American Health Care: Very Expensive, Very Low-Quality

Algernon Austin presents an excellent, concise, and wonderfully read scholarly examination of the complicated landscape of race, class and popular perception. Besides the prison industrial complex, black strides in education, poverty rates, crime and other indices contradict claims that blacks are “moving backward.”
--Jeffrey O. G. Ogbar, Director, Institute for African American Studies, University of Connecticut and author of Black Power: Radical Politics and African American Identity (The Johns Hopkins University Press), 2004 and Hip-Hop Revolution: The Culture and Politics of Rap (University Press of Kansas), 2007.

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Source: Karen Davis et al., Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care, The Commonwealth Fund, May 2007, p. viii.

The U.S, spends more than twice as much per capita on health care as the United Kingdom, yet a recent report ranked the U.K.’s health system first and the U.S.’s last among six nations. We pay the most to get the least.

Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care by Karen Davis et al. compares the health care systems in Australia, Canada, Germany, New Zealand, the United Kingdom and the United States. The researchers compare the countries on the quality of care, access, efficiency, equity, and the promotion of healthy living. The U.S. scored last on access, efficiency, equity, and the promotion of healthy living. On quality of care the U.S. was second to last.

The report states:
The most notable way the U.S. differs from other countries is the absence of universal health insurance coverage. Other nations ensure the accessibility of care through universal health insurance systems and through better ties between patients and the physician practices that serve as their long-term “medical home.” It is not surprising, therefore, that the U.S. substantially underperforms other countries on measures of access to care and equity in health care between populations with above-average and below-average incomes.
With the inclusion of physician survey data in the analysis, it is also apparent that the U.S. is lagging in adoption of information technology and national policies that promote quality improvement. The U.S. can learn from what physicians and patients have to say about practices that can lead to better management of chronic conditions and better coordination of care. Information systems in countries like Germany, New Zealand, and the U.K. enhance the ability of physicians to monitor chronic conditions and medication use. These countries also routinely employ non-physician clinicians such as nurses to assist with managing patients with chronic diseases.
For decades, nations in the developed world have provided high-quality, inexpensive health care to all of their citizens. The U.S. stands alone with an expensive, low-quality health care system than covers fewer and fewer of its citizens each year.

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--Algernon Austin, Ph.D.

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