U.S. Not Getting Good Value for Its Health Care Investment

Article excerpt

DESPITE health care expenditures that are the highest in the world, the United States lags behind other countries in virtually every measure of health care and is not getting good value for its investment, according to a new report from the Commonwealth Fund in New York City.

The report, the first to offer comparisons within the United States by state and region in addition to international comparisions, scores the nation's performance against benchmarks of high performance achieved either within the United States or by other countries. As of early October, the Commonwealth Fund was preparing to release results of comparisons within the United States.

The report, "Why Not the Best? Results from a National Scorecard on U.S. Health System Performance," gave the U.S. health care system low grades compared to other industrialized nations--a score of 66 out of a possible 100--across 37 indicators of health outcomes, quality, access, efficiency and equity.

By improving its performance in key areas, the nation could save as many as 150,000 lives and up to $100 billion annually, the report said.

"The fact is that the United States spends 16 percent of its gross domestic product on health care," said Commonwealth Fund President Karen Davis, PhD, at a news conference releasing the report Sept. 20 in Washington, D.C. "That's more than twice the average of industrialized nations, but as several studies have shown over the past several years, and as our ever-growing uninsured rates underscore, we are not getting good value for that investment."

Among the report's findings:

* Only half of U.S. adults, 49 percent, received preventive and screening tests according to national guidelines for their age and sex.

* Only 17 percent of U.S. doctors used electronic medical records, compared with 90 percent in Sweden, 88 percent in the Netherlands and 62 percent in Denmark.

* On average, uninsured rates among low-income people would need to improve by one-third to close the gap with highincome insured populations.

* Mortality, quality, access to care and efficiency must improve by at least 24 percent for U. …