SSA: U.S. Health Care Reform

______________________________________________________________________

Health reform in the US refers to the overhaul of its health care system and is frequently used interchangeably with the Affordable Care Act (ACA). Health reform includes addressing the ever- increasing costs of national health care by individuals, families, and the government. It also addresses the benefits people receive and how people obtain health insurance. The goal of health reform is to reduce the number of uninsured, making healthcare more affordable and improving quality of care. In context of global health, health reform that takes place in health systems across the world vary depending upon various factors within the nation. Factors driving health reform in other countries will depend on the economy of the country, average per capita income spent on health care costs and expenditure, insurance industry structure, government support to the health care sector, and research and development.

Country	Life Expectancy	Infant Mortality Rate /1,000 live births	Health Expenditures	Physician Density /1,000 population	Hospital Bed Density /1,000 population
Unites States	80.59 years	5.17 deaths	16.8% of GDP	2.61 physicians	2.9 beds
United Kingdom	82.75 years	3.79 deaths	12.0% of GDP	3 physicians	2.5 beds
Japan	85 years	1.88 deaths	10.9% of GDP	2.48 physicians	13 beds
Germany	81.72 years	3.14 deaths	12.8% of GDP	4.44 physicians	8 beds
Taiwan	81.38 years	3.9 deaths	6.4% of GDP	2.17 physicians	5.73 beds
Switzerland	83.42 years	3.51 deaths	11.8% of GDP	4.38 physicians	4.6 beds
Canada	83.99 years	4.31 deaths	12.9% of GDP	2.44 physicians	2.5 beds
France	82.79 years	3.1 deaths	12.2% of GDP	3.27 physicians	5.9 beds

The United States spends more on health care than any other high-income country but still has the lowest life expectancy at birth and the highest rate of people with multiple chronic diseases, according to a new report from The Commonwealth Fund, an independent research group. The report also says that compared with peer nations, the US has the highest rates of deaths from avoidable or treatable causes and the highest maternal and infant death rates.

“Americans are living shorter, less healthy lives because our health system is not working as well as it could be,” the report’s lead author, Munira Gunja, senior researcher for The Commonwealth Fund’s International Program in Health Policy and Practice Innovation, said in a news release. “To catch up with other high-income countries, the administration and Congress would have to expand access to health care, act aggressively to control costs, and invest in health equity and social services we know can lead to a healthier population.”

People in the US see doctors less often than those in most other countries, which is probably related to the US having a below-average number of practicing physicians, according to the report, and the US is the only country among those studied that doesn’t have universal health coverage. In 2021 alone, 8.6% of the US population was uninsured.

“Not only is the U.S. the only country we studied that does not have universal health coverage, but its health system can seem designed to discourage people from using services,” researchers at the Commonwealth Fund, headquartered in New York, wrote in the report. “Affordability remains the top reason why some Americans do not sign up for health coverage, while high out-of-pocket costs lead nearly half of working-age adults to skip or delay getting needed care.”

The researchers analyzed health statistics from international sources, including the Organisation for Economic Cooperation and Development, or OECD, which tracks and reports on data from health systems across 38 high-income countries. Researchers examined how the United States measured against Australia, Canada, France, Germany, Japan, the Netherlands, New Zealand, Norway, South Korea, Sweden, Switzerland and the United Kingdom. They also compared the US with the OECD average for 38 high-income countries.

Globally, health care spending has been increasing since the 1980s, according to the report, driven mostly by advancements in medical technologies, the rising costs of medical care and a higher demand for services. The US has the highest rate of people with multiple chronic health conditions, the data showed, and the highest obesity rate among the countries studied.

Life expectancy at birth in the US in 2020 was 77 years – three years less than the OECD average – and early data suggests that US life expectancy dropped even further in 2021. Since the start of the Covid-19 pandemic, more people died from coronavirus infections in the US than in any other high-income country, according to the report.

Deaths caused by assaults also appeared to be highest in the US compared with all peer countries. The researchers found that deaths from physical assault, which includes gun violence, occurred at a rate of 7.4 deaths per 100,000 people in the US in 2020, significantly higher than the OECD average of 2.7 and at least seven times higher than most other high-income countries in the report.

Where the US appeared to do well was in cancer prevention and treating cancers early. Along with Sweden, it had the highest number of breast cancer screenings among women ages 50 to 69, and the US exceeded the OECD average when it came to screening rates for colorectal cancer.

The new Commonwealth Fund report “continues to demonstrate the importance of international comparisons,” Reginald D. Williams II, who leads The Commonwealth Fund’s International Program. “It offers an opportunity for the U.S. to learn from other countries and build a better health care system that delivers affordable, high-quality health care for everyone.”

Much of the data in the new report shows trends that have been seen before.

“It validates the fact that we continue to spend more than anybody else and get the worst health outcomes. So we’re not getting the best value for our health care dollar,” said Dr. Georges Benjamin, executive director of the American Public Health Association.

“The big takeaway is that Covid did not become the great equalizer among nations. It did not help our case at all,” Benjamin said. “If anything, it exposed the existing holes in our health care system.”

To help fix the holes in the US health care system, Benjamin referenced three steps the nation can take.

“We’re still the only nation that does not have universal health care or access for all of our citizens,” Benjamin said.

Second, “we don’t do as much primary care prevention as the other nations, and we still have a public health system, which is fractured,” he said.

“The third thing is, we under-invest compared to other industrialized nations in societal things. They spend their money on providing upfront support for their citizens. We spend our money on sick care.”

______________________________________________________________________

Disclaimer

The views and opinions expressed here are those of the students and speakers of our government classes and do not necessarily reflect the views or positions of this website, institution, or organization. Any views or opinions are not intended to malign any religion, ethnic group, club, organization, company, or individual.