More bad news for the U.S. health care system. According to a new report by the Commonwealth Fund, America is worst among three other industrialized nations when it comes to preventing avoidable deaths through timely, effective medical care. The problem, once again, is the lack of health insurance, the report suggests. (Things were worse for folks under 65; presumably those over that age qualify for Medicare.)
Commonwealth Fund President Karen Davis is quoted in the news release saying: “Despite spending about twice as much per person each year on health care as France, Germany or the U.K.— $8,400 in 2010—the U.S. is increasingly falling behind these countries in terms of progress in lowering the potentially preventable death rate. The good news is that the Affordable Care Act is already beginning to close the gaps in access to care. When fully implemented, it will cover nearly all Americans, with the potential to put our country on track to improve to levels seen in the best-performing countries.”
From the Commonwealth Fund news release:
The United States lags three other industrialized nations — France, Germany, and the United Kingdom — in its potentially preventable death rate, and in the pace of improvement in preventing deaths that could have been avoided with timely and effective health care, according to a Commonwealth Fund–supported study published as a web first online today in Health Affairs. Between 1999 and 2006/2007, the overall potentially preventable death rate among men ages 0 to 74 dropped by only 18.5 percent in the United States, while the rate declined by nearly 37 percent in the U.K. For women, the rate fell by 17.5 percent in the U.S. but by nearly 32 percent in the U.K.
Compared with people enrolled in individual market plans, a majority of those enrolled in employer group plans have far more comprehensive coverage with less cost-sharing. Most group plans had an actuarial value of 80 percent to 89 percent, qualifying them as “gold” plans to be sold in the exchanges, compared with an actuarial value of below 60 percent for the “tin” plans, according to the study. Actuarial value is the proportion of the medical bill that the insurer pays, compared with what the insured person pays out of pocket in deductibles, co-payments, and other cost-sharing.
In “In Amenable Mortality—Deaths Avoidable Through Health Care—Progress In the U.S. Lags That of Three European Countries,” Ellen Nolte, Director of Health and Healthcare at RAND Europe and Martin McKee, Professor of European Public Health at the London School of Hygiene & Tropical Medicine analyzed amenable mortality trends. Amenable mortality is a measure of deaths before age 75 that could potentially have been prevented by timely access to appropriate health care. The research also looked at death rates for those under 65, as well as deaths between ages 65 and 74 from conditions like treatable cancer, diabetes, infections, and heart disease.
While the pace of improvement was slower in the U.S. for both age groups, the lag was most pronounced among American men and women under age 65, who are more likely to be uninsured and have problems with access to care than those 65 and older, who are eligible for Medicare. By comparison, France, Germany, and the U.K. all provide affordable, universal coverage to their populations regardless of age. “These findings strengthen the case for reforms that will enable all Americans to receive timely and effective health care” said Nolte, lead author of the study.