Last week, we posted a blog entry about the observations of a group of visitors from the United Kingdom on the state of health care in the United States. Our country’s fragmented and inequitable health care system shocked our visitors and they expressed great concern that the UK’s conservative led government was leaning toward a U.S. style health care system. The recent release of Health at a Glance 2011, a report published by the Organization for Economic Cooperation and Development (OECD) on the health systems of its 34 member countries, affords another opportunity to see how the U.S. stacks up to other countries throughout Europe, North and South America, and the Asia-Pacific region.
The report looks at a variety of indicators in health status and the health workforce and breaks down key findings by country. Overall, medical care has improved in OECD countries and life expectancy has increased dramatically over the past 50 years. However, the United States suffers in comparison to other OECD countries in a number of ways. While the U.S. stands out in the area of cancer care, its rate of avoidable hospital admissions for chronic conditions, such as asthma or pulmonary disease, is much greater than the OECD average. For diabetes prevalence, only the U.S. and Mexico have more than 10% of the adult population living with the disease. The U.S. is also the most obese country in the group, with 34% of its adult population classified as obese in 2008, an increase from 15% in 1980. In childhood obesity, the U.S. ranks second only to Greece.
In health care expenditures, the U.S. ranks first by far, spending 17.4% of its GDP on health care in 2009. The next closest country is the Netherlands, which allocates 12% of its GDP to health care, but has much better health outcomes. Almost all the countries in the OECD rely on the public sector as the main source of health funding, but in the U.S. more than half of health spending in 2009 was through the private sector. In other words, the U.S. spends a larger portion of its GDP on health care than any other OECD country, but it also spends proportionately less from the public coffers than the other countries in the group. Despite these huge expenditures, health outcomes in the U.S. are mediocre at best and dismal at worst when compared to other developed nations.
These reports should serve as a wakeup call that our health care system is failing the American people. Health spending per capita is much higher in the U.S. than any other OECD country, but yet our obesity and diabetes rates are skyrocketing. The already high hospital admission rate for chronic disease will only increase as diabetes and obesity related complications require medical intervention. And the troubling childhood obesity statistics are a dangerous omen for future generations and their impact on the system. The Affordable Care Act offers some remedies for these pressing issues, such as promoting a more integrated and coordinated model of care and providing more support and incentives for primary care doctors, but to get the U.S. to where it should be there need to be major changes in how health care is delivered. Being the richest country in the world doesn’t mean as much when its people can’t live a healthy life.