U.S. Health-Care System Gets a "D"

By Catherine Arnst Thu Sep 21, 3:08 AM ET

The U.S. health-care system is doing poorly by virtually every measure. That's the conclusion of a national report card on the U.S. health-care system, released Sept. 20. Although there are pockets of excellence, the report, commissioned by the non-profit and non-partisan Commonwealth Fund, gave the U.S. system low grades on outcomes, quality of care, access to care, and efficiency, compared to other industrialized nations or generally accepted standards of care. Bottom line: U.S. health care barely passes with an overall grade of 66 out of 100.
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The survey was carried out by 18 academic and private-sector health-care leaders, who rate the system on 37 different measures. The poor grade is particularly discomfiting, the researchers note, because the U.S. spends more on medicine, by far, than any other country. Approximately 16% of the nation's gross domestic product (
GDP) is devoted to health care, compared with 10% or less in other industrialized nations.

Health care is also responsible for most new job creation, according to BusinessWeek's Sept. 25 cover story (see BusinessWeek.com, 9/25/06, "What's Really Propping Up The Economy"). Yet the U.S. ranks 15th out of 19 countries in terms of the number of deaths that could have been prevented. The study estimates that each year 115 out of 100,000 U.S. deaths could have been avoided with timely and appropriate medical attention. Only Ireland, Britain, and Portugal scored worse in this category, while France scored the best, with 75 preventable deaths per 100,000.

Below Potential.
The U.S. ranks at the bottom among industrialized countries for life expectancy both at birth and at age 60. It is also last on infant mortality, with 7 deaths per 1,000 live births, compared with 2.7 in the top three countries. There are dramatic gaps within the U.S. as well, according to the study. The average disability rate for all Americans is 25% worse than the rate for the best five states alone, as is the rate of children missing 11 or more days of school.

The report found that quality of care and access to care varied widely across the country, and it noted substantial gaps between national averages and pockets of excellence. The authors concluded that, if the U.S. improved and standardized health-care performance and access, approximately 100,000 to 150,000 lives could be saved annually, along with $50 billion to $100 billion a year.

The Commonwealth Fund, which studies health-care issues, commissioned the report last year as part of an effort to come up with solutions to the nation's troubled health-care system. The report "tells us that overall we are performing far below our national potential," says Dr. James J. Mongan, chairman of the team that pulled together the study and chief executive officer of Partners Healthcare in Boston. "We can do much better and we need to do much better," he says.

Among the reports' findings:

--Only 49% of U.S. adults receive the recommended preventive and screening tests for their age and sex.

--Only half of patients with congestive heart failure receive written discharge instructions regarding care following hospitalization.

--Nationwide, preventable hospital admissions for patients with chronic health conditions such as diabetes and asthma were twice as high as the level achieved by the best performing states.

--Hospital 30-day re-admission rates for Medicare patients ranged from 14% to 22% across regions.

--One-third of all adults under 65 have problems paying their medical bills or have medical debt they are paying over time.

--Only 17% of U.S. doctors use electronic medical records, compared with 80% in the top three countries.

--On multiple measures across quality of care and access to care, there is a wide gap between low income and the uninsured, and those with higher incomes and insurance. On average, measures for low income and uninsured people in these areas would have to improve by one-third to close the gap.

--As a share of total health expenditures, insurance administrative costs in the U.S. were more than three times the rate in countries with integrated payment systems.

http://news.yahoo.com/s/bw/20060921/bs_ ... NlYwM5NjQ-

HUGE surprise!

That we aren't #1 or that G_V posted this? OH SNAP!

I think we have an excellent health care system....the big problem is the cost to the "consumer." We need to make health care much more affordable than it is. Universal Healthcare, while appealing in some aspects, won't fix things. We're better off with the system we have now, but it does need some work.
We are still the leader in research and at the cutting edge for new medical technology.

I absolutely hate these types of papers.

Let's be honest here, there are HUGE gaps of erroneous data that falls into studies like this. When you look at a study like this, you should automatically assume that we're gonna end up at the bottom of it simply because of our society.

