It is not just about high costs in America for healthcare, it is about quality too
Back on September 17, I did a quick blog on the Peterson-KFF Health System Tracker Chart Collection comparing U.S. healthcare prices and utilization against those in other developed nations. I like these periodic looks at prices and utilization throughout the developed world because it reveals at least one of the biggest reasons our healthcare system is in crisis or at least tumbling toward it – the highest prices in the developed world.
A few key Peterson-KFF findings as I related in the blog, which can be found here ( https://www.healthcarelabyrinth.com/u-s-healthcare-prices-compared-with-other-developed-nations/ ):
- The U.S. spends nearly twice as much on healthcare per person as the average of peer nations. The U.S. spent $14,432 in 2023, while the comparable country average was $7,393, with a range of $5,640 to $9,688. So, America’s costs are actually anywhere from about 49% to 156% more, with an average of about 95% more.
- The study says the U.S. spent about 16.7% of gross domestic product (GDP) on healthcare in 2023, while the comparative country average was 11%.
- Compared to its peers, the U.S. has about half as many in-person doctor consultations per person. This goes to my concerns about primary care.
Now, Peterson-KFF has released a new analysis and charts related to how America compares to the rest of the developed world in terms of quality outcomes and healthcare system performance. This is a bit like what The Commonwealth Fund does every three years or so in its “Mirror, Mirror” reports. In them, Commonwealth looks at both price/cost and quality against about a dozen countries around the world.
Both Peterson-KFF and Commonwealth point to a huge problem for the U.S. Healthcare system. It is not just that America has the highest prices and costs, but that it has the lowest value – huge costs against the lowest performance of any developed country.
What did Peterson-KFF find in its recent analysis on quality performance?
- Australia, Austria, Belgium, Canada, France, Germany, Japan, the Netherlands, Sweden, Switzerland, and the UK are included in the analysis and are compared with the United States.
- Peterson-KFF finds that the U.S. performs worse in long-term health outcomes measures (e.g., life expectancy), certain treatment outcomes (e.g., maternal mortality and congestive heart failure admissions), some patient safety measures, and health system capacity. On the other hand, the U.S. performs similarly to or better than peer nations in other measures of treatment outcomes (e.g., mortality rates within 30 days of hospital admission) and some patient safety measures (e.g., post-operative complications).
In essence, if you have good access to the U.S. healthcare system, treatment and quality is good. But if you do not, quality is low. It is all about your consistent and affordable access.
One key barometer of healthcare quality is life expectancy. Here Peterson-KFF finds the United States has lower life expectancy than peer nations. The analysis notes that differences in socioeconomic conditions and population behaviors that are largely outside of the domain of the health system could impact life expectancy. But my view is that a well-functioning healthcare system for all would positively offset some of the socioeconomic and other impacts.
Here are some additional details:
- Life expectancy in the U.S. has rebounded to nearly pre-pandemic levels but remains far below peer countries. U.S. life expectancy is 4.1 years shorter. The gap has grown substantially since 1980 as peer nations saw more rapid improvement in life expectancy.
- Maternity mortality rates are much higher in the U.S. than comparable nations and America is a major outlier. The U.S. had 18.6 deaths per 100,000 live births in 2023 compared with 5.1 deaths per 100,000 live births on average in the other nations. The U.S. has significant racial disparities on this measure.
- Hospital admissions for congestive health failure (CHF) and diabetes were more frequent in the U.S. than in comparable countries. For congestive heart failure, in 2022 the U.S. had 387 admissions per 100,000 vs. 192 for other nations. For diabetes, the U.S. had 223 admissions per 100,000 vs.103 for other nations. For pulmonary diseases, the U.S. had about the same or lower admissions. The admission statistics point to the need to have more robust primary care and disease management in the U.S.
- Just 87% of the U.S. population vs. an average of 93% in the other nations have a regular source of primary care.
- About 16% of Americans used the emergency room either for care which could have been provided by a regular doctor or because they did not have a regular doctor. This compares with an average of 11% in the other nations.
- The U.S. has a primary care shortage and crisis and this is borne out in the statistics. The U.S. has fewer general health practitioners than most peer nations. As of 2024, 53% of the U.S. population lived in areas that did not have enough primary care providers. In 2022, the U.S. had 0.6 general practitioners per 1,000 individuals. In the other nations, that was an average of 1.3 general practitioners per 1,000 individuals – double the primary care providers.
Peterson-KFF Analyses: https://www.healthsystemtracker.org/chart-collection/how-do-healthcare-prices-and-use-in-the-u-s-compare-to-other-countries/ and https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/
#healthcare #coverage #quality #primarycare
— Marc S. Ryan
