US still has the worst, most expensive health care of any high-income country
By: Chen Mengtong (Ars Technica)
S E E D E D C O N T E N T
Over 660,000 white flags were installed here to honor Americans who have lost their lives to COVID-19.
Getty | Chen Mengtong
Americans spend an exorbitant amount of money on health care and have for years. As a country, the US spends more on health care than any other high-income country in the world—on the basis of both per-person costs and a share of gross domestic product. Yet, you wouldn't know it from looking at major health metrics in years past; the US has relatively abysmal health. And, if anything, the COVID-19 pandemic only exacerbated the US health care system's failures relative to its peers, according to a new analysis by the Commonwealth Fund.
The Commonwealth Fund
Compared with other high-income peers, the US has the shortest life expectancy at birth, the highest rate of avoidable deaths, the highest rate of newborn deaths, the highest rate of maternal deaths, the highest rate of adults with multiple chronic conditions, and the highest rate of obesity, the new analysis found.
"Americans are living shorter, less healthy lives because our health system is not working as well as it could be," Munira Gunja, lead author of the analysis and a senior researcher for The Commonwealth Fund's International Program in Health Policy and Practice Innovation, said in a press statement. "To catch up with other high-income countries, the administration and Congress would have to expand access to health care, act aggressively to control costs, and invest in health equity and social services we know can lead to a healthier population."
Dying young
Overall, the analysis paints a grim picture of how much catching up the US has to do. In terms of life expectancy, the US has trailed its peers for years but took a nosedive during the pandemic, while other countries fared better. In 2020, the average life expectancy at birth in the US was 77 years, three years lower than the average for high-income countries. The next lowest life expectancy among high-income countries was from the UK, which had a 2020 life expectancy at birth of 80.4 years.
Provisional data for 2021 suggests US life expectancy fell nearly a full year further, from 77.0 years to 76.1 years. Relatedly, the US had the highest rate of deaths from COVID-19 in 2020 compared with its high-income peers and was among the lowest of its peers in rates of COVID-19 vaccination.
In a particularly shameful set of statistics, the US continues to have the highest infant and maternal mortality rates of any other high-income country. In 2020, there were 5.4 infant deaths per 1,000 live births in the US, while the average among high-income countries was 4.1 infant deaths. In Norway, there were 1.6 deaths per 1,000 live births. The health care system is also failing mothers. In 2020, there were 24 maternal deaths per 100,000 live births, about 2.5 times higher than the average for high-income countries. The country with the next highest maternal mortality rate was New Zealand with 13.6 per 100,000 live births.
Rates of infant and maternal mortality among high-income countries.
The Commonwealth Fund
With many US states now rapidly turning back the clock on reproductive rights and maternity care, the US's appallingly high rates of infant and maternal deaths are expected to worsen.
Beyond pregnancy, Americans are dying from other conditions that are treatable or preventable at a rate far higher than those seen in all other high-income countries. In 2020, 336 US deaths per 100,000 people were avoidable, while the average among high-income countries was just 225 deaths per 100,000. The rate of avoidable deaths has been rising in the US since 2015, the analysis notes.
Sicker
That tracks with the finding that Americans are more likely than their high-income-country peers to have multiple chronic conditions. In 2020, 30.4 percent of US adults said that they had previously been diagnosed with two or more chronic conditions in their life. Among other high-income countries, no more than a quarter of adults reported having two or more chronic conditions. America's high obesity rate may play into that discrepancy. The US has a higher obesity rate than any other high-income country. In fact, it's nearly two times higher than the average of its peers.
While Americans are dying young from avoidable conditions, they're also spending an exorbitant amount on health care. The US spent 17.8 percent of its GDP on health care in 2020, nearly twice as much as the average of 9.6 percent among high-income countries. On a per-person basis, it outspent its peers, paying nearly $12,000 per person via government insurance programs, private insurance coverage, and out-of-pocket costs. The country that came the closest to US spending was Germany, with a little over $7,000 per-person spending.
The data hints that these high prices are discouraging Americans from getting the care they need, potentially feeding into the country's high rates of chronic conditions and avoidable deaths. In the analysis, the US had among the lowest rate of doctor visits, with just four per year. The average was 5.7. The US also has one of the lowest rates of practicing physicians per 1,000 people—2.6 per 1,000, while the average is 3.7.
The US was the only high-income country in the analysis that does not guarantee health coverage. People in most other high-income countries have guaranteed health coverage with the option of buying supplemental private coverage.
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Some governors are still refusing the additional funds that are available to them under Obamacare. All of them are Republicans, of course.
Why aren't we controlling costs?
If we are going to pay for health care with the people's money like Europe does, then we should control costs like Europe does!
Successfully? Economically?