- Infant Mortality. No shit huh. Find me a nation with more crack babies, alcohol babies and generally doped up babies. Find me a country where moms treat their future babies like worse shit. It doesn't exist. Then you couple that with the fact that prenatal care here is just SO GOOD. I wonder how our women compare in terms naturally aborted fetus'. I always pin high infant mortality rates on the environments that these children and feti' grow up in. Not our healthcare system. Further more, is 115 out of 100,000 really all that dramatically higher than 75 out of 100,000?

- Life expectancy. Yeah, no shit there too. American's live FAR unsafer and unhealthier lives than any other country.

- I understand that access to healthcare is going to vary. It's obviously gonna be a lot harder to get to a hospital in rural Idaho than if you live in a major city. But how is standardizing everything going to save lives and then on top of it save money? I'm really confused there, because so far as I can tell, if you brought every medical center up to par with the best place, it would only cost more money. Especially when most treatments are ambulatory.



I'm sorry, but this is NOT an indictment of our healthcare system. This is an indictment of our SOCIETY. I don't recieve necessary recommended preventative tests and screenings. But that's because I'm too lazy to give a shit. It's not because I can't do it and our healthcare system is inept at providing the service to me. The majority of the people in that lot fall into my category.







This is NOT because of our healthcare system!!! YAAAAAAAAARGH!!!! This is because our nation is full of fat disgusting slobs. We have diabetes because our nation is fat. We have asthma because we're lazy and nobody goes the fuck outside to play cowboys and indians. We sit inside and play fucking Halo, visit Red Mosquito, and breath in bad air our entire fucking lives.



That is another social problem.

It's no surprise really as the most Obese nation on earth you're gonna have some problems. But generally I've been told that if you can afford it the hospitals are very good.

Liberal guilt makes me preface this with saying it's not racist;

BUT

I would how all these 'superior' helath care systems would be if the authors scaled the racial diversity of the US to match the nations in the report. The US has massive immigrant populations which tend to take time adjusting to changes in economic systems and overburden hospitals and government.

This one cracks me up. NC offers free software to manage your immunization records, but it's new so a lot of doctors aren't on the system. When they get on, the number of unneeded or missing shots is always staggering. I can't believe how much public vaccine gets wasted because doctors can't keep track of the shots that they're giving kids.

Some offices don't even have computers. NO COMPUTERS! How does a doctor stay viable without even one computer in the office!!!

Either I’ve been drunk for the past week, or something has been in the water over here because I’ve been in complete agreement with LW’s posts for well, at least a week.

Doctors who run the practices are old, white men who are set in their ways. They call the shots as far as the administrative systems go. The young doctors who might be more receptive to using electronic record keeping, are not in a position of power yet. They will be soon though.

Also when more healthcare corporations take over (I don't know what to call them but my doctor works for Compass Medical, which has several doctors and several buildings. Kinda like Aspen Dental but for doctors) these companies will insist on transferring records to all computer.

It means they can hire much fewer staff members to do the same amount of work. Every time I go to Compass Medical some medical assistant types my symptoms into a computer, then the doctor comes in for 2 minutes, looks at the computer, and then patches me up. I swear the fucking computer dianoses me now. But it makes for a speedy trip to the doctors. Yet I find myself misdiagnosed a lot more now....

Yeah, I pretty much agree with every point he made above also.

I still have no health insurance......5 years and counting. Just thought i would keep everybody informed

As of Oct 9th I go uncovered for 120 days because I'm starting a new job. It's really scary. When I started my job at SPIN, I was only making $7 an hour. I got sick the first month there, but still had weeeeeks to go before I could go to the Dr. I went the first day my insurance covered me, and by then I had bronchitis AND Pnemonia at the same time. Which I didn't even think was possible. . .LOL. Without the insurance, my Dr visit and meds would have cost over $300. That's more than I made in a week after taxes.

$300. For one dr. visit, and one script for antibiotics.

