US: Not getting much bang for its buck on health care

May 3, 2012, 7:43 a.m.

The U.S. spent more than 12 other industrialized countries on healthcare in a recent study – but does not have "notably superior" care, it found. (Credit: Jason Hill/Flickr Creative Commons)

The U.S. spends more on health care than 12 industrialized nations, but does not provide "notably superior" care.

That's according to a new study from the Commonwealth Fund, a foundation that aims to promote a high-performing health care system. That spending is driven primarily by higher prices and greater use of technology – not more doctor visits or hospital stays.

The high cost of care manifests rewards to an extent – the U.S. performs well on breast and colon cancer survival rates, but has some of the highest rates of preventable deaths from asthma and amputations due to diabetes, and rates that are merely average for in-hospital deaths from heart attack and stroke.

According to the study, the U.S. spent nearly $8,000 per person in 2009 on health care services – or 17 percent of its gross domestic product that year. Japan and New Zealand spend one-third of that amount; Switzerland and Norway spend two-thirds.

So where's that money going? Not to physicians – in 2009, there were 2.4 physicians for every 100,000 people in the U.S., the fewest of the study's participants save Japan. The cash isn't going toward doctor consultations, either – there were only 3.9 per capita that year, less than any country in the study except Sweden.

Besides that, relative to the other countries in the study, the States had fewer hospital beds, shorter lengths of stay for acute care and fewer hospital discharges (per 100,000 people).

But U.S. hospital stays were, by far, more expensive than those in the other countries – more than $18,000 per discharge. Compare that to Canada ($13,000) or Sweden, Australia, New Zealand, France and Germany, where they each ran less than $10,000.

It was the same trend with the 30 most commonly-used prescription drugs: prices were a third higher in the U.S., compared to Germany and Canada, and more than twice as much as the same drugs in Australia, France, the Netherlands, the U.K. and New Zealand.

"It is a common assumption that Americans get more health care services than people in other countries, but in fact we do not go to the doctor or the hospital as often," said study author David Squires in a statement. "The higher prices we pay for health care and perhaps our greater use of expensive technology are the more likely explanations for high health spending in the U.S."

MRI and CT scans are certainly more expensive in the U.S., found the study, and performs the most scans among countries for which data was available. Knee replacements are also performed more in the U.S. than any other country except Germany.

High spending may also be partly explained the nation's high rate of obesity – some estimate it's as high as 66 percent – and the medical costs that come with that.

All of the countries in the study, except for the United States, provide universal health care and struggle with rising health care costs. The U.S., however, is alone in its spending. The Netherlands spent the second-highest amount on health care in 2009, and if the U.S. had spent that much, it would have saved $750 billion that year alone.

"Unfortunately," said Squires, "we do not seem to get better quality for this higher spending."

Not much of that high spending seems to be trickling down in South L.A., a place that's characterized by a lack of access to specialty and primary care. The development director at South Central Family Health Center, Jerra Ferguson, told OnCentral that "the need is still very overwhelming," despite a recent influx of funds through President Obama's Affordable Care Act.

"When you have a segment of the population that's about 64 percent under-served residents – just look at that percentage," she said. "And that percentage is growing."

Photo by Jason Hill via Flickr Creative Commons.

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