US Leads in Health Spending, But Lags in Health Outcomes Among Rich Countries | Partner Content: Life and Lifestyles

TUESDAY, Jan. 31, 2023 (HealthDay News) — The United States spends up to four times more on health care than most wealthy countries, but it doesn’t have much to show for it.

Life expectancy in America continues to fall even as this country spends nearly 18% of its gross domestic product on health care, according to a new report from the not-for-profit Commonwealth Fund.

“The United States stands out as the only nation in the Organization for Economic Co-operation and Development [OECD] without universal health coverage, our life expectancy decreases and we have higher preventable death rates than other countries,” the report author said. Munira Gunja. She is a senior researcher for the Commonwealth Fund’s International Health Policy and Practice Innovation Program in New York.

Besides the lack of universal health care coverage, the United States has too few primary care providers and does not spend enough on primary care, making it difficult for people to get basic preventive health care. and puts them in place for chronic conditions, she added. .

In the report, Gunja’s team compared health care spending and outcomes in the United States with those of 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 has failed to comply with many measures.

Americans had the lowest life expectancy at 77, three years less than the average for people in other wealthy countries.

Despite spending more on health care than other countries, the United States also continues to have the highest rates of preventable deaths from diabetes, high blood pressure-related diseases, and certain cancers, and the highest rate of people living with multiple chronic conditions, according to the report. found. The obesity rate in the United States is almost double that of other OECD countries.

Moreover, the United States also had the highest death rate from COVID-19 compared to other countries. And Americans are more likely to die from physical attacks, including gun violence, despite the country having the highest infant and maternal mortality rates among OECD countries.

Even though U.S. breast and colon cancer screening and flu shot rates are among the highest in the world, COVID-19 vaccination rates lag behind many countries, according to the new report.

There has been some progress in expanding access to health insurance in the United States, but more work needs to be done to close the gaps and provide people with the health care they need. said the researchers.

Enacted in 2010, the Affordable Care Act (ACA, or “Obamacare”) opened a market for purchasing affordable health insurance. More than 3 million new people signed up for health insurance through the ACA this year, bringing the number of enrollments to a record 16.3 million Americans.

Despite the ACA, millions of Americans still cannot afford coverage and/or live in health care deserts without access to doctors. “Many states haven’t expanded Medicaid, so they don’t have good affordable options,” Gunja noted.

“We need to make sure everyone has access to an affordable health insurance plan and that preventive care is free with no co-pays,” Gunja said. “We need to invest in the primary care workforce, provide incentives for doctors to enter primary care, and enact loan forgiveness for medical school debt, otherwise we can never solve this. crisis.”

But it is still possible to turn the tide. “Other countries have done it, so we should be able to do it too,” she said.

American 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 spending too much on what others get for much less money, with no effect on health outcomes,” said Dr. Arthur Caplanbioethicist and founder of the Division of Medical Ethics at NYU’s Grossman School of Medicine in New York City.

In addition to improving access to health insurance, the United States must ensure health care is available everywhere, Caplan added. “We need to find ways to reach rural or poor people because even if they have insurance, that doesn’t mean there’s a doctor nearby,” he said.

Better use of technology, including telemedicine, could help fill some of these gaps, he said. Primary care provided by physician assistants, nurse practitioners and pharmacists can also improve access to health care.

“We have to be more creative than we have been in delivering services,” Caplan said.

Focusing on prevention and wellness in schools and other community settings can also help people live longer, Caplan suggested.

Improving access to primary care physicians is an important part of the solution, said Emma Betpolitical analyst at the Kaiser Family Foundation, San Francisco.

“We have fewer doctors than other countries, and fewer Americans see a primary care physician each year, and that’s one of the biggest reasons we have poorer health outcomes,” he said. said Wager, because people who see primary care physicians tend to fare better.

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SOURCES: Munira Gunja, MPH, senior researcher, International Program on Innovations in Health Policy and Practice, Commonwealth Fund, New York; Arthur Caplan, MD, Bioethicist, Founder, Division of Medical Ethics, NYU Grossman School of Medicine, New York; Emma Wager, policy analyst, Kaiser Family Foundation, San Francisco; Commonwealth Fund, United States health care in a global perspective, 2022, January 31, 2023

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