USA health spending twice other countries' with worse results

Huge cost of US healthcare driven by drugs prices and salaries

The investigators found that the United States spends almost twice as much of its wealth on health care - 17.8 percent of its gross domestic product, compared with between 9.6 percent and 12.4 percent in other countries. In the United States, the average salary was $218,173.

"These findings indicate that efforts targeting utilization alone are unlikely to reduce the gap in spending between the United States and other high-income countries, and a more concerted effort to reduce prices and administrative costs is likely needed", the authors write.

While it's been said that Americans use more medical services than peer countries, leading to higher costs, the study found salaries of physicians, as well as higher pharmaceutical prices play a significant roles in health care costs.

Instead, it looks as though the United States pays more because it faces higher price tags for drugs, tests, office visits and administration, Woskie said.

The findings were published March 13 in the Journal of the American Medical Association.

"These inefficiencies are likely the product of a number of factors including a reliance on fee-for-service reimbursement, the administrative complexity of the USA health care system and the lack of price transparency across the system", Papanicolas said by email. "This gap and the challenges it poses for American consumers, policymakers, and business leaders was a major impetus for healthcare reform in the US, including delivery reforms implemented as part of the Affordable Care Act", said senior author Ashish Jha, a professor at the Harvard Global Health Institute (HGHI).

The study also updated the reason behind these data.

The study compared potential spending drivers, including structural capacity and utilization, in the USA and 10 high-income countries (the United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland and Denmark). "We need to better understand why prices are so high and dive into that into much more detail, because some of the previous explanations may not actually be what's driving the U.S.'s spending", Woskie said. The United States spent 17.8% of its gross domestic product in 2016 on healthcare. He notes, for example, that while US doctors make high salaries, there are fewer doctors per capita than in other countries, so the total cost of paying doctors isn't far out of line with countries like Germany or The Netherlands. 'However, there are many different beliefs as to why this is the case'.

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Nor does America have too many high-paid specialists.

Evidence: The primary care versus specialist mix in the roughly the same as that of the average of other countries.

Researchers debunked another belief that claims the U.S. doesn't spend enough money on social services that benefit health and helps prevent illness, thus contributing to higher health care costs. For other countries, the average infant mortality rate was 3.6 fatalities for every 1,000 live births.

Researchers used 98 indicators to compare countries across seven areas: general spending, population health, structural capacity, utilization, pharmaceuticals, access and quality and equity. The U.S. had the shortest life expectancy and highest infant mortality rate of any country included in the analysis, as well as the highest obesity rate.

America has "the best outcomes for those who have heart attacks or strokes, but is below average for avoidable hospitalizations for patients with diabetes and asthma", said the report.

What does explain higher spending in the administrative complexity and high prices across a wide range of healthcare services.

Administrative costs accounted for 8 percent of GDP, compared to 1 percent to 3 percent in the other countries.

For example, administrative costs related to planning, regulating, and managing accounted for 8% of total U.S. healthcare costs, compared with a range of 1% to 3% for other countries. For several commonly used brand-name pharmaceuticals, the USA had substantially higher prices than other countries, often double the next highest price.


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