Washington – 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 deficiencies in treatment, the U.S. 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 based in New York 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 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 Leape, of the Harvard School of Public Health.
The new survey, the eighth in an annual series of cross-national surveys conducted by Harris 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. Canadians and Australians came next, with only 14 percent of patients spending that much.
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.
