65 is passing

The Commonwealth Fund aims to improve our healthcare system. One tool they use is an annual ranking of our system vis-à-vis the systems of other countries. The system compares the performance of our healthcare system against benchmarks that have been established both here and abroad. This is the third year in which they have performed their rankings. And things have not improved over the past three years; in fact, they have gotten worse. We now rank dead last among nineteen countries; in 2007 we were fifteenth. Out of a possible score of 100 based on 37 indicators of performance we scored 65, which was considered a D when I went to school. This low score is achieved despite our spending twice as much per capita as other industrialized countries.

We are especially bad on what you would think would be a strength – efficiency. We scored 53 when tested for use of information technology, administrative costs, avoidable hospital stays, wasteful care

The study looked at healthy lives, quality, access, efficiency and equity. In all of these areas we had some top-rated healthcare systems, but overall we sucked. For example, in the case of healthy lives, more of us die because we don’t get the right care or get it in time than should. 18% of our working-age adults are unable to carry out daily activities because of health problems.

We are particularly bad in the area of accessibility and getting worse; in 2007 42% of working-age adults were either uninsured or underinsured, in 2003 the number was 35%. 41% of adults had great difficulty paying their medical bills, in 2005 it was 34%.

However, the great American talent for advertising works. We did much better in areas which received a lot of coverage in the media and were subjects of national campaigns.

The authors of the report advocate for the following changes in our health care system:

• universal and well-designed
• coverage that ensures affordable access and continuity of care, with low administrative costs;
• incentives aligned to promote higher quality and more efficient care;
• care that is designed and organized around the patient, not providers or insurers;
• widespread implementation of health information technology with information exchange;
• explicit national goals to meet and exceed benchmarks and monitor performance; and
• national policies that promote private-public collaboration and high performance.