U.S. Health Care Spending Highest Among Developed Countries


The United States, on a per capita basis, spends much more on health care than other developed countries; the chief reason is not greater health care utilization, but higher prices, according to a study from a team led by a Johns Hopkins Bloomberg School of Public Health researcher.

The paper appears in the January issue of Health Affairs.

The researchers determined that the higher overall health care spending in the U.S. was due mainly to higher prices—including higher drug prices, higher salaries for doctors and nurses, higher hospital administration costs and higher prices for many medical services.

The paper finds that the U.S. remains an outlier in terms of per capita health care spending, which was $9,892 in 2016. That amount was about 25 percent higher than second-place Switzerland’s $7,919. It was also 108 percent higher than Canada’s $4,753, and 145 percent higher than the Organization for Economic Cooperation and Development (OECD) median of $4,033. And it was more than double the $4,559 the U.S. spent per capita on health care in 2000—the year whose data the researchers analyzed for a 2003 study.

The researchers, along with the late Princeton health care economist Uwe Reinhardt, who died in 2017, came to the same conclusion in their well-known 2003 study, “It’s the prices, stupid: why the United States is so different from other countries.” The new analysis is in part a tribute to the late Reinhardt.

“In spite of all the efforts in the U.S. to control health spending over the past 25 years, the story remains the same—the U.S. remains the most expensive because of the prices the U.S pays for health services,” says lead author Gerard F. Anderson, PhD, a professor in the Bloomberg School’s Department of Health Policy and Management.

Read the full study at John Hopkins.


The problem with lack of emphasis on primary care in healthcare

“In the U.S., primary care is nothing more than an assembly line,” he said. “I had to see twenty to twenty-five people a day, and then spend a third of my day coding. The patients were getting eight minutes with me if they were lucky. That’s why I got out. We should stop insuring primary care, and start ensuring that everyone has good primary care.”

Risheet Patel, MD, a direct primary care physician who leads Fishers Direct Family Care in Fishers, Ind., pointed to the lack of focus on primary care in the United States as one of the most important reasons for the gaps.

“When looking at metrics like percentage of primary care providers in the workforce, primary care visits, or dollars spent on primary care, the US falls behind other countries,” he said. “If we want to change the direction of our healthcare system, we need to put more emphasis on primary care along with screening and prevention as opposed to costly testing and treatments.”

The insurance-based healthcare system rewards physicians for ordering tests, treatments, medications, and office visits, driving up the cost of care, he said.

“It’s often hard to get insurance plans to cover preventative counseling, smoking cessation, or weight loss programs,” said Patel. “If we can work to prevent disease progression, we can help reduce the burdens of testing and treatment. However, there is a definite lack of focus in this area.”

Read the full article at Modern Medicine Network.