Monday, August 24, 2009

JHU study: U.S. health care most expensive, with 'average' outcomes

This is what I've been saying all along: "Be entrepreneurial about looking at what works," "and then figure out why does it work for them." Then pick and choose the best from everywhere! We've already wasted so much time and energy trying to scare and enrage each other. Let's educate ourselves instead. Wake up, Amurica!

Expensive without the results: Health care in the U.S. costs the most, not the best in the world

By Michael Saul

August 23, 2009 | NY Daily News

What nation offers the best health care on the globe? Answer: Not the United States.

The U.S. health care delivery system is by far the costliest on the planet, but comparison studies consistently show Americans get second-rate results by nearly every benchmark.

"We're twice as expensive as most other industrialized countries," said Gerard Anderson, professor of health policy and management at the Bloomberg School of Public Health at Johns Hopkins University.

"But we have outcomes that are typically about average, and we're not improving as quickly as other countries are improving," he said.

Last year, a study comparing preventable deaths in 19 industrialized countries placed the U.S. dead last. France was first, followed by Japan and Australia.

In the U.S., one in three chronically ill patients says the health care system needs to be rebuilt completely. Only one in 10 feels the same way in the Netherlands and the United Kingdom.

Foes of President Obama's push for universal coverage are quick to find fault with foreign systems, and some complaints are legitimate. In Canada, for example, a typical patient seeking surgical or other therapeutic treatment had to wait 18.3 weeks in 2007, an all-time high, one study showed.

But nonpartisan, scholarly studies show that for the most part, universal systems work well. And the key numbers, from infant mortality to life expectancy, show those countries are doing something right.

"No one is suggesting that we adopt another country's health care system," said Robin Osborn, vice president and director of the international program in health policy and practice at the Commonwealth Fund, a nonprofit.

"We should be open-minded, and we should be entrepreneurial about looking at what works," she said.

Universal care has long been the norm in many countries, accepted by political parties and their followers from both the left and the right.

Of the 30 industrialized countries in the Organization for Economic Cooperation and Development, only Mexico, Turkey and the United States fail to achieve universal coverage.

"There's a solidarity that operates in these other countries in terms of social values, a sense that people are entitled to health care," Osborn said. "In these countries, the idea of someone going bankrupt because of medical bills, it just does not exist."

In the United Kingdom, for example, there is no out-of-pocket cost to see a primary care physician or a specialist. Adults can fill prescriptions, no matter how new, rare or advanced the drug, for about $12.

Australia gives high priority to promoting access to primary care physicians. Patients in the United States spend, on average, about one-third the time that Australians spend in minutes per year with their primary care doctor.

People do better in countries that encourage regular primary care visits, in part because they get frequent counsel to follow healthy habits.

Obama has pointed to the Netherlands as a model closer to what he would like here. Dutch residents are required to purchase private health insurance coverage. And insurance companies must accept every resident in their coverage area.

Other countries are also further along than the United States in using information technology and employing a team approach to manage chronic conditions and coordinate care.

"It's really valuable to look at how other countries do it," Osborn said. "The issue is to look around and see what's good and what works, and then figure out why does it work for them."

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