U.S. Health Care Erodes, Costs Too Much, Covers Too Little, Excludes Too Many

by Mike Hall, Jul 21, 2008

Not only is the U.S. health care system on the “wrong track” and needs to “change direction,” but its performance is declining, it costs too much and ranks below most other industrialized nations in terms of access and quality.

A new report from the Commonwealth Fund, a nonprofit research group, warns:

Rising costs put families, businesses, and public budgets under stress, pulling down living standards for middle- as well as low-income families. New national policies that take a coherent, whole-system, population view are essential for the nation’s future health and economic security.

The report, released last week, is the group’s second National Scorecard on U.S. Health System Performance and examines access, quality, healthy lives efficiency and equity. It finds:

Overall, performance did not improve from 2006 to 2008. Access to health care significantly declined, while health system efficiency remained low….Of greatest concern, access to health care has significantly declined. As of 2007, more than 75 million adults—42 percent of all adults ages 19 to 64—were either uninsured during the year or underinsured, up from 35 percent in 2003.

The U.S. spends more than twice as much per person for health care as most of the other 19 industrialized nations studied. But the report finds that the U.S. ranks last in deaths that might have been prevented with timely and effective care. The scorecard estimates 101,000 lives could have been saved if the U.S. matched the mortality rates of the top nations.

The report also says since 2006, delivery rates for basic preventive care have not improved. In addition, 37 percent of U.S. adults reported going without needed care because of costs in 2007, versus only 5 percent in the benchmark country, the Netherlands. (See chart.)

Other findings from the report:

• By 2007, two of five adults (41 percent) reported they had medical debt or problems with medical bills, up from 34 percent in 2005.
• People of color, low-income or uninsured adults and children were generally more likely to wait when sick, to encounter delays and poorly coordinated care, uncontrolled chronic disease, avoidable hospitalizations and worse outcomes.
• As insurance premiums rose faster than wages, the share of non-elderly adults living in a state where group health insurance premiums averaged less than 15 percent of household income dropped sharply, from 58 percent in 2003 to 25 percent in 2005.
• U.S. health insurance administrative costs as a share of total health spending are 30 percent to 70 percent higher than in countries with mixed private/public insurance systems and three times higher than in countries with the lowest rates.

The report says “national leadership is urgently needed” to address health care reform that can provide quality health care for all.

In the presidential race, John McCain’s health care proposal rehashes President Bush’s failed scheme. It won’t cut costs, won’t cover more people and would raise taxes on employees, pushing workers out of job-based plans and leaving them at the mercy of the private insurance market.

Meanwhile, Barack Obama’s health care plan would give everyone access to same quality coverage members of Congress get and would and improve current benefits and coverage.

Earlier this month, the AFL-CIO joined the coalition Health Care for America Now in a nationwide campaign to build support for health care reform when a new president and Congress take office in 2009. (Check out the new video, “Health Insurance Company Rules.”)

Part of that campaign takes place in August during the summer recess for Congress. Local and state union leaders and activists will meet with key representatives, senators and candidates in home district around the country to stress the need for action on health care reform when a new Congress and president take office.

Click here to download the full report or summary of National Scorecard on U.S. Health System Performance.

Print This Article | E-Mail This Article |Comments (3)