You would have thought that Washington might had learned that lesson from the peak of the Covid hospitalization where so many hospitals stopped all elective procedures and did their best to limit anything other than Covid patients. The feds were paying Medicare reimbursements rates only and how many rural hospitals laid off staff to close floors and ended up closing their doors due to a lack of money.
If they won't set up a system to control the costs there is no hope for this to be successful. But Washington has an extensive history of only working one side of a problem and expecting it to fix everything.
Consistent.
Instead of having the payment side Socialist while the medical profession enjoys free enterprise and charges whatever they want. In the case of American Pharmaceutical companies, the drugs are sold for much less in Socialist countries and the big profits are made here.
That should have been the 1st provision of Obamacare.
Interesting article...
How the pandemic killed a record number of rural hospitals | CNN
Sadly, the US doesn't seem to care but then again profit is the buzzword here.
Having lived in a country with national healthcare, I found it to be quite good. My entire family lives in Australia and is quite pleased with their National healthcare system.
No, it doesn't. How ignorant do you have to be to equate life expectancy to health care? Do people think the only reason someone dies is because of the quality of health care they receive?
America's high obesity rate may play into that discrepancy. The US has a higher obesity rate than any other high-income country. In fact, it's nearly two times higher than the average of its peers.
You think? Maybe drug use, violence etc play a part?
American health care, when it comes to actual health care, like treating cancer or heart attacks, is second to none. Americans make lifestyle choices that can shorten life expectancy. That's not healthcare.
Seriously, Sean?
What simple indicator would you suggest?
Things like drugs and obesity are part of a nation's health profile. Things like ambulance coverage are part of the health system.
I remember back in the Obamacare Wars, how some conservatives would advance indicators like the recovery rate from a particular kind of cancer... because that was literally the only indicator they could find that was favorable to the US.
This is shameful. The US is fifty-fucking-fourth! Behind western Europe, OF COURSE. Far behind Cuba, for pity's sake.
Maybe we should stop being the world's military and start diverting that money to health care?
I am sure our NATO allies, and others (such as Ukraine) if we took all of that military spending that allows them to maintain their top of the line health care systems by not maintaining a combat ready military; and put it towards our own.
That would improve the US standing in health care and lower all of our "allies" very damn quickly.
Can't have guns and butter.
Look a little more closely at the numbers. "... all of that military spending that allows them to maintain their top of the line health care systems by not maintaining a combat ready military" is just not true.
America's "health system" has for mission to send the big dividends to shareholders. Paying for treatment lessens dividends. The health of the "client" is unimportant.
Duh.
Yeah, how dare conservatives use objective measures of actual health care to determine how the health care system is performing. Better include all sorts of variables like eating, violence, driving habits, suicide, drug use and lump them in all under "health care."
By your standards, Obamacare and increased government intervention in health care has been a massive failure. Just look at life expectancy trend lines. We go full socialized medicine, our life expectancy might drop to the 50s.
The idea that going to single payer is going to keep Americans from eating too many calories and spending too much time on the couch is silly.
behind Cuba, for pity's sake
You would take Cuba's reported records seriously.
The denials are something, eh Bob? I didn't see any reference to bankruptcies caused by the expense of health care, or references to people being turned away from hospitals because they don't have insurance.
I always wonder how much is willful ignorance and how much is straight-up hypocrisy.
Maybe fear of appearing disloyal to the side that they're glued to?
It's the myth ( or the reality ) or growing up thinking The 1st Amendment allows you to say anything you want or owning any number of firearms you want per the 2nd.
It's the John Wayne -Frank Sinatra school of rugged individualism that says
""I'll do it my way" and no doctor is going to tell me what to eat or how much to exercise
We'll eat, drink, smoke and take whatever illegal drugs we want because we can
until it's too late.
We don't care about statistics, or becoming one, we have rights!!! /s
Which is the same attitude as for not wearing masks and not giving a shit that that was one of the causes for more than a million people dying before their time,
Ambulance costs are outrageous. I had a car accident in a work vehicle and had to transported to the hospital. That ride cost $700 dollars. Thank goodness workman's comp paid for it and the $13,000 ER bill
Yers, patients can get a nasty surprise unless the emergency medical services company has contracted with the patient’s insurance plan. Only about half of our ground ambulance services have done so.
The bills can get extremely large in rural areas where distances are farther and EMS services are an big source of public revenue.
Air ambulance services, which are owned by a few private-equity-backed firms, fall under FAA regulations and 3/4 have not contracted with any health insurance plan.
I've heard of bills between $30,00 and $50,000..
I traveled by ambulance from my workplace last week but have seen the cost yet.
Seriously?
I have him on ignore so I can't read his post. I wish he would stop talking at me
As a heart attack.
You're wise. He has very little useful to say.
You've set the bar exceedingly high.
