A report from the Commonwealth Fund finds that, although our health care costs have have increased at twice the rate, our gains in life expectancy, over the last 30 years, have lagged behind the 12 other countries in the study. White women fared the worst of all groups.
The usual suspects of obesity, smoking, traffic fatalities, and homicide are not the cause, says the report.
The culprit appears to be attributable to flaws in the overall health care system.
The report points to the role of unregulated fee-for-service payments and our reliance on specialty care as possible drivers of high spending without commensurate gains in life expectancy.
“This study provides stark evidence that the U.S. health care system has been failing Americans for years,” said Commonwealth Fund President Karen Davis. “It is unacceptable that the U.S. obtains so much less than should be expected from its unusually high spending on health care relative to other countries.” The good news is that the Affordable Care Act will take significant steps to improve our health care system and the health of Americans by expanding health insurance, improving primary care, and holding health care organizations accountable for their patients’ overall health and ensuring the coordination of primary care and specialty care to eliminate errors, waste of patients’ time, and wasteful duplication of tests and services.”
The study, by Peter Muennig and Sherry Glied at Columbia University, looked at health spending; behavioral risk factors like obesity and smoking; and 15-year survival rates for men and women ages 45 and 65 in the U.S. and 12 other nations (Australia, Austria, Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Sweden, Switzerland, and the United Kingdom).
Key Findings of the study “What Changes in Survival Rates Tell Us About U.S. Health Care.”:
- Even as health care spending per capita has increased in the U.S. over the last three decades, the nation has fallen behind 12 other wealthy nations in 15-year survival for men and women at ages 45 and 65.
- By 2005, 15-year survival rates for 45-year-old white women in the U.S. were lower than in all comparison countries; these rates had not even surpassed 1975 survival rates for Swiss, Swedish, Dutch, or Japanese women.
- U.S. white men ages 45 and 65 experienced declines in their rankings in 15-year survival rates among the comparison countries, but they were not as dramatic as the declines in rankings for women.
- While smoking and obesity are two important behavior-related risk factors, they do not explain the nation’s deteriorating performance. Prevalence of obesity in the U.S. has grown more slowly in the U.S. than in other nations, and smoking prevalence has declined more rapidly.
The Commonwealth Fund