal it.

Other coverage of the Commonwealth Fund's report can be found here, here, here and here...

NOTE #1: I attempted to provide a link to Fox News.com's coverage of this story and none was to be found on their homepage, on their "health" page or the "US News" page. Likewise, I found nothing on the Newsmax.com website either.

NOTE #2: Our talented friends over at the Incidental Economist have a related column up on their website. Its worth a visit. You can find it here: Zombie arguments defending the US healthcare system....






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