"useful"
Exactly, your comments are extremely useful.
Hope you are doing ok.
Thanks, I’m doing fine. I let myself get dehydrated with very low levels of magnesium and potassium. After those got adjusted, I was good to go. I just have to work harder to stay in balance.
Take care of yourself and try to keep things in balance
Thanks and am working on that,
Try Gerolsteiner. It's pricey but full of minerals. Helps with the wife with balance
and cramps due to the same.
Thanks for the tip, I like mineral water and this one is high in magnesium.
"According to the CDC's most recent obesity numbers, the state with the highest obesity rate is Mississippi , with an obesity rate of 40.8%. Mississippi also has the shortest life expectancy among all states at 74.5 years. West Virginia has the second-highest obesity prevalence at 39.7% and the second-lowest life expectancy of 74.8 years."
Top 10 most obese States:
Has anyone told you that you have an odd sense of humor?
Indeed, though I would think there are many who find such irony humorous.
Lol, one could say "almost wry".
Did you really LoL?
Could be, sick people just don’t make me laugh.
Highest Cancer Survival Rate by Country
Australia ranks the highest amongst the countries with the highest cancer survival rates, with 1,849.8 survivors per 100,000 people. This is significantly higher than New Zealand’s 1,686.8 survivors per 100,000 people and Ireland’s 1,240.5 survivors per 100,000 people. Following these three countries, the United States of America and Canada follow closely behind, with 1,195.7 estimated survivors for the US and 1,148.3 cancer survivors for Canada. Norway follows in sixth place with a rate of 1,120.3 survivors, while the Netherlands come in seventh place with 1,103.4 cancer survivors per 100,000 people. Switzerland ranks eighth, at 1,102.9 survivors per 100,000 people. Belgium places ninth with a rate of 1,076 cancer survivors per 100,000, while Denmark rounds out the top ten countries with the highest cancer survival rates, with a rate of 1,068.9 survivors per 100,000 people.
Best Cancer Survival Rates by Country
1. Australia – 1,849.8 survivors per 100k people
2. New Zealand – 1,686.8 survivors per 100k people
3. Ireland – 1,240.5 survivors per 100k people
4. United States of America – 1,195.7 survivors per 100k people
5. Canada – 1,148.3 survivors per 100k people
6. Norway – 1,120.3 survivors per 100k people
7. Netherlands – 1,103.4 survivors per 100k people
8. Switzerland – 1,102.9 survivors per 100k people
9. Belgium – 1,076 survivors per 100k people
10. Denmark – 1,068.9 survivors per 100k people
Arvo Kavika...
Yes I am more than happy with all the treatments I have gone through and has not cost me one cent...it would be hundreds of thousands of dollars by now including a stem cell transplant.. medications alone were $20,000 a month...all free...
I have to go into hospital on Monday for a day procedure again all free..I don't have private health insurance and waited three weeks to get into the public hospital...so certainly no complaints from me...
It's good to hear that you're doing well, shona.
I have two great-grandchildren that were born with severe problems. One had 30 surgeries by the time he was 15. Perth Children's Hospital is one of the best in the world and today he is in high school, doing well if that would have happened in the US his parents would be bankrupt. My other great-grandson was born with Downs syndrome and how Oz handles this situation with the family is unlike anything the US would do and was a real relief for his mom and dad.
Hoping that your procedure on Monday goes well.
Glad your rellies are in good hands..we do try our best.. just as well they live here in that case..still all a massive worry for their families and you though.
Yes we have failings in our system as well but overall compared to the States we are streets ahead. But we do fly in Aussies that treatment can only be sourced in America and we know the starting cost is half a million before anything is even started. Sometimes the government will pay others it's fund raising to get them over there..
The majour one is Car T cell treatment for blood cancers and it was only done in the States...cost half a million..it is now done here in Australia and cost..free..not sure if I will be a candidate, but will cross that bridge when the time comes..🐨
It's nothing drastic the procedure..every two years every Australian over 50 gets a free bowel cancer kit to do..mine has detected an abnormal sample so getting it checked it.. doesn't mean it's cancer but hundreds of lives have been saved by doing it..all the compliments of the Australian government..🦘🦘
Good news. Our cousin also has private health insurance.
Potentially shorter wait, possible private room and choice of doctors?
Rarely needed it, "knock on wood", lol.
Priceless when she got sick in Canada which was covered
or even the States, most of which was reimbursed.
I dropped private health insurance years ago because out in the country areas it is no advantage...
The doctors aren't allowed into the hospitals, private rooms are on a needs basis and if you are chucked on a helicopter and sent to Melbourne..you get who ever is on...
Private health insurance maybe an advantage in the city, but not worth it in the country regions...so I opted out and have had no regrets...