And my boyfriend just found out yesterday that his sore throat wasn't from the potato chip he swallowed wrong over the weekend. It's Strep throat. And he slept over my house Monday. Grrr. So I'm probably going to get Strep throat in the next day or so. If this was a month from now, I'd be in some biiiiiig trouble.

And now we have this article.

http://news.yahoo.com/s/ap/20060927/ap_ ... re_quality

Quality of health care in U.S. improves

By KEVIN FREKING, Associated Press Writer Wed Sep 27, 12:59 AM ET

WASHINGTON - The quality of the health care provided to millions of Americans improved last year across several dozen categories, including increased immunization rates among insured children.
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The improvements are seen through the reporting of data that the White House and Congress want more of from health-care providers. They're contained in a report being issued Wednesday by the National Committee for Quality Assurance, which accredits and certifies insurers.

The association tracks dozens of care measurements, submitted by many of the nation's insurance plans. The long-term tracking of the measurements helps improve the quality of care, according to the report.

For patients in private insurance plans, there was improvement in 35 of 42 measurements, including such categories as cervical cancer screening, colorectal cancer screening and the controlling of high blood pressure in hypertension patients.

Categories that showed a decrease in the quality of care included breast cancer screenings. The percentage of women in commercial insurance plans, ages 50-69, who got a breast cancer screening in the past two years dropped to 72 percent from 73.4 percent. Similar drops were seen in insurance plans covering Medicare and Medicaid patients.

The gains also include increased numbers of children with private health insurance getting all their recommended immunizations, with the rate reaching 77.7 percent, up from 72.5 percent. Also, more smokers enrolled in Medicare received advice about kicking the habit.

From year to year, many of the changes are small — often just a percentage point or two. But the differences come into clearer focus over a 10-year period, officials said.

For example, the committee said that more than 96 percent of patients who suffered heart attacks last year were given drugs to lower their blood pressure and slow the heart rate, which helps prevent a second attack. A decade ago, about 62 percent of patients suffering heart attacks were given such medicines.

One in four Americans are enrolled in health plans that collect and report data on the quality of care. However, more than 100 million Americans are enrolled in plans that report no objective quality data, the report said.

"This past decade has demonstrated the benefits of measurement, reporting and accountability, but three out of four people don't enjoy those benefits today," said Margaret E. O'Kane, the president of the National Committee for Quality Assurance. "It's time to ask, 'Why not?'"

The committee noted that one important exception to a pattern of improvement was the quality of care for Americans with mental health problems. Patients in insurance plans who are hospitalized for mental illness are only marginally more likely to get appropriate follow-up care than they were when the insurers began collecting quality data in 1998.

[img]Doctors who run the practices are old, white men who are set in their ways. They call the shots as far as the administrative systems go. The young doctors who might be more receptive to using electronic record keeping, are not in a position of power yet. They will be soon though. - lorelie[/img]

I'll be honest, I don't know how things are run in the cities. I worked at a small town hospital. And I gotta say, from my observation it's one of the most racially diverse fields out there. Where I come from, typically, each doctor has some pretty powerful say over how they run things. It's not dictated by hospital administration, or odl white doctors set in their ways. But again, it may be different where you are.

Perhaps I misunderstand, but I think that Lorelie is refering to private medical offices. I wouldn't imagine that hospitals have any problem switching over to electronic systems, and most if not all already have. However, when it comes to primary care doctors or specialists who see their patients outside of the hospital setting, the likelihood of using electronic files significantly diminishes, at least in my experience.

I was speaking of private practices.

That is what I meant. Hospitals are a whole different animal. I find that in most private practices, there are one or two older doctors who run the show. Or the medical corporation company runs the show. I imagine most people spend more time at doctor's offices than hospitals. Hopefully.

Roger, I thought you were refering only to the hospital's system.

The private practice I worked in did not have an electronic file system, but then again it was a terribly mismanaged office to begin with so that was the least of their problems. When you have three different doctors where one is interested primarily in profits, one hates his job in general and the one who's supposed to be in charge is too busy to manage the office, things like software and records upgrades just fall through the cracks.

I would like to think that the office I worked at was the exception and not the rule.