Ailing health system
Report slams U.S. effort, notes gains
The U.S. healthcare system is doing a dismal job delivering affordable, accessible and efficient care, the Commonwealth Fund concludes in a new report. The Commonwealth Fund gave the nation’s healthcare providers an overall performance score of 64 out of a possible 100, when compared with top performers across the U.S., and with other countries, in “Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2011.”
That score slipped slightly from the organization’s two previous national performance reports. In 2006, the country’s overall score was 67 and in 2008, that number fell to 65.
“I wasn’t really surprised that the score dropped,” said Cathy Schoen, senior vice president of the Commonwealth Fund. “We’ve been watching these indicators over time so we knew that access had declined and premiums are rising faster than incomes. We also know that administrative costs have remained high, and we’re still lagging behind in health IT.”
The scorecard assesses health system performance using 42 indicators, covering areas such as equity, efficiency and quality. For instance, indicators of efficiency include rates of duplicate medical tests and preventable hospital readmissions.
Eighty-one million adults were without insurance or underinsured at some point in 2010—a steep jump from 61 million in 2003, according to the report. Also, only 4% of adults live in states where average insurance premiums are less than 15% of household income.
During an event marking the release of the report, Dr. David Blumenthal expressed dismay that being uninsured or underinsured was quickly becoming the norm. Blumenthal chairs the Commonwealth Fund’s 17-member Commission on a High Performance Health System, which authored the report. He also is a faculty member at Harvard Medical School, Boston, and from April 2009 to April 2011 was HHS’ national coordinator for healthcare information technology. “There is an enormous amount of work to do,” Blumenthal said. The news wasn’t all bad, however. The scorecard report noted big gains in some areas of clinical quality, credited largely to public-reporting efforts and other performanceimprovement initiatives. The percentage of adults whose high blood