My single biggest grip is the cost of drugs. We develop the majority of the world's drugs, and while most countries negotiate their costs, we don't. Add to that, that most of the R&D is done at the university level, where the companies get free work, plus a nice tax write-off for "donations" given to the universities and pepper that with minor changes to drugs so that they are no longer generic, you can see why profits keep going up. When insulin costs 10 times the price in the US than any other country, we have a problem.
Minimally, we should be able to negotiate the prices of our medicines like other countries around the world.
Arvo Perrie... insulin costs $6.94 here..Which in US$4.82.
Last week, California governor Newsom said that the state would start producing its own insulin.
But at what cost... something drastically wrong somewhere for to be such a huge difference... someone is lining their pockets at the expense of their own people.
You mean like the big oil companies did over the past year of inflation - doubling, at least, their annual profits at the expense of the people filling their cars' gas tanks AND GETTING AWAY WITH IT?
The someone's start with big Pharma, then the lobbyists then the politicians.
This link will give you a good idea of how it works in the US. Payoffs and more payoffs.
Joe Manchin is the senator from West Virginia and this is only the start of the crooked bastards screwing the citizens. BTW he represents one of the very poorest states with a huge number of citizens without insurance.
Evening Shona! That is what it should cost. It was cheaper when we got it from pigs.
Exactly
I have had frequent, intimate, exposure to health care over the last 3 years. It includes numerous doctor office appointments, large number of medical tests, Three surgeries, one that lasted for 18 hours. 16 Chemo infusions and a total of 80 days in a hospital including days a week ago. A year of feeding by intravenous infusions.
Between this experience and my research, I'm convinced that our current approach to healthcare is unsustainable. Rural and inner-city hospitals are closing, nurses are overworked and increasing stressed out Medicare and Medical Insurance is growing evermore unaffordable and as many have noted here, patent outcomes aren't what they should be
I am very fortunate and expect a good outcome from America's unmitigated mess of health care. I had access to great surgical teams and treatment for a rare operation at Johns Hopkins, local access to a strong oncology department in the INOVA system, I've spoken with many doctors,technicians gotten to know many dedicated, professional nurses.
I'm convinced that had I been a blue collar worker, younger than 65 in a rural state, I would likely be dead by now after leaving my family with extreme debt or bankruptcy.
At one time US health carte was a market and it was driven by market forces but that is no longer true, if you want to call it a market now, it's a failed market. It is ever consolidating into fewer monopolies with very few competitive forces at play. Consumers are vulnerable, without much ability to execute purchasing power.
I think that medical debt is the single, largest reason for personal bankruptcy. I'm a fairly educated man, but when I tried to review my bills, what was charged against what was paid, I couldn't figure it out. I wouldn't be surprised if many patients opt out of needed treatment duje to the lack of billing transparency and the many shocking stories of finding out, after the fact that you have a massive bill. The only rationale I can find for soaring drug costs is cooperate greed and political power.
Health care is one of the growing issues were we a completely divided with few looking for middle ground. The losers are the poor and lower middle class.
.
Good health and positive thoughts to you and yours. Every day is truly a gift.
Thanks and youn're absolutely right.
Good luck Drinker. My daughters were both pre-med students at Hopkins. They tell me you have the best of the best.
And even better when that info is shared all around the world, even more lives are saved or extended by which ever country has developed it...
I feel that they are right. And congratulations to you and your daughters.
The wealthy do not use the public health system. They have their private services.
So... the wealthy do not give a flying fuck about health services. Every penny spent on John Doe's health is a penny they won't be able to skim.
The wealthy do not want good healthcare in the USA.
Good health to you, Drinker.
I'm retired and I'm covered by IHS (Indian health service). the closest IHS hospital to me is a bit over 1200 miles away and the closest Health Center (clinic) is 200 miles. They are understaffed and underfunded and have been for decades. I'm also covered by the VA and there is a huge VA hospital just 50 miles from me in Gainesville and a clinic 5 miles away.
I'm also covered by medicare and my supplement cost is covered by my union from decades ago.
I do not use IHS the distance being one reason but I don't need to use them and it would take away services from others that really cannot afford any other insurance. I use the VA for prescriptions only and stick with medicare.
I'm lucky but I know of hundreds of Indians and non Indians that are not so lucky.
Thanks and ther same to you Kavika. I use Medicare Part A & B, and my Tricare For Life as my supplemental and prescription drugs. I've never used the VA as I know they don't need an increase patient load.
As bad as VA health care is and what I imagine the IHS to be, they are still better than what millions have to deal with.
Then you get the "explanation" of what you owe ( "This is not a bill ")
from your provider like Aetna or Humana
and a good portion of that is wrong.
Mastering the obvious, eh Bill.
Apparently you missed the other three sentences:
I apologize for posting something too long for your span of attention.