http://www.forbes.com/sites/danmunr...ked-dead-last-compared-to-10-other-countries/ U.S. Healthcare Ranked Dead Last Compared To 10 Other Countries Earlier this year, Cadillac ran a controversial TV ad that first aired during the opening ceremonies of the 2014 Winter Olympics. It was called “Poolside” and featured actor Neal McDonough extolling America’s work ethic over other countries — specifically France. Turns out that many of those “other countries” (including France) score better than the U.S. in at least one key metric not included in Cadillac’s TV spot — healthcare. At least that’s according to The Commonwealth Fund in their latest report “Mirror, Mirror On The Wall — 2014 Update” (pdf here). For this year’s survey on overall health care, The Commonwealth Fund ranked the U.S. dead last . 1. United Kingdom 2. Switzerland 3. Sweden 4. Australia 5. Germany & Netherlands (tied) 7. New Zealand & Norway (tied) 9. France 10. Canada 11. United States It’s fairly well accepted that the U.S. is the most expensive healthcare system in the world, but many continue to falsely assume that we pay more for healthcare because we get better health (or better health outcomes). The evidence, however, clearly doesn’t support that view. The report itself is fairly short (32 pages), but included prior surveys and national health system scorecards as well as data from the World Health Organization (WHO) and the Organization for Economic Cooperation and Development (OECD). The report also included a list of major findings (abbreviated here): Quality: The indicators of quality were grouped into four categories: effective care, safe care, coordinated care, and patient-centered care. Compared with the other 10 countries, the U.S. fares best on provision and receipt of preventive and patient-centered care. Access: Not surprisingly — given the absence of universal coverage — people in the U.S. go without needed health care because of cost more often than people do in the other countries. Efficiency: On indicators of efficiency, the U.S. ranks last among the 11 countries, with the U.K. and Sweden ranking first and second, respectively. The U.S. has poor performance on measures of national health expenditures and administrative costs as well as on measures of administrative hassles, avoidable emergency room use, and duplicative medical testing. Equity: The U.S. ranks a clear last on measures of equity. Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick; not getting a recommended test, treatment, or follow-up care; or not filling a prescription or skipping doses when needed because of costs. On each of these indicators, one-third or more lower-income adults in the U.S. said they went without needed care because of costs in the past year. Healthy lives: The U.S. ranks last overall with poor scores on all three indicators of healthy lives — mortality amenable to medical care, infant mortality, and healthy life expectancy at age 60. Overall, France, Sweden, and Switzerland rank highest on healthy lives. Perhaps the biggest single takeaway was this one: The most notable way the U.S. differs from other industrialized countries is the absence of universal health insurance coverage. Other nations ensure the accessibility of care through universal health systems and through better ties between patients and the physician practices that serve as their medical homes. The Commonwealth Fund “Mirror, Mirror On The Wall — 2014 Update” Unfortunately, many still equate “universal healthcare” with “Government run” or “single payer” healthcare. It isn’t (Universal Coverage Is Not “Single Payer” Healthcare — here). All of which makes Cadillac’s advertising chutzpah even more brazen. After all, it was just seven short months ago that the Government “bailout” of GM officially ended. One of the more commonly cited reasons for the dire financial predicament of the auto industry was always — yup — ballooning healthcare costs. Just as Starbucks SBUX -2.31% spends more on healthcare benefits than coffee beans (here) — GM (at least in 2005) spent more on healthcare benefits than steel (here). The U.S. excels in many areas, but clearly population health (and all its components) isn’t one of them. N’est-ce pas? (full report here: http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror) ---------------- What do you think? Why is the healthcare cost in the USA so high, and the quality still relatively bad? The USA are spending almost 20 % of their GDP on healthcare, significantly more than other countries which, arguably, have a much better healthcare system. I recently watched a presentation by the CEO of Kaiser Permanente Medical who said that if the US healthcare spending was the GDP of a country, it would be the 6th largest economy in the world - the healthcare cost of the USA alone is more than the whole GDP of, e.g., the United Kingdom. Do you think the USA should look more at healthcare systems of other countries and try to emulate them? What are the obstacles on that path? Do you think technology will help to reduce healthcare cost in the USA? Are the USA too proud or too ignorant to look at what works in other countries?
Many Americans have no faith in government to run anything effectively. There are countless examples of government inefficiency, lazy/entitled employees and ridiculously frustrating experiences. Coupled with a political system that makes wholesale change absurdly hard to enact (gridlocked congress + 50 separate states, many of which don't want to be told what to do), you get a sub-optimal result (like Obama's half-assed "solution"). The US does have the "best of the best" regarding top flight care -- if you can afford it. There's a reason famous soccer players from Europe fly to the US for their surgeries, or why the Sheikh from UAE flies to Houston for his cancer care. The US is also the source for much of the healthcare innovation that takes place today in the world. The problem is a solution for the masses.
I agree with that. As to healthcare innovation - yes and no. Something that amazes me is how US investors seem to think that healthcare innovation would have to come from the US (this is not restricted to healthcare, actually). Yes, much of the innovation comes from the US. But I am sometimes surprised how little US investors look for innovation outside of their own borders, especially in areas where the USA are partly lagging behind.
I'm not an expert here, but I'd assume the same reasons as other industries 1. US investors will naturally look close to home first for familiarity and convenience reasons 2. Business climate and infrastructure -- ability to start and fund businesses 3. Legal climate -- rule of law to protect innovation/IP
I think while the medical expertise in the US can be brilliant (for those who can afford it), the problem of US's health system compared to other places is operational, rather than health innovation or technical expertise. Here in the UK, the government provides healthcare directly, cutting out the middlemen or insurance and the like. Before I heard about the system in the US, I would never have thought that somebody's health care is tied directly to their jobs. There are still massive inefficiencies in the UK system, very long queues, which is why the NHS is a political football every election year, but according to the report, it seems the US's inefficiencies are even worse.
