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HEALTH SPENDING IN THE UNITED STATES AND THE REST OF THE INDUSTRIALIZED
WORLD
Health Affairs of July/August 2005
By GF Anderson, PS Hussey, BK Frogner and HR Waters
Surprisingly, Americans have access to fewer health care resources than people in most other industrialized countries, measured in three major categories: hospital beds per capita, physicians and nurses per capita, and magnetic resonance imaging (MRI) and computed tomography (CT) scanners per capita [even though Americans pay twice per capita and have less people covered to access these health care resources].
There are several reasons to believe that waiting lists explain little of the difference. First, not every OECD country experiences waiting lists. The OECD Waiting Times project identified seven countries besides the USA that did not perceive that they had a problem with waiting times. Health spending in the twelve countries with waiting lists averaged $2,366 per capita, while in the seven countries without waiting lists, it averaged $2,696.
Furthermore, procedures for which waiting lists exist in some countries represent a small part of total health spending. We calculated the amount of U.S. health spending accounted for by the fifteen procedures that account for most of the waiting lists in Australia, Canada, and the United Kingdom. Total spending for these procedures in 2001 was 3 % of US health spending in that year.
Although malpractice litigation is a growing problem in the United States as well as in Australia, Canada, and the United Kingdom, there is limited evidence that it is responsible for much of the difference in health spending levels between the United States and these countries. In all four countries, malpractice litigation costs for claims against physicians are small compared with total health spending.
The finding that litigation and waiting lists do not explain most of the higher USA health spending is perhaps not surprising considering previous research showing that the prices of care, not the amount of care delivered, are the primary difference between the US and other countries. These higher prices are increasingly making health care unaffordable for many Americans. Equally troubling, the more-costly US health care has not resulted in demonstrably better technical quality of care or better patient satisfaction. Future US policies should focus on the prices paid for health services and on improving the quality of those services.
You may still have access to the article's abstract CLICK HERE
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OUTCOMES AND COST OF CORONARY ARTERY BYPASS GRAFT SURGERY IN THE UNITED
STATES AND CANADA
Archives of Internal Medicine of July 11, 2005
By MJ Eisenberg, KB Filion, A Azoulay, AC Brox, S Haider, L Pilote
Coronary artery bypass graft surgery (CABG) requires substantial resources
in Canada and the United States. However, patients undergoing CABG at US
hospitals incur approximately twice as much cost compared with those at
Canadian hospitals, with little difference in clinical outcome and despite
shorter average LOS (length of stay). The difference in total in-hospital
costs is almost equally attributable to differences in direct and overhead
costs between the Canadian and US hospitals. This cost differential
primarily reflects higher resource prices for products and labor and higher
overhead costs in the United States resulting from a nonsocialized medical
system.
You may still have access to the article's abstract CLICK HERE
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1 According to a Los Angeles Times article by Judy Foreman on Feb 23 2004: "An impressive array of data shows that Canadians live longer, healthier lives than we do. What's more, they pay roughly half as much per capita as we do ($2,163 versus $4,887 in 2001) for the privilege. " Foreman wrote this subheading for her article: :Want a health tip? Move to Canada. |
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