Measuring the U.S. Health Care System: A Cross National Comparison

Measuring U.S. HealthCare System: A Cross-National Study
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Measuring U.S. HealthCare System: A Cross-National Study
This paper evaluates the current state of healthcare in the United States of America. By looking at the state of the member countries of the OECD (Organization for Economic Cooperation and Development), a picture of the American health system can be estimated. The OECD monitors the member countries and generates yearly reports from over 1,200 health system in 30 developed countries. Different measures and parameters are used in the generation of these reports. Cross-national comparisons have allowed assessment of the U.S. healthcare system, point out the strong points and vulnerabilities, and highlight the possible undermining or facilitating factors for improvement. The United States of America spends more than most OECD countries on healthcare but still gets worse outcomes. (OECD, 2016)
Current data from the OECD demonstrates that of its total gross domestic product (GDP) the United States expended 17.1 percent on healthcare in 2013, making it the biggest spender among the OECD countries (Anderson & Squires, 2010). It is 50 percent above the country with the second-highest expenditure, France, which spends up to 11.6% of GDP on health, and is almost twice that of The UK which expends 8.8% of the GDP. The common U.S. citizen spent $1,074 out-of-pocket on healthcare on costs such as payment of check ups at the doctors’ offices and common prescription medication besides medical insurance plan payments in 2013.

