U.S. spends more cash, gets less care than other countries

A survey published Wednesday in “Health Affairs: The Policy Journal of the Health Sphere” concluded that, compared with individuals residing in six other countries, United States citizens tend to pay significantly more for health care, report more medical errors and “waste” more time on superfluous paperwork.

On the upside, however, U.S. residents reported more accessibility to quality health care and less wait time for elective surgeries.

Survey Particulars

The 2007 Commonwealth Fund International Health Policy Survey interviewed 12,000 adults in seven countries regarding their experiences with their respective health-care systems. It is important to note that all of the countries surveyed but the U.S. have a single-payer, universal health-care system in place, similar to what most Democratic presidential hopefuls are promoting in their campaigns. The countries surveyed were:

  1. The United States
  2. The Netherlands
  3. The United Kingdom
  4. Germany
  5. Canada
  6. Australia
  7. New Zealand

The survey, which was conducted by The Commonwealth Fund and Harris Interactive in March, and published on Wednesday, covered everything from access to health care, quality, cost, waiting times, insurance coverage, after-hours care and preventive medicine.

The Good:

  • Eighty percent of U.S. respondents said they have a primary-care physician or primary-care system in place, which the study concluded allows them better overall access: to preventive care, knowledge of medical history, after-hours care and coordination of care in case a specialist is required. At 80 percent, however, the U.S. individuals’ access to a regular doctor was significantly lower than in all the other countries; in the Netherlands, it was 100 percent.
  • Because of privatized medicine and insurance, U.S. respondents had the least wait time for elective surgeries. But U.S. residents were also the most likely to forego the necessary procedures due to affordability issues.
  • The U.S. respondents also claimed to have the best access to quality care, probably because of private insurance, but much of the care was deemed to be cost-prohibitive.

The Bad:

  • The U.S. spends twice per capita than the other six countries on health care, and receive less of it — most being bogged down in insurance and overhead costs.
  • One-fifth of the U.S. respondents said they had difficulty paying medical bills over the last year — more than double the rate of the other countries.
  • Thirty percent of insured and 34 percent of insured Americans spent more than $1,000 in out-of-pocket medical costs during the last year.
  • Thirty-two percent of Americans switched their insurance carrier at least once in the past year, which means the possibility of losing the all-important primary-care physician or system.
  • The chances of Americans having a “medical home”; that is, a regular doctor or clinic who is familiar with their medical history and current medical status were significantly affected by income level: 58 percent of high-income residents had a “medical home” as opposed to only 26 percent of low-income residents. This could be the result of low-income people having to resort to clinics and/or emergency rooms because they cannot afford insurance.
  • U.S. adults were the least likely of any country to report same-day access to a doctor and the most likely to experience a long wait (six days or more) when sick.
  • Patients in the U.S. were also the least likely to say that their doctor always spent enough time with them during visits or answered all their questions.

The Prognosis:

The good news about all the bad news is that at least now we know what to fix. As most of the presidential candidates have said, Americans do need access to more and better-quality health care. Additionally, as again the candidates have noted, the seemingly endless paperwork connected with doctors’ visits needs to be reduced; most presidential hopefuls have mentioned a switch to electronic medical records to alleviate this problem. Another significant problem to be addressed is the high rate of uninsured and underinsured Americans, which makes medical care cost-prohibitive and places a great amount of financial stress upon patients.

Perhaps this study, if widely publicized, will allow lawmakers to compare their proposed health-care reforms to the systems already in place – and already working – in foreign countries.


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