Medicine

Healthcare in United States costs nearly twice as much as other rich nations

Healthcare in United States costs nearly twice as much as other rich nations

The U.S. spent almost 18 percent of its gross domestic product (GDP) on health care in 2016.

Researchers used data from 2013-2016 on about 100 metrics that underpin healthcare spending, and confirmed what experts have long known - that the United States "has substantially higher spending, worse population health outcomes, and worse access to care than other wealthy countries".

Nor does America have too many high-paid specialists.

"We know that the U.S.is an outlier in healthcare costs, spending twice as much as peer nations to deliver care".

The study confirmed that the USA has substantially higher spending, worse population health outcomes, and worse access to care than other wealthy countries. But he finds that four main areas account for most of the difference in health care costs between the United States and other rich countries: drug prices; the popularity of high-volume, high-margin procedures like knee replacements, angioplasties and C-sections; the widespread use of costly CT scans and MRIs in the US; and high administrative costs.

The good news is that despite poor overall outcomes, when people are sick, the quality of delivered healthcare is quite high. The U.S. also had the lowest health-adjusted life expectancy, or the average length of time a person lives in good health: 69 years, compared to a mean of 72 years in the other areas.

Senior author Dr Ashish Jha, professor of Global Health at Harvard University, said it's well known that the USA spend way more than peer nations to deliver care, but the common beliefs as to why these costs are so high - too many doctor visits, hospitalizations and procedures - aren't accurate.

But cost varied widely when it came to drugs.

Per capita spending for pharmaceuticals was $1,443 in the US, compared with a range of $466 to $939 in other nations.

Americans also appear to pay more for diagnostic tests and office visits, Woskie said.

Belief: The quality of healthcare is much lower in the US than in other countries. It's not necessarily that a lot of it is unnecessary, because our volume is similar.

What does explain higher spending in the U.S.is administrative complexity and high prices across a wide range of healthcare services.




Doctors and nurses are also paid more generously in the United States.

Doctors' pay was also much more, with the average salary for a general practice physician in the United States at $218,173, compared to other countries where the range was $86,607-$154,126.

Administrative costs of care-activities related to planning, regulating, and managing health systems and services-accounted for 8% of total healthcare costs, compared with a range of 1%-3% for other countries.

That's not just because the United States has a complicated insurance setup, either.

Other causes of unneeded spending are the overuse of expensive health services, low social spending, and the lack of an adequate number of primary health physicians.

"There's something funky about the USA system that's not just about the administrative inefficiencies of having more than one payer", Woskie said. During their study, it was found that the United States is spending twice the amount of its wealth on its health care.

"This work suggests that some of the more straightforward or simple solutions that have been posed are unlikely to address it in full", Woskie said.

The study will be published March 13, 2018 in JAMA (Journal of the American Medical Association).

The new analysis is "ambitious and comprehensive", and "represents a major advance" in understanding America's health care spending patterns, according Katherine Baicker, who cowrote an accompanying editorial.

But Baicker cautioned that even this study can not provide a direct apples-to-apples comparison between countries, given variations in the way health care is provided between countries.

Jha said whether the U.S. moves toward more private healthcare, as advocated by Republicans, or to single-payer healthcare, as advocated by liberal Democrats, price tags on all American health services need to be addressed. "It can tell you how different policies are going to affect the health care that we get, but it can't tell us what our priorities are".


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