TUESDAY, Jan. 31, 2023 (HealthDay News) — The United States spends up to four times more on health care than most rich countries, but doesn’t have much to show for it.
Life expectancy in America continues to decline even though this country spends nearly 18% of its GDP on health care, according to a new report. Report from the non-profit Commonwealth Fund.
The United States stands out as the only country in the Organization for Economic Co-operation and Development [OECD] “Without universal health coverage, our life expectancy is falling, and we have higher avoidable death rates than other countries,” said the author of the report. Munira Junga. She is a senior research fellow at the Commonwealth Fund’s International Program in Health Policy and Practice Innovation in New York City.
She added that, along with a lack of universal health care coverage, the United States has too few primary care providers and does not spend enough on primary care, which makes it difficult for people to get basic preventive health care and predisposes them to chronic conditions. .
In the report, Gunja’s team compared healthcare spending and outcomes in the United States with 12 other high-income countries and the averages of 38 OECD member countries between January 2020 and December 2021.
What did the team find? The United States failed in many measures.
Americans had the lowest life expectancy at 77 years, which is three years short of life expectancy among people in other rich countries.
Despite spending more on health care than other countries, the United States also still has the highest rates of preventable deaths from diabetes, diseases related to high blood pressure, and certain types of cancer, and the highest rate of people living with multiple chronic conditions. have found. The obesity rate in the United States is nearly double what we see in other OECD countries.
Moreover, the United States also had the highest death rate from COVID-19 compared to other countries. Americans are more likely to die from physical abuse, including gun violence, while the country has the highest rates of infant and maternal mortality among OECD countries.
The new report showed that although rates of breast and colon cancer screening and flu vaccinations in the United States are among the highest in the world, COVID-19 vaccination rates are falling behind many countries.
Researchers said there has been some progress in expanding access to health insurance in the United States, but more work is needed to close the gaps and get people the health care they need.
The Affordable Care Act (ACA, or “Obamacare”) was enacted in 2010, opening up a market for purchasing affordable health insurance. More than 3 million new people signed up for health insurance under the ACA this year, bringing enrollment numbers to a record 16.3 million Americans.
Despite the ACA, millions of Americans still cannot afford coverage and/or live in a healthcare desert without access to doctors. “Many states haven’t expanded Medicaid, so they don’t have good, affordable options,” Gunja noted.
“We have to make sure that everyone has access to an affordable health insurance plan and that preventive care is free with no co-payment,” Gonga said. “We need to invest in the primary care workforce, provide incentives for physicians to enter primary care, and enact a loan forgiveness law for medical school debt, or we will never be able to solve this crisis.”
But things can still be changed. “Other countries have done that, so we should be able to do that, too,” she said.
US health care policy experts have ideas on how to solve the health care crisis in the United States.
“We are financially out of control in the United States and spend a lot on what other people are getting for a lot less money, with no impact on health outcomes,” Dr. Arthur KaplanHe is a bioethicist and founder of the Department of Medical Ethics at New York University Grossman School of Medicine in New York City.
Kaplan added that in addition to improving access to health insurance, the United States needs to make sure health care is available everywhere. He said, “We need to find ways to get services to rural people or the poor, because even if they have insurance, it doesn’t mean there is a doctor around.”
He said better use of technology, including telemedicine, might help fill some of those gaps. Primary care provided by physician assistants, nurse practitioners, and pharmacists can improve access to health care.
“We have to be more creative than we have been to provide services there,” Kaplan said.
Kaplan suggested that focusing on prevention and wellness in schools and other community settings might also help people live longer.
He said improving access to primary care physicians is an important part of the solution Emma Wagera policy analyst at the Kaiser Family Foundation in San Francisco.
“We have fewer physicians than other countries, and fewer Americans see a primary care physician each year, which is a major reason why we have poor health outcomes,” Wager said, because people who see primary care physicians tend to be better off.
Sources: Munira Junga, MPH, Senior Researcher, International Program in Health Policy and Practice Innovations, Commonwealth Fund, New York City; Arthur Kaplan, MD, bioethicist, founder of the Department of Medical Ethics, New York University Grossman School of Medicine, New York City; Emma Weiger, Policy Analyst, Kaiser Family Foundation, San Francisco; commonwealth fund, American healthcare in a global perspective, 2022, January 31, 2023