Expensive mediocrity
Toward Higher-Performance Health Systems: Adults’ Health Care Experiences In Seven Countries, 2007
By Cathy Schoen, Robin Osborn, Michelle M. Doty, Meghan Bishop, Jordon Peugh and Nandita Murukutla
Health Affairs
November 1, 2007
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.
The survey asked adults about their overall health system views, confidence, access, cost burdens, and perceptions of waste and complexity. Repeating the pattern observed since 1998, U.S. adults held the most negative views and were the most likely to report affordability concerns. In contrast to the United States, public views in Canada and New Zealand have grown steadily more positive in the past decade and are now comparable to views in Australia and the United Kingdom.
http://content.healthaffairs.org/cgi/content/abstract/26/6/w717?etoc
Comment:
By Don McCanne, MD
Nothing new. This is yet another international study of health care experiences demonstrating that the United States has the most expensive and least efficient system and that we have the most negative views of all the nations studied. We have a lousy system, and we don’t like it.
The U.S. opponents of reform continue to expound on how we have the greatest health care system in the world, and none of us would ever tolerate the government controlled systems of other nations. But the truth is that their systems are less expensive, more efficient, and more appreciated by their citizens.
The first step in reform is to accept the true facts as they are. The second step is to find enough money to pay for a high-performance health care system. Fortunately, we’ve already accomplished that step since we’re currently spending enough; we merely need to make the contributions more equitable. The next step is to establish a rational system of allocating those funds, beginning with the establishment of a medical home for each and every individual residing in the United States.
With the funds we already have, a high-performance system is only a few policy steps away.