The United States spends more on health care than 12 other industrialized countries, yet does not provide notably better care, according to a study from The Commonwealth Fund. The United States spent nearly $8,000 per person in 2009, while other countries in the study spend between one-third (Japan and New Zealand) and two-thirds (Norway and Switzerland) as much.
High U.S. spending on health care does not seem to be explained by either greater supply or higher utilization of services. There were 2.4 physicians per 1,000 population in the United States in 2009, fewer than in all the countries except Japan. The United States had the fewest doctor consultations (3.9 per capita) of any country except Sweden. And relative to the other countries in the study, the United States also had fewer hospital beds, shorter lengths of stay for acute care, and fewer hospital discharges per 1,000 population.
On the other hand, U.S. hospital stays were far more expensive than those in other countries — more than $18,000 per discharge. By comparison, the cost per discharge in Canada was about $13,000, while in Sweden, Australia, New Zealand, France and Germany, it was less than $10,000.
Prices for the 30 most commonly used prescription drugs were a third higher in the United States compared with those in Canada and Germany, and more than double the prices in Australia, France, the Netherlands, New Zealand and the United Kingdom. MRI and CT scans also were more expensive in the United States, and U.S. physicians received the highest fees for primary care office visits and hip replacements.
U.S. health care involves greater use of expensive technology than in many other countries. The United States performed the most MRI and CT scans among countries for which data were available. Knee replacements were also performed more often in the United States than in any country except Germany, although hip replacements were not as common as in most other study countries.
High spending does not always translate into high-quality care. The Commonwealth Fund reported that the United States had the highest survival rate in the study for breast cancer, as well as the best survival rate, along with Norway, for colorectal cancer. However, the cervical cancer survival rate in the United States was worse than average and well below that of Norway.
Compared with other countries in the study, the United States had high rates of asthma-related deaths among people aged 5 to 39 and, along with Germany, very high rates of amputations resulting from diabetes. U.S. rates of in-hospital deaths after heart attack and stroke were average.
For more information, go to www.cmwf.org.