Quality Health Care in the U. S.

In his inauguration address, U. S. President Barack Obama mentioned the poor state of the U. S. health care system as a fundamental issue facing the nation and his administration. The sobering truth of America’s health care system is that it dramatically under-performs. In an August 2008 poll by the Commonwealth Fund, 8 of 10 adults agreed with the statement that the health care system “needs either fundamental change or complete rebuilding”. This becomes even clearer when comparing the system with those of its international peers. In 2000, the World Health Organization ranked the performance of the U. S. health care system 37th in the world. In this and other international comparisons, despite spending more than twice per capita than other developed countries, the U. S. were beaten on virtually every metric of health care cost, quality and access. In other words, they spend more and get less. Scoring the U. S. health care system on key benchmarks achieved in other countries is about as complex a process as the new scoring system for gymnastics. Yet, experts at the Commonwealth Fund give the U. S. a score of 65 out of a possible 100, when examining how it compares to other countries on 37 different metrics for a high performing health care system, including life expectancy, preventable deaths, and timely doctors’ visits. For instance, the Institute of Medicine estimates medical errors in the U. S. cost $17 billion to $29 billion each year. Over the past 40 years, U. S. health care spending has grown on average between 1.3 and 3.1 per cent faster than the overall economy; 16.3% of the gross domestic product is consumed by health care. What’s frightening is the constant upward trend. The federal agency that directs Medicare and Medicaid projects U. S. health care spending to double by 2017. It is estimated to cost more than $4 trillion and accounts for 20% of the GDP. Other industrialized countries with above average per capita national income like the U. S. and systems that cover all residents, spend about half what the U. S. spends per person. In 2004, per capita spending was just over $6,000. France, Germany and Canada each spent roughly $3,100 per person and the UK spent less at $2,560. Yet, in terms of quality and access, each of these countries outperforms the U. S.

1. What strategies can be used to improve the system?