U.S. Health Care System Best in the World? What are the odds?
등록일 2019년 01월 07일 화요일
수정일 2017년 07월 25일 화요일

Photo by: DWilliams via Pixabay

Many have believed that the American Health Care system is the best in the world, but is there evidence to support this claim?There's hardly any, and the few reports in favor lack credibility.On the contrary, credible sources appear to show that the U.S.healthcare system is last among high-income-earning countries.

One of the most prominent of these sources is the Commonwealth Fund.Since 2004, it has frequently conducted surveys and shared data only to show that the U.S.healthcare system is among the weakest when compared with other developed countries.

Even so, the same reports reveal that the U.S.is one of the biggest spenders in health care and that, indeed, Americans spend more on health than other countries which exhibit superior performance in the same sector.

The credibility of this information is backed by the way the Commonwealth Fund carries out its analyses.After conducting surveys of primary care doctors, the general population, and secondary data on health outcomes, the most recent studies demonstrated that the U.S.healthcare system, despite offering the most advanced and technical treatment, fails to show a solid performance.


The best way to spot the necessary improvements in the U.S.healthcare system is to first point out the main reasons why it lags behind.In theory, a well-performing health care system will deliver quality care to improve the well-being of individuals and populations.This means that countries are gauged according to how effective they treat their sick and how successful they are in reducing avoidable mortalities.

With regard to this criteria, the first challenge within the U.S healthcare system is that a large percentage of the country's population is sick.The rate of mortality is also higher compared to other developed countries around the world.

The U.S.records a relatively higher number of deaths which result from manageable conditions ("mortality amenable to healthcare" in technical terms).And although it is virtually impossible to treat all diseases or control the fate of many conditions, other high-income countries record lower rates and are much more successful in reducing these deaths.

Other strategies that the U.S.health care system can be gauged against are the delivery of evidence-based and appropriate care activities, as well as the promotion of timely access to preventive, acute, and chronic care.In the American system, people with health risks often lack timely access to care because of three hindrances: Cost of delivery, administrative burden, and differences in race, family income, education attainment, and other nonclinical factors.  

Improvements can be made by providing adequate insurance solutions, reducing administrative burdens, and minimizing disparities in facilities.

The latest report from Commonwealth Fund pinpoints the critical areas where the U.S.health care system should focus when implementing the much-needed improvements.

First, the system misses the mark when it comes to access to care (this is measured regarding affordability and care).Other countries like Australia, United Kingdom, and the Netherlands are much more ahead in part because they provide universal insurance coverage which demands less regarding out-of-pocket costs, for primary and preventive care.

The lack of such coverage means that many people in the U.S.are left out with hardly any affordable and comprehensive insurance coverage to depend on when seeking care.Some of them end up contracting severe illnesses while others delay to seek care and eventually die.

Second, the U.S.has not invested adequately in primary care compared to other countries.According to the Commonwealth Fund report, a majority of highly ranked countries dedicate their funds to primary care and provide a wider range of services at first contact regardless of time and schedule.

Third, the U.S.healthcare system suffers from administrative inefficiency, where many patients, and even health professionals, are puzzled by the complexity of accessing and paying for care.The Commonwealth Fund report says that American clinicians spend more time on completing documentation and verifying the validity of insurance coverage, delivery of services, and confirmation of reimbursement.

When doctors are compelled to go through many administrative layers in the healthcare administration system, it results in high levels of burnouts, which can serve as a hindrance in access to quality care.In addition to the challenges of receiving confusing benefits descriptions, surprise bills (unexpected bills) for services, limited information on physicians and facilities, and random copayments at pharmacies and labs, patients are also burdened by the many procedures involved in accessing care.

These barriers can only be removed by reducing complexities for clinicians and patients, and one step towards success would be to completely change hospital reimbursement systems to global methods, fee schedules, payments, formularies, and defined benefits.This would make revenues predictable for facilities, and payments and costs more comprehensible to patients.

Lastly, the Commonwealth Fund report points out that the U.S.health care system needs to address perverseness of disparities in the delivery of care.Many Americans with low incomes, social-economic challenges, and low education attainment face greater health risks compared to people from other high-income countries.

So, along with providing more comprehensive insurance coverage, investing in primary care, reducing administrative complexity, the U.S.needs to dedicate more resources through social spending in order to reduce health risks as well as address each of the cited challenges.

Oliver Smith기자  
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