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| A study by researchers at Harvard University and the London School of Economics disputes the long-held belief that US healthcare costs are high because patients see doctors too often or otherwise abuse the healthcare system |
The United States spends almost twice as much on healthcare as other rich nations, largely because everything from drugs to devices to doctors' pay simply costs more, researchers said Tuesday.
The study
by researchers at Harvard University and the London School of Economics
disputes the long-held belief that US costs are high because patients see
doctors too often or otherwise abuse the healthcare system.
"The
reasons for these substantially higher costs have been misunderstood,"
said senior author Ashish Jha, professor of global health at the T.H. Harvard
Chan School of Public Health at Harvard University.
"These
data suggest that many of the policy efforts in the US have not been truly
evidence-based."
The study
in the Journal of the American Medical Association (JAMA) compared the US
health system to 10 other high-income countries -- Britain, Canada, Germany,
Australia, Japan, Sweden, France, Denmark, the Netherlands, and Switzerland.
Researchers
used data from 2013-2016 on about 100 metrics that underpin healthcare
spending, and confirmed what experts have long known -- that the United States
"has substantially higher spending, worse population health outcomes, and
worse access to care than other wealthy countries."
The reason?
Prices are higher for nearly everything in the United States.
For
example, administrative costs related to planning, regulating, and managing
accounted for eight percent of total US healthcare costs, compared with a range
of one to three percent for other countries.
Per capita
spending for pharmaceuticals was also higher in the US -- about $1,443 compared
with a range of $466 to $939 in other nations.
Common
brand-name medicines were often double the price seen in other nations.
Doctors'
pay was also much more, with the average salary for a general practice
physician in the US at $218,173, compared to other countries where the range
was $86,607-$154,126.
Value of
international comparisons
Researchers
also pointed out many myths regarding why US health care is so pricey.
Despite
beliefs to the contrary, "the US has lower rates of physician visits and
days spent in the hospital than other nations," said the report.
Nor is the
quality much lower than in other countries.
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.
Fewer
people in the United States are insured -- 90 percent, compared to other
countries which ranged from 99-100 percent.
But overall
spending is far higher. The United States spent 17.8 percent of its gross
domestic product in 2016 on healthcare.
Australia
spent 9.6 percent of GDP on healthcare and Switzerland spent 12.4 percent.
Meanwhile,
US life expectancy in the US was the lowest of all 11 countries in the study,
at 78.8 years.
Other
countries' life expectancy ranged from 80.7-83.9.
"As
the US continues to struggle with high healthcare spending, it is critical that
we make progress on curtailing these costs," said first author Irene
Papanicolas, visiting assistant professor in the Department of Health Policy
and Management at Harvard.
"International
comparisons are very valuable. They allow for reflection on national performance
and serve to promote accountability."
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