Health Affairs

Sue Ducat
Director of Communications
(301) 841-9962
sducat@projecthope.org

From Health Affairs

How Do American Survival And Medical Spending Rates Compare With Other Countries?

Bethesda, MD -- It is widely known that Americans spend more on health care per capita than many wealthier nations. It is also known that fewer of us are living as long as our international counterparts. A recent study shines a new light on this situation by exploring changes in 15-year survival at middle and older ages alongside per capita health care spending for the United States and 12 other countries. The study then examines the extent to which the survival and cost variations over time can be explained by demographics, obesity, smoking, or non-medical causes of death.

What Changes In Survival Rates Tell Us About US Health Care
By Peter A. Muennig and Sherry A. Glied
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2010.0073
Muennig and Glied are affiliated with the Mailman School of Public Health at Columbia University in New York. Glied, currently on leave from Mailman, is Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services. This paper, written prior to that appointment, does not reflect the official views of HHS. The study was funded by a grant from The Commonwealth Fund.

 

The authors compared the United States and 12 countries that provide their citizens with universal health coverage: Australia, Austria, Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Sweden, Switzerland, and the United Kingdom. They examined relative changes in cost and 15-year survival from 1975 to 2005, and focused on men and women 45 and 65 years old. According to the data, the United States is falling further and further behind the 12 other countries with respect to 15-year survival, and at the same time relative health care spending has more than doubled. However, smoking and obesity, two major health problems, do not seem to explain the poor U.S. performance. As it turns out, the prevalence of obesity has grown more slowly in the United States than in other countries and smoking prevalence has declined more rapidly here. Rising health spending itself, the authors conclude, might be responsible for the relative decline in survival. They cite three consequences of rising health spending: an increase in the number of people with inadequate health insurance; the inability to allocate financial resources to life-saving programs; and unregulated fee-for-service reimbursement and an emphasis on specialty care that leads to unneeded procedures and fragmented care. As a result, they concluded, “meaningful reform may not only save money over the long term: it may also save lives.”

Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears each month in print, with additional Web First papers published weekly at http://www.healthaffairs.org/. The full text of each Health Affairs Web First paper is available free of charge to all Web-site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund.