U.S. health sys­tem worst among peers in ac­cess for poor

Lodi News-Sentinel - - Front Page - By Cathie An­der­son

Even as Se­nate Repub­li­cans re­new ef­forts to pass a bill ex­pected to raise health-in­sur­ance pre­mi­ums be­yond the means of mil­lions of Amer­i­cans, new re­search re­leased Fri­day shows that in­come in­equal­ity al­ready lim­its the poor’s ac­cess to care more pro­foundly in the United States than it does in 10 other wealthy na­tions.

The New York-based Com­mon­wealth Fund will share this find­ing and other in­for­ma­tion from its re­search as part of a per­spec­tive piece in the New Eng­land Jour­nal of Medicine. In the ar­ti­cle, lead­ers of the 99-year-old non­profit foun­da­tion, which stud­ies how the U.S. can achieve a high-per­form­ing health care sys­tem, will ex­am­ine how the U.S. can move from last to first among its high-in­come peers.

“As back­ground, it is of­ten said that the U.S. has the best health-care in the world, but there is lim­ited ev­i­dence to sup­port that claim,” said Eric Sch­nei­der, se­nior vice pres­i­dent for pol­icy and re­search at the fund and the study’s lead au­thor. “The over­all per­for­mance of the U.S. health care sys­tem ranks last among the 11 coun­tries in­cluded in this study. This re­sult is due to poorer per­for­mance in sev­eral ar­eas, in­clud­ing ac­cess, ad­min­is­tra­tive ef­fi­ciency, eq­uity and health out­comes.”

Yet Sch­nei­der said the United States spends far more on health care than other wealthy na­tions do, and that spend­ing has grown more rapidly than any other coun­try’s in the study. Since 1980, U.S. health care spend­ing as a per­cent­age of the na­tion’s gross do­mes­tic prod­uct has grown by 16.6 per­cent. Aus­tralia ranks low­est in this cat­e­gory at 9 per­cent.

Spend­ing grew by 10.9 per­cent in the Nether­lands, 9.9 per­cent in the U.K., 10 per­cent in Canada, 11.1 per­cent in France.

Al­though health-care costs have grown at a much lower pace in the U.K., Swe­den and the Nether­lands, the Com­mon­wealth Fund study found, their sys­tems are marked by greater eq­uity be­tween rich and poor when it comes to ac­cess to safe, pre­ven­tive care. An­other key find­ing: Amer­i­cans un­der age 75 are more likely than cit­i­zens from any of the other wealthy na­tions to die from causes con­sid­ered pre­ventable.

De­bate con­tin­ues around dis­man­tling or re­plac­ing the Af­ford­able Care Act, said Dr. David Blu­men­thal, pres­i­dent of the Com­mon­wealth Fund, but the na­tion has seen gains in ac­cess, un­der the law, also re­ferred to as Oba­macare.

“Roughly 20 mil­lion peo­ple have gained cov­er­age, push­ing our unin­sured rates to the low­est in decades,” Blu­men­thal said, “and there have been a num­ber of qual­ity im­prove­ments, in­clud­ing a de­cline in health care-ac­quired in­fec­tions in U.S. hos­pi­tals.”

Un­der the orig­i­nal Se­nate GOP pro­posal, Cal­i­for­nia would lose $114 bil­lion in fed­eral fund­ing for Medi-Cal by 2037. Low re­im­burse­ments al­ready de­ter some doc­tors from tak­ing pa­tients cov­ered by Medi-Cal, so ad­vo­cates have said they fear cuts could make it im­pos­si­ble for im­pov­er­ished state res­i­dents to ac­cess pre­ven­tive care, even if they do have cov­er­age.

The Cal­i­for­nia Black Health Net­work has been con­duct­ing town halls all around the state, and Deputy Direc­tor An­gelo Wil­liams said they have heard par­tic­i­pants ex­press mild to in­tense panic as they dis­cuss cuts pro­posed in the House and Se­nate bills. The bill’s sup­port­ers have stressed the need for in­di­vid­ual re­spon­si­bil­ity for health care, but Blu­men­thal said coun­tries with min­i­mum or no med­i­cal cost-shar­ing per­form bet­ter than the United States where cost-shar­ing lev­els are high.

“Far too many peo­ple in the U.S. can’t get the health care they need,” he said. “Far too many re­main unin­sured, es­pe­cially com­pared to other wealthy na­tions. If we’re go­ing to do bet­ter for pa­tients, we should learn from what is work­ing in other na­tions and con­tinue the path to cre­at­ing a health sys­tem that will pro­vide high-qual­ity care to ev­ery­body.”

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