U.S. health care lagging behind other countries

A new national scorecard says the U.S. system costs twice as much as other countries and isn't as good.

By Kevin B. O'Reilly, AMNews staff. Oct. 23/30, 2006.

There's lots of room for the U.S. health care system to improve on measures of health outcomes, quality, access, efficiency and equity, according to a national scorecard the Commonwealth Fund released last month.

The first annual scorecard examined how the United States' national average compared with the top 10% of industrialized nations, as well as states, hospitals and insurance plans here at home. Researchers looked at 37 indicators and found the United States scored 66 on a 100-point scale. The study also breaks down how the nation fares on the following five dimensions on the same 100 scale:

• Quality: 71
• Equity: 71
• Long, healthy and productive lives: 69
• Access: 67
• Efficiency: 51

Catherine Schoen, the lead researcher on the scorecard project, said the United States should be doing better considering that its system costs twice as much as that of other industrialized countries.

Areas where the U.S. national average falls short of the top performers include infant mortality, control of adult diabetics' hemoglobin A1c levels and the number of adults insured all year.

"These gaps cut across all core domains of performance," Schoen said, estimating that if the system could hit the study's benchmark rates it would save as many as 150,000 lives a year and save $100 billion in direct health costs.

James J. Mongan, MD, CEO of Boston's Partners HealthCare System Inc. and chair of the Commonwealth Fund's Commission on a High Performance Health System, said the scorecard draws attention to the tremendous variation in care available in the United States.