Beyond all the ongoing Obamacare rhetoric, the US healthcare system has major problems. A new study by UCLA and McGill University reported that the US healthcare system ranks 22nd out of 27 high income nations; in addition, it found that women fare worse than men. The ranking was based on how efficiently the spending of healthcare dollars saves lives. The study was published online on December 12 in the First Look section of the American Journal of Public Health. It is entitled “Analyzing Whether Countries Are Equally Efficient at Improving Longevity for Men and Women.”
For the study, the investigators accessed data from 27 Organization for Economic Cooperation and Development (OECD) nations over the course of 17 years (1991 through 2007). The study authors note that the low ranking reflects a high price and low return rate on investment received. They found tremendous differences in the efficiency of money spent by high income nations on healthcare. They found that for every additional hundred dollars spent on US healthcare translated into a gain of less than half a month of life. In contrast, in Germany, every additional hundred dollars spent translated into more than four months of increased life expectancy. They also found significant gender disparities within the US and other nations. “While there are large differences in the efficiency of health spending across countries, men have experienced greater life expectancy gains than women per health dollar spent within nearly every country,” noted first author Douglas Barthold, a doctoral candidate in the Department of Economics at McGill University. He explained that their study was the first to estimate health spending efficiency by gender across 27 industrialized nations. “Out of the 27 high income nations we studied, the United States ranks 25th when it comes to reducing women’s deaths. The country’s efficiency of investments in reducing men’s deaths is only slightly better, ranking 18th,” noted senior author Dr. Jody Heymann, dean of the UCLA Fielding School of Public Health.
The investigators’ findings raise two major questions: (1) How is it possible for the United States to have one of the most advanced economies, yet one of the most inefficient healthcare systems? (2) While the US healthcare system is performing so poorly for men, why is it performing even worse for women? The study authors note that the specific causes of the gender gap are unknown; thus, the study highlights the need for additional research on the topic. In addition, the nation’s lack of investment in prevention for both men and women warrants attention.
“The most effective way to stop people from dying prematurely is to prevent them from getting sick in the first place,” noted Dr. Heymann. She pointed out that in 2012, the US spent a miniscule fraction of its 2.65 trillion dollar annual healthcare budget on prevention. Healthcare spending is a huge, and ever-increasing, percentage of government budgets, particularly in the US Therefore, allocating the necessary resources for prevention and improving overall efficiency are both critically important to preventing premature deaths and wiser spending.
The study was a component of the McGill University Institute for Health and Social Policy’s Healthier Societies Initiative, which is a research program funded by McGill Chancellor Arnold Steinberg and Professor Blema Steinberg; it informs the public on healthcare issues related to increasing costs, health quality and access in Canada and other leading economies. The UCLA Fielding School of Public Health is dedicated to enhancing the public's health by conducting original research, training future leaders and health professionals from diverse backgrounds, translating research into policy and practice, and serving our local communities and the communities of the nation and the world. The school has 650 students from more than 35 nations engaged in promoting the vision of building healthy futures in greater Los Angeles, California, the nation, and the world.