U.S. Health System on Wrong Track, say National Health System Scorecard

The U.S. health care system is on the wrong track despite higher spending, according to the 2008 National Scorecard on U.S. Health System Performance.

In 2007, 75 million adults were either uninsured or underinsured during the year – an increase of 33 percent from 2003, the report said.  Of those 42 percent were adults ages 19 to 64.

“Overall performance has not improved since the first national scorecard was issued in 2006,” the report said. “Of greatest concern, access to health care has significantly declined.”

The report is prepared for the Commonwealth Fund Commission on a High Performance Health System, a private foundation.  It updates the 2006 scorecard, which was the first comprehensive report to measure and monitor health care outcomes, quality, access, efficiency and equity in the United States.

According to the report, the U.S. performed especially low on measures of health care efficiency, garnering just 53 out of 100 on a measure gauging inappropriate, wasteful, fragmented care and avoidable hospitalizations.  Variation in quality and cost, administrative costs, and the use of information technology also contributed to the efficiency score. The report said lowering insurance administrative costs alone could save up to $100 billion a year.

The U.S. spends twice per capita what other major industrialized countries spend on health care, and costs continue to rise faster than income, the report said.  At the current pace, it estimates that Americans are headed towards paying $1 out of every $5 of national income toward health care.

But measured against other countries, the U.S. ranked last out of 19 countries on a measure of mortality amenable to medical care, the report said. If the U.S. could achieve leading benchmark country rates, it predicted that up to 101,000 fewer people would die prematurely here. 

The U.S., however, did score better on quality metrics, improving 19 percent from 2000-2002 and 2004-2006, thanks to a risk adjusted measure and high profile local and national programs to improve hospital safety and reduce mortality.

“Hospitals are showing measurable improvement on basic treatment guidelines for which data are collected and reported nationally on federal websites,” the report said.