America’s Lagging Health Care System

http://www.nytimes.com/2007/11/01/opinion/01thu3.html?_r=1&ref=opinion&oref=slogin

Published: November 1, 2007

Americans are increasingly frustrated about the subpar performance of this country’s fragmented health care system, and with good reason. A new survey of patients in seven industrialized nations underscores just how badly sick Americans fare compared with patients in other nations. One-third of the American respondents felt their system is so dysfunctional that it needs to be rebuilt completely — the highest rate in any country surveyed. The system was given poor scores both by low-income, uninsured patients and by many higher-income patients.

The survey, the latest in a series from the Commonwealth Fund, is being published today on the Web site of Health Affairs, a respected health policy journal. Researchers interviewed some 12,000 adults in Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom and the United States.

Given the large number of people uninsured or poorly insured in this country, it was no surprise that Americans were the most likely to go without care because of costs. Fully 37 percent of the American respondents said that they chose not to visit a doctor when sick, skipped a recommended test or treatment or failed to fill a prescription in the past year because of the cost — well above the rates in other countries.
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From the Study by Health affairs.....

http://content.healthaffairs.org/cgi/content/full/26/6/w717

This 2007 survey compares adults’ health care experiences in Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. In all countries, the study finds that having a "medical home" that is accessible and helps coordinate care is associated with significantly more positive experiences. There were wide country differences in access, after-hours care, and coordination but also areas of shared concern. Patient-reported errors were high for those seeing multiple doctors or having multiple chronic illnesses. The United States stands out for cost-related access barriers and less-efficient care.
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"As illustrated, the United States spends by far the highest share of national income on health care yet is the only country that leaves a high percentage of the population uninsured or poorly protected in the event of illness. An estimated one-third of U.S. adults are either uninsured during the year or underinsured."
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"Although patients in the United States reported rapid access to elective surgery, they were the most likely to have gone without care because of cost and to have high out-of-pocket costs. One-fifth of U.S. adults reported serious problems paying medical bills in the past year—more than double the rates in the next-highest countries. These high rates reflected cost sharing as well as high rates of uninsurance. Thirty percent of the insured and 34 percent of the uninsured spent more than $1,000 out of pocket in the past year."
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"Affordability was of particular concern in the United States, where 42 percent of chronically ill adults said that they had skipped medications, not seen a doctor, or forgone recommended care because of costs—a rate two to eight times higher than rates in the other countries. Asked specifically about care/advice for their chronic conditions, U.S. patients were the most likely to report a time when they did not adhere to medical advice and to name cost as the reason. In the other countries, the main reasons given for not adhering were lack of agreement or that it was too difficult."

Big study, much more.

Go USA! We're number one! ....pitiful.