Switzerland spent $1,630 and is the only country whose citizens incurred medical costs that exceeded the American expenditure. The expenses of France and the Netherlands, when compared to America, are almost negligible. The bulk of the expenditure in proportion to other countries, in the US health system, falls in the private citizen’s health care – whooping $3,400 per capita. This cost of private health care exceeds the amount for the second Canada, by four times the total Canadian expenditure on private health care. This fact is astonishing in the light of the fact that Canada is the second highest spender on the private health care. U.S. public spending on healthcare is high, despite use by fewer residents. It stood at above $4,000 per capita in 2013 and was greater than that expenditure in the health sector in most countries. There were only two exceptions, Norway and Netherlands. Norway spent up to $4,981 in its health sector while the Netherlands spent up to $4,495. Amongst all the countries that were included in the study, it was only the U.S. that lacked a universal healthcare system. Around 34% of the citizens were covered by at least one public health insurance programs in 2013 in America, such as Medicare and Medicaid (Li, 2016). However, for the UK every citizen is a direct beneficiary of the public system and the total amount spent per capita was approximately $2,800. The public expenditure on healthcare in the U.S. is seemingly small only because the tax exclusion for health insurance sponsored by employers are not included as part of the public expenditure. If they were, this cost would balloon remarkably. Since 2009, another trend has emerged; expenditure in the health sector for most countries and including the USA seems to be taking on a downward trend. From 2.47% between 2003 and 2009, the per capita growth rate in the US was at a low of 1.5% in five years time. This pattern reflects a significant downward trend in this index. The peculiar timing of this downward trend coupled with its global aspect where most countries were affected, presupposes that the international financial crisis may have been a great contributor to the phenomenon, more than any other factors.
While the financial resource that the Americans dedicate to their health system is higher than it is for most OECD countries, the Americans invest less time in health practices such as routine check-ups and even have noticeably fewer medical facilities (Murray & Frenk, 2010). The number of physicians in the U.S. who are actively practicing average 2.6 per 1000 population. This is inadequate to give comprehensive care to the people of America. Although other OEC countries have a rate of only 3.2 practicing doctors per 1000 population, the difference with the American rate contributes a lot to the difference in the quality of the health system. Also, in America, the physician visits were less than the OECD median of 6.5 visits. In comparison, the average Canadian visited the doctor 7.7 times, while a resident of Japan would visit the doctor up to 12.9 times in 2012. Compared side by side, the markers for efficiency and effectiveness of the health systems in American and other OECD countries indicate that the American health sector is in need of intervention. In the United States, the hospital capacity was far less than in other countries as evidenced by the fewer hospital beds. The number of discharges in the same nation was lower than in most OECD countries.
Diagnostic imaging and interventional radiology are highly valued in America. Alone, the U.S. has one of the highest per capita consumption of the medical imaging technology. The downside to the high technology consumption is that the cost of medical care is high. The paradoxical poor outcomes are the result of prioritizing technology. The US health system promotes the integration of technology into the health practice. However, this approach is more of a brute force approach where bigger is better and ignores the utility of simple routine medical practices such as check-ups. Also, there is a high rate of use of prescription drugs in the U.S. and New Zealand than in many other countries. In these two countries, the adults, use at least 2.2 prescription drugs per adult.
In 2001, the cost f both private and public health services were relatively high. By-pass surgeries were more affordable in other OECD countries than in the U.S. The research also reported that MRI and CT imaging services were most costly in the U.S. The pricing data is not very reliable or accurate. The data collection methodology may not be entirely foolproof, and the implications of the data may be less than imagined. Still, the data shows a pattern of greater prices in several areas of U.S. health care. (Squires & Anderson, 2015).
The high U.S. prices for pharmaceuticals have been reported by other studies. Kanavos and colleagues did an investigation that approximated the cost of commonly used medications for the inpatient management. The medications’ cost was used to create an index that could be used to compare the cost of pharmaceuticals across different countries. The cost of pharmaceuticals in the United States outweighed the other OECD countries. Other countries such as Australia provide the same drugs as the U.S. at only have the price. For population health indices that were assessed, Americans had less promising outcomes than international peers. At birth, the live infant in America has an expectancy of 78 years. While this may seem favorable, it I low when compared to the median OECD life expectancy of 8 years. Also, U.S. had a surprisingly high infant mortality rate. On average, every six children out of 1,000 live births died in 2011. The American infant mortality rate was almost double the OECD median country infant mortality rate of 3.5 deaths for each 1000 live births.
Chronic diseases are prevalent amongst the elderly in the U.S. A 2014 Commonwealth Fund Survey shows that 68 in each hundred U.S. adults over 65 years had one chronic medical condition and another one accompanying it as a comorbidity. Outside America within the OECD zone, this figure oscillates between 33 and 56 per cent.
In 2013, the Institute of Medicine compared the American system to that of the other high-income countries. The U.S. was seen to perform poorly on several important factors of health. The prevalence of obesity among the adults is at least 33 percent. When compared to the country with the highest rate, New Zealand, at 15%, the United States is faring poorly in the health sector. Although the smoking rates are low, the population still suffers from the effect of high smoking rates from earlier periods. The smoking rates, as of 2013, were very low, whereas the 1960s were a time of very prevalent tobacco abuse in the United States. The effects of the use of tobacco are numerous. It is a plausible postulation that the poor health status of the elderly residents of the United States is attributable to this period of tobacco abuse. Other likely causes of the United States’ health disadvantage may include a burden of many citizens without adequate health coverage, and also a great degree of variation in lifestyle with many individuals adopting unhealthy practices, environmental factors that do not favor good health, and high rates of accidents and violence. According to the Institute of Medicine, deteriorating health and health service provision in the U.S. is not just the result of socioeconomic, or ethnic differences. It cuts across the board.
Healthcare spending in the U.S. surpasses spending on the same in other countries. Investment in health has extensive consequences to the U.S. economy. On the macroeconomic level, the wage of the health workers is heavily dependent on this expenditure. On a personal level, bankruptcy because of health expenses is not uncommon. Expensive health systems are detrimental to other social systems on which the health systems rely. This is because they all draw from a common pocket. In the U.S., healthcare spending markedly is more than that of social services. Such an imbalance is harmful to the whole system.

References
Anderson, G.F., Squires D.A.(2010). “Issues in International Health Policy.”The Commonwealth Fund.
Squires D., Anderson C. (2015). “U.S. HealthCare from a Global Perspective.” The Commonwealth Fund.
OECD (2016). Members and Partners. OECD. Retrieved from <http://www.oecd.org/about/membersandpartners/>.
Murray C.J.L., Frenk J. (2010). Measuring the Performance of the U.S. Health Care System.
New Engl Journal of Medicine, 362, 98-99
Li Y.(2016). Defining and Measuring Quality of Care: A Perspective from US Researchers. International Journal for Quality in Health Care. 12(4), 281-295.