American are spending more on health care but why?

Healthcare in US costs 2x as much as other rich nations

Despite efforts to control healthcare costs, the still spending about twice as much as other high-income countries on medical care, according to a new JAMA report.

More doctor visits and hospital stays aren't the problem. However, on a per capita basis, the USA spends much more than any other country: $9451 in 2015, compared to Germany's $5267.

The US ranked last in life expectancy; had the worst maternal mortality rates (nearly triple that of the United Kingdom); more infant deaths than any other country, and a high rate of low birth weight babies.

Despite beliefs to the contrary, "the United States has lower rates of physician visits and days spent in the hospital than other nations", said the report.

Instead, the main drivers of higher healthcare spending in the USA are generally high prices, particularly for medical devices and pharmaceuticals.

Despite this, the United States still lags behind all other developed countries when it comes to the quality of said healthcare. Other nations spend between 1%-3% to administer their health plans.

But, contrary to popular belief, the researchers did not find that people in the USA use the medical system significantly more often than those in other countries - nor did they find that the way Americans use the medical system accounts for the disconnect in spending. "This gap and the challenges it poses for American consumers, policymakers, and business leaders was a major impetus for healthcare reform in the USA, including delivery reforms implemented as part of the Affordable Care Act", said senior author Ashish Jha, a professor at the Harvard Global Health Institute (HGHI). The U.S. was also similar concerning utilization rates for acute myocardial infarction, pneumonia, chronic obstructive pulmonary disease, hip replacement, knee replacement and coronary artery bypass graft surgery.

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If the US did less imaging and fewer of 25 common procedures, and lowered prices and the number of procedures to levels in the Netherlands, it would translate into a savings of $137 billion, Dr. Ezekiel Emanuel of the Perelman School of Medicine at the University of Pennsylvania writes in an accompanying editorial.

"As the USA continues to struggle with high healthcare spending, it is critical that we make progress on curtailing these costs".

Meanwhile, US life expectancy in the US was the lowest of all 11 countries in the study, at 78.8 years.

The US is also the only developed country which doesn't offer universal healthcare. The U.S. insured population of 90% was also well below the other countries that ranged from 99% to 100%. For example, life expectancy in Hawaii, Minnesota and CT were similar to other high-income countries, while life expectancy was much worse in states like Mississippi.

However, the US had higher utilization of magnetic resonance imaging and CT scans compared to the others.

"Although some states and regions throughout the US serve as excellent laboratories for best practices, these parts of the USA system need to be shared with greater equity so that underperforming US regions can and will demand better care", Parente writes.

"It is quite challenging to disentangle the share of worldwide differences in spending driven by differences in the quantity of care used and differences in the prices paid for that care, given how hard it is to measure quality and intensity of care", Katherine Baicker, author of a separate editorial and dean of the Harris School of Public Policy at the University of Chicago, said by email.


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