Thursday, July 31, 2014
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American Health Care Still Needs A Lot of Work

Think we have the best health care system in the world? Consider this: More people in the United States die from preventable causes than anywhere else in the industrialized world. That finding should give anyone pause.

American Health Care Still Needs A Lot of Work

Think we have the best health care system in the world? Consider this: More people in the United States die from preventable causes than anywhere else in the industrialized world. That finding should give anyone pause.

As you’ve probably noticed, our health care system has some big problems. A report released this week by the nonprofit Commonwealth Fund, which included the finding on preventable deaths, shows exactly how big the problems are.

It is already well known that we spend far more on health care than anyplace else in the world. Yet despite that, lack of insurance keeps more of us from getting care than in any other developed country. (Emergency rooms must see everyone, but their services are limited to stabilizing emergency conditions.) And thousands die each year from medical errors.

The new report looked behind these failings with a scorecard that measured 42 indicators of quality, efficiency, equity, and overall health. We scored only 64 out of a possible 100.

Here is some what the scorecard showed:

o Our infant mortality rate is the highest of 8 countries that were measured and is over three times higher than the rate of the lowest country, Iceland.

o Our healthy life expectancy at age 60 is the third lowest of 23 countries that were measured.

o Only about half of adults receive all recommended screening and preventive care, and only 56% have an accessible primary care provider.

o Almost a third of Americans experienced a medical mistake, medication error or lab error in the past two years. That’s the highest rate of 8 countries that were measured and double the rate of the lowest country, the Netherlands.

o One-quarter of the elderly received a prescription for an inappropriate high-risk medication.

o Only 43% percent of us can get a medical appointment the same day when we’re sick, the second-lowest rate of 8 countries that were measured.

o We spend the most on administering health insurance, about 7% of total health care costs, of 10 countries that were measured (although France tied us for last place).

o We have the second-lowest rate of use of electronic medical records of 11 countries that were measured.

There was a little bit of good news. Compared with the last Commonwealth Fund scorecard issued in 2006, more hospitals are following recommended protocols to prevent surgical complications, the percent of adults who smoke declined from 21% to 17%, and more people with high blood pressure report that it is under control. (Click here to see the 2006 report.)

Without doubt, America has some of the best high-end care in the world. People come here for complex treatments from all over the world. But that doesn’t mean the system is giving us everything it should. The new report shows that it unquestionably is not.

Maybe, you’ve experienced one of these problems firsthand - you couldn’t see doctor right away when you needed one, a lab mixed up your results, or you received an inappropriate prescription for a drug that could be harmful. Maybe, you lost your insurance and had trouble getting any care. Those kinds of things happen much less often in many other developed countries.

Health reform addresses one of the most significant of these problems – access to insurance. It makes a start on a few others. But many problems will require different solutions.

It’s easy to find flaws in health reform. It has many. But to scrap it without offering an alternative would be to relegate America to second-class status in health care, as the new report clearly shows. How long can we afford to go on like that?


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About this blog

Check Up covers major health events in our region and offers everything from personal health advice to an expert look at health reform. Read about some of our bloggers here.

For Inquirer.com. Portions of this blog may also be found in the Inquirer's Sunday Health Section

Robert Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
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