Cablayan LNHA, MHA

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Is health care quality in the United States really the worst?

June 27, 2014Erwin Cablayan5 Comments

Health Care Quality in the United States

“Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system,” asserts Maggie Fox of Reuters, citing a 2010 report released by the Commonwealth Fund that ranked the United States last based on measures of quality and equity of care against 6 other developed nations.

This year, stacked up against 10 other developed nations, the U.S. still ranked last in The Commonwealth Fund’s health care report, according to Dan Munro, a Forbes contributor. Munro states that although the U.S. ranked best in some measures of quality, namely “provision and receipt of preventative and patient-centered care,” the United States fare poorly in the areas of access, efficiency, equity, and healthy lives, which Munro defines as “mortality amenable to medical care, infant mortality, and healthy life expectancy at age 60.”

Though we in the health care industry must examine ways to improve quality in light of these metrics and in light of studies such as the 2013 Health and Voluntary Workplace Benefits Survey by the Employee Benefit Research Institute, whose subtitle states “Nearly 90% of Workers Satisfied With Their Own Health Plan, But 55% Give Low Ratings to Health Care System,” others, such as Dr. Scott W. Atlas, M.D. assert that our health care quality is excellent and that the Affordable Care Act could pose a threat to our quality, implying that it is an inhibitor to innovation. Dr. Atlas counters The Commonwealth Fund’s claims that our nation’s outcomes are worse than our European counterparts due to poor quality of care, attributing poor treatment outcomes to significantly higher rates of obesity and historical cigarette use in the United States.

Lifestyle appears to be the hidden variable in these international studies. Dr. Atlas goes on to provide evidence that treatment for heart disease, cancer, and chronic conditions such as hypertension and diabetes is superior in the United States when compared to Western European nations.

Whom do you believe? Or is there truth to both sides? Either way, we as health care professionals have a duty to continually raise the bar higher, excel in innovation, and provide personalized, compassionate care to our patients.


This article has 5 comments
  1. Dr. Atlas’ assertions parallel the political denial of scientific evidence – evidence that supports climate change, evolution and this myth that Americans are somehow superior in every way, including health care. His arguments just don’t stand up as credible against the Commonwealth Fund, World Health Organization, and others, and instead appear motivated by efforts to protect the status quo.

    Isn’t this just like others in the medical industrial complex who spend twice as much lobbying as the military industrial complex spends? These stakeholders obviously don’t want to lose any of their $3 trillion/year in revenue. But if Americans truly spend twice as much as other nations but still live sicker and die younger, as the evidence shows, we surely “should” be able to cut that cost in half, saving over $1.5 trillion/year, while improving care at the same time, if only guys like Dr. Atlas would just get on board with meaningful health reform instead of repeatedly trying to repeal Obamacare.

  2. Dr. Jacob R. Raitt
    June 28, 2014

    The question is, “are we getting the bang for our buck?” In general, the answer is no. For what we pay for medical services in professions that should not be for profit, we do not get value added. Those who are wealthy have no problem, and the impoverished often are cared for by our welfare system. However, the middle class is caught between a rock and a hard place. We do believe that the ACA will ultimately deliver the necessary care.

  3. Rick
    June 28, 2014

    Rankings can and are very subjective. I totally agree that care for the aged citizens is a disaster. As for other areas of traditional medicine the US is as good as any. The problem in this area is lack of attention by our culture to personal responsibilities to exercise each patient’s care. When America gets serious about prevention we will finally demonstrate our true ability. Wellness does not come in a pill, it comes by individuals taking responsibility for the wellness.

  4. The answer depends on the metrics. I recently participated in a lenghty, intelligent discussion started by the initial question which asked why do so many come here from across the planet for health care in spite of our standings as described by WHO. The conclusion was that if you can afford it, specific remedial procedures and outcomes in this country are world class, but if you can’t afford it, then you become one of the herd, destined to visit the emergency room when desperate, die early from lack of preventive medicine, and watch too many of your children die when they shouldn’t. A head in the sand mentallity keeps us here and unless and until the rule makers start thinking about ALL OF US, it’s not likely to change.

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