The USA has exceptional levels of health-care expenditure, but growth has slowed dramatically in recent years, amidst major efforts to close the coverage gap with other countries of the Organisation for Economic Co-operation and Development OECD. We reviewed expenditure trends and key policies since 2000 in the USA and five other high-spending OECD countries. Higher health-sector prices explain much of the difference between the USA and other high-spending countries, and price dynamics are largely responsible for the slowdown in expenditure growth. Other high-spending countries did not face the same coverage challenges, and could draw from a broader set of policies to keep expenditure under control, but expenditure growth was similar to the USA. Tightening Medicare and Medicaid price controls on plans and providers, and leveraging the scale of the public programmes to increase efficiency in financing and care delivery, might prevent a future economic recovery from offsetting the slowdown in health sector prices and expenditure growth.
Health-care expenditure and health policy in the USA versus other high-spending OECD countries : The LancetJuly 17, 2014
But when it comes to health care spending, the picture is starting to look more global. After decades when health spending in the United States grew much faster than it did in other Western countries, a new pattern has emerged in the last two decades. And it has become particularly pronounced since the economic crisis. The rate of health cost growth has slowed substantially since 2000 in every high-income country, including the United States, Canada, Britain, France, Germany and Switzerland, according to data from the Organization for Economic Cooperation and Development.“We used to be different,” said Louise Sheiner, a senior fellow at the Brookings Institution and a former senior economist at the Federal Reserve. “Since about 1990, we’ve looked about the same.”Continue reading the main storyHealth Cost Growth, Slowing Around the WorldThe growth in health costs has slowed in the United States, but it has slowed in other countries, too.Annual growth in per–capita health care costs, 2001 and 2011+6%4%2%0%+5%CanadaFranceGermanyNetherlandsSwitzerlandBritain+1% – U.S.20012011Source: OECDThe synchronized slowdown offers reasons to be skeptical about neat explanations for the trends in any one country, be it local changes in medical practices or Obamacare’s various attempts to slow cost growth.
Studies show that survival rates for major cancers are better in America than they are in other developed nations. A 2012 study led by the University of Chicago’s Tomas Philipson, for instance, concluded that cancer patients diagnosed between 1995 and 1999 lived an average of 11.1 years after diagnosis in the United States, but only 9.3 years after diagnosis in Europe. America, in other words, is getting something for all that extra spending.
The Commonwealth Fund has come out with the latest iteration of its ongoing campaign to inform our political leaders not so much the public that the American health care system sucks.Many of my conservative friends have pushed back, arguing that it is Commonwealth’s study that sucks. David Hogberg argues that it would have been more useful to print the study on toilet paper. Avik Roy says it is bogus to base such conclusions on public opinion surveys. And Philip Klein says Commonwealth cherry-picked what it looked at to derive its pre-determined conclusion.Personally, I agree with all of the above. Yes, Commonwealth’s study is deeply flawed, but so is American health care, which is inefficient, bureaucratic, unaccountable, inconvenient, of questionable quality, and far too expensive.
Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally – The Commonwealth FundJune 17, 2014
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.
“Despite all the government rhetoric, despite the Francis, Keogh and Cavendish reports, the spectre of another Mid Staffs still looms large over the NHS. Progress on safe staffing levels has been glacial and that means poorer care and patients still at risk.
“It’s clear that despite nurses working through breaks and beyond their hours, they simply do not have enough time to give patients the care and attention they need. That is distressing for patients and for the staff trying to care for them.
“The government needs to face up to the damage it is inflicting on patients and staff, by not introducing legally enforceable nurse-to-patient ratios, and take urgent action.”
One thing Lowrey didn’t mention, however, was the link between the social determinants of health (which often correlate with geography) and healthcare costs. That’s where The American Health Care Paradox, a new book by Elizabeth H. Bradley and Lauren A. Taylor, comes in.
TAHCP aims to shed light on the titular paradox, familiar to readers of this blog—why does America get such poor health outcomes, given the staggering amount spent on healthcare? It turns out that Bradley and Taylor don’t think America’s spending too much on improving health—it’s that it’s spending on the wrong things.
The good news is that we don’t have to theorize about unproven solutions to our health care problems. Two wealthy countries have health care systems that, if we could substitute them for our own, would exceed the wildest dreams of American conservative reformers. Switzerland and Singapore achieve universal coverage while spending a fraction of what we spend, and they ensure broad access to high-quality doctors and the latest technology.
National Health SHAMBLES: Three damning reports describe mothers abandoned during labour, serious hospital blunders every day and how patients have lost faith in their GPs | Mail OnlineDecember 16, 2013
Three damning reports last night laid bare the crisis in NHS hospitals, maternity units and GP surgeries.One investigation revealed that a quarter of new mothers were abandoned by their midwives during labour, with some left to give birth on the floor or in corridors.The second found that mistakes deemed so serious they should never happen are being made in hospitals five times a week.And the third survey said thousands of patients have all but given up trying to secure appointments with their family doctor.
Because of long queues for surgery and expensive private health care at home, more and more Finns are turning to private hospitals in Estonia. However, in cases of malpractice, seeking compensation may prove difficult.