Good Article

[Guest guest]

I thought all of us would be interested in this.

Happy Reading,

Jerry/NC

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*U.S. Health Care Costs Big Money*

Survey Says Americans Pay More, Get Disorganized Care

By Rob Stein

Washington Post Staff Writer

Thursday, November 3, 2005; 2:48 PM

Americans pay more when they get sick than people in other Western nations

and receive more confused, error-prone treatment, according to the largest

survey to compare U.S. health care with other nations.

The survey of nearly 7,000 sick adults in the United States, Australia,

Canada, New Zealand, Britain and Germany found Americans were the most

likely to pay at least $1,000 in out-of-pocket expenses. More than half went

without needed care because of cost, the survey found, and more than a third

endured mistakes and disorganized care when they did get treated.

While patients in every nation sometimes run into obstacles to getting care

and face deficiencies in treatment, the United States stood out for having

the highest error rates, most disorganized care and highest costs, the

survey found.

" What's striking is that we are clearly a world leader in how much we spend

on health care, " said Cathy Schoen, senior vice president for the

Commonwealth Fund, a private, nonpartisan, nonprofit foundation that

commissioned the survey. " We should be expecting to be the best. Clearly, we

should be doing better. "

Other experts agreed, saying the results offer the most recent evidence that

the quality of care delivered by the U.S. health care system is seriously

eroding even as health care costs skyrocket.

" This provides confirming evidence for what more and more health policy

thinkers have been saying, which is, 'The American health care system is

quietly imploding, and it's about time we did something about it,' " said

Lucian L. Leape of the Harvard School of Public Health.

The new survey, the eighth in an annual series of cross-national surveys

conducted by Interactive for the fund, is the largest to examine

health care quality across several nations during the same period of time.

The survey, published in the journal Health Affairs, questioned 6,957 adults

who had recently been hospitalized, undergone surgery or reported health

problems between March and June of this year.

" These patients are the canary in the coal mine of any health care system, "

Schoen said.

Nearly a third of U.S. patients reported spending more than $1,000 in

out-of-pocket expenses for their care, far outpacing all other nations.

Canadians and Australians came next, with only 14 percent of patients

spending that much. The proportion reporting similarly high costs was far

lower in the other countries.

While Americans had the easiest access to specialists, they experienced the

most problems getting care after hours, and Americans and Canadians were the

most likely to report problems seeing a doctor the same day they sought one.

Americans were also much more likely to report forgoing needed treatment

because of cost. About half of Americans said they had decided not to fill a

prescription, see a doctor when they were sick or get recommended follow-up

tests. About 38 percent of patients in New Zealand reported going without

care, as did 34 percent in Australia, 28 percent in Germany, 26 percent in

Canada and 13 percent in Britain.

" If that's not a reason for moral outrage, I don't know what is, " Leape

said.

About one-third of U.S. patients reported problems with the coordination of

their care, such as test results not being available at the time of their

doctor's appointment or doctors ordering duplicate tests. In the other

countries, between 19 percent and 26 percent of patients reported similar

problems.

Americans also reported the greatest number of medical errors: Thirty-four

percent reported getting the wrong medication or dose, incorrect test

results, a mistake in their treatment or care, or being notified late about

abnormal test results. Those types of errors were reported by only 30

percent of Canadian patients, 27 percent of Australian patients, 25 percent

of New Zealanders, 23 percent of Germans and 22 percent of Britons.

" The findings show that we have a lot to learn from our colleagues " in other

countries, said Carolyn Clancy of the federal Agency for Health Care Quality

and Research during a briefing at which the results were released. She said

the federal government has launched a number of initiatives to find ways to

improve the quality of care, particularly for the increasing number of

Americans who are suffering from chronic illnesses.

" The findings here reinforce how difficult it is coordinating care, " Clancy

said. " That's the next frontier. "