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U.S. Health Care Still Ill, Survey Finds


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When it comes to access to and affordability of health care in the United States, the numbers seem to be moving in the wrong direction, according to the scorecard. In 2003, 35 percent of working-age adults either had no health insurance or were underinsured; by 2007, that number had risen to 42 percent.

The United States also lags behind other countries in health-care results, Schoen said. "Even where the U.S. average improved, other countries have improved much more rapidly," she said. "As a result, we are falling further behind the leaders."

For example, the United States is now last among 19 industrialized nations in premature deaths that might have been prevented by better access to health care. In 2006, the United States was 15th on the list.

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The scorecard also contended that 100,000 lives -- and some $100 billion -- could be saved each year if health care were improved in the United States.

The scorecard also found that health care varies widely from state to state, region to region, and from one hospital and health plan to another. The difference between the best and worst performers can be as much as fivefold, according to the scorecard.

On the positive side, mortality rates in hospitals improved 19 percent over the past five years. This gain was the result of concentrated public-private efforts to improve hospital safety, according to the report.

While there have also been improvements in the care given in hospitals, some of those improvements have been offset by an increasing number of adverse drug events, and more hospitalizations of nursing home patients and deterioration in timely patient care, according to the report.

Other findings of the scorecard include:

  • Basic preventive care hasn't improved, with only 50 percent of all adults receiving recommended preventive care, such as cancer screenings.
  • Health insurance premiums continue to rise faster than wages. In 2007, 41 percent of adults said they had medical debt or trouble paying medical bills, up from 34 percent in 2005.
  • The number of primary-care doctors using electronic medical records rose from 17 percent in 2001 to 28 percent in 2006. But this gain still lags some other countries where 98 percent of doctors use electronic records.
  • Disparities in health care continue to be pervasive, with minority, low-income and uninsured adults more likely to wait to see a doctor and encounter delays and poorly coordinated care. Also, they have worse dental care, more uncontrolled chronic disease, more avoidable hospitalizations, and worse outcomes.

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Copyright © 2008 ScoutNews, LLC. All rights reserved.
Last updated 7/17/2008

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SOURCES: July 16, 2008, teleconference with Karen Davis, president, The Commonwealth Fund, New York City; Cathy Schoen, senior vice president for research and evaluation, The Commonwealth Fund; Commonwealth Fund report, Why Not The Best? Results From The National Scorecard on U.S. Health System Performance, 2008


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