In my opinion, the largest flaw with our country as a whole, is one of its best redeeming features as well. Free enterprise. There are certain things and certain places where free enterprise should not, nor should have ever been involved. Healthcare should have never been made into a private business (hell, insurance companies are now buying out hospitals and nobody blinks an eye). Now, with the way the political landscape has eroded, I believe that many feel, especially those that have made a career of politics (which is a whole different animal unto itself, that I don't agree with), that there's no going back. And truly, I feel there is not. Its a socio-economics-political beast. Lobbyists are a large root of the problem as well, I believe. (That's a whole other beast, too. They're a huge disservice to this country, for the most part as well). What would need to be done would be for a huge mass of people to give up a large chunk of their pie, in order to better help the medical situation in this country. That's something that will never happen. As a medical worker, I feel slightly ashamed to say that I live in one of the best countries in the world, yet I am forced to see people constantly sacrificing their health because they can't afford it. I've literally seen a guy almost die because he ran out of anti-rejection meds, didn't have insurance, couldn't afford a refill, and his body was trying to kill his new liver off. Its a shame.
I object to this report's rankings on the basis of national pride. Lets start with how the rankings do not appear weighted (if effective care is #3 then there is no way the US should rank dead last out of 11). There is no way of knowing which categories were given the highest significance and what the gap is between certain countries. Also, the US is larger and more culturally diverse than any other country on that list. If you combine the populations of the other 10 countries it doesn't even add up to the US's population. It probably isn't as bad as it looks for the US because there are probably some states (regions) where healthcare is great and others where healthcare is terrible.
Except it's not really free enterprise either. The supply is artificially kept low, something that keeps people from getting basic medical advice that doesn't require someone with 10 years of medical knowledge.
Based on size and diversity I'd reduce that list to Germany, France and the US. In the other, smaller and more homogeneous countries, people are more trusting and empathic of each others' efforts, obstacles, motives and interests if they share similar backgrounds. That translates to a more collaborative society in terms of benefits and opportunities.
And why is that exactly? Could it be that they (like you) choose to listen to lying pundits who spout this anti-government garbage all day long, regardless of facts? You do realize that all of the countries that rank ahead of us in healthcare have dramatically more government involvement in the industry, right? Yes, the fact that a minority party has the ability to completely obstruct the process, as the Republicans have to an unprecedented level over the last four years, makes for poor or no solutions to the problems facing the country. Sounds like you want to change to a parliamentary system, is this the case? Do you understand the difference? It sure sounds like you are arguing for single payer, the way you've gone off about Congressional obstructionism and the sub-optimal ACA. It sounds like you actually want a good solution for healthcare, too bad you listen to those liars in the Fox echo chamber. The masses about whom you just don't seem to care. You admit that the healthcare system only works for those with money, but decry the obvious solution which the rest of the world found decades ago. The lack of cognitive dissonance you display is stunning, given your commentary here.
I cry foul because there are only 10 countries being compared to the US. There are many more with better health systems not compared. I think in a real comparison they would be a lot lower than 11th.
So, you have no facts whatsoever, you're making assumptions left and right, but you're absolutely certain that a panel of healthcare experts are wrong because...national pride. Par for the course for "conservatives" these days. Always willing to believe speculation over facts.
hey kid, adults are having a discussion here. Take your pent up frustration elsewhere. Your post was only meant to put words in my mouth and insult me -- grow up and quit trolling.
The population and cultural diversity do not add up. Those are facts. I think it would be better to compare the US to a country like Brazil.
The data says otherwise. The US spends more money on healthcare yet receives an inferior quality based on many metrics.
You want to compare the US to Brazil, a third world country? It would be more appropriate to compare it to Canada or Australia a company with many more immigrants.
Our system is a hybrid between government supported- Medicaid for the elderly and everyone else for themselves. Customer satisfaction in Medicaid is fairly high, as are age requirements. Insurance companies and administrators seem to take up a huge slice of the pie. Tort reform would help, as would increasing the supply of general practitioners or reducing the requirements for them. Here, I think single payer would be a better start, but we all love our freedomz until we're old and drooling for our entitlements. Obamacare doesn't even add more government to any of this. Right now it's just forcing or funneling people into existing private insurance companies, and introducing laws to make people who pay more for better, pay even more so that the market catering to the "better" normalizes in costs with everyone else. State health exchanges is a start in reducing information asymmetry of scale, but won't be able to adjust as much as a national health exchange or the colluding efforts of existing regional oligopolies. So if you're young, suck it up, walk it off, and start hustlin for some doctors visits.
I've always thought it was odd that people complain about the combination of high costs and "poor outcomes" in the US as if that combination doesn't make perfect sense. If Americans have the unhealthiest lifestyles of the people in all these countries, wouldn't you expect them to have the highest health care costs? And at the same time, medicine can only do so much, particularly when you have many people getting incurable chronic illnesses because of poor lifestyle (e.g., diabetes) so you'd still expect the "Healthy Lives" metric to come out near the bottom even while we're spending more than other countries. The efficiency ranking is a real concern, but if you look at the other metrics I would consider most important (quality and timeliness), the US comes out at #5 when ranked against 10 of the wealthiest countries in the world. There's room for improvement, but hardly seems to be the crisis it's made out to be.
