Monday, December 16, 2013

Fwd: qotd: U.S. ranks near bottom on efficiency of health care spending

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-------- Original Message --------
Subject: qotd: U.S. ranks near bottom on efficiency of health care spending
Date: Mon, 16 Dec 2013 11:39:40 -0800
From: Don McCanne <>
To: Quote-of-the-Day <>

UCLA Fielding School of Public Health
December 12, 2013
U.S. ranks near bottom among industrialized nations in efficiency of
health care spending

A new study by researchers at the UCLA Fielding School of Public Health
and McGill University in Montreal reveals that the United States health
care system ranks 22nd out of 27 high-income nations when analyzed for
its efficiency of turning dollars spent into extending lives.

The study, which appears online Dec. 12 in the "First Look" section of
the American Journal of Public Health, illuminates stark differences in
countries' efficiency of spending on health care, and the U.S.'s
inferior ranking reflects a high price paid and a low return on investment.

For example, every additional hundred dollars spent on health care by
the United States translated into a gain of less than half a month of
life expectancy. In Germany, every additional hundred dollars spent
translated into more than four months of increased life expectancy.

The researchers also discovered significant gender disparities within

"Out of the 27 high-income nations we studied, the United States ranks
25th when it comes to reducing women's deaths," said Dr. Jody Heymann,
senior author of the study and dean of the UCLA Fielding School of
Public Health. "The country's efficiency of investments in reducing
men's deaths is only slightly better, ranking 18th."

The study, which utilized data from 27 member countries of the
Organization for Economic Cooperation and Development collected over 17
years (1991–2007), is the first-known research to estimate
health-spending efficiency by gender across industrialized nations.

"While there are large differences in the efficiency of health
spending across countries, men have experienced greater life expectancy
gains than women per health dollar spent within nearly every country,"
said Douglas Barthold, the study's first author and a doctoral candidate
in the department of economics at McGill University.

The report's findings bring to light several questions. How is it
possible for the United States to have one of the most advanced
economies yet one of the most inefficient health care systems? And while
the U.S. health care system is performing so poorly for men, why is it
performing even worse for women?

The exact causes of the gender gap are unknown, the researchers said,
thus highlighting the need for additional research on the topic, but the
nation's lack of investment in prevention for both men and women
warrants attention.

American Journal of Public Health: Abstract - "Analyzing Whether
Countries Are Equally Efficient at Improving Longevity for Men and Women":

Comment: To no surprise to those who have been paying attention to the
U.S. health care system, we rank very low amongst OECD nations - 22nd
out of 27 studied - on the efficiency of health care spending when
measured by improvements in life expectancy. Spending on women was even
less efficient than spending on men. As we have long known, we spend
more while getting less.

There are likely many factors that contribute to these differences, but
there is no doubt that we have a very dysfunctional, fragmented,
wasteful, inequitable health care financing system that certainly is an
exemplar of inefficiency. Why should we not expect poor outcomes for our
high level of spending?

Once we have in place a single payer national health program it will be
much easier to identify the deficiencies specifically related to health
care delivery, and then we can correct them. Ladies first, please.

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