US health care is expensive, but it is supposed to be the best for those who can afford it. However, a new study published in JAMA Internal Medicine it shows how little even the richest benefit. Although white citizens living in 1% and 5% of the richest counties present better health data than those in the poor, they are in the saga in key areas compared to the average citizen of other countries.
The US spent 18% of GDP on health in 2018, according to Peterson-KFF. The average expenditure in comparable countries was only 10%. And the richest quintile of the U.S. population accounts for 43% more spending than the poorest, according to a 2016 study published in Health issues. This explains why rich Americans are thought to receive the best care in the world.
But that may not be true. The study of JAMA shows, for example, that maternal mortality in the richest 1% of counties is about 10 per 100,000 births, less than half the country rate; but the average among 12 developed nations is 3 per 100,000. Something similar happens with survival at 30 days after suffering a heart attack.
Of course, the US scores among the best in breast cancer survival, for example. And the populations are not the same: Americans are generally fatter and more sedentary than other nationalities.
Still, it’s one more proof that something is wrong. Having a referral doctor would help. An official survey notes that Americans with complex conditions have an average of more than 12 doctors, which increases the chances of drug interactions or ignoring patients. The situation could improve with more home visits by nurses.
Evaluating and paying doctors based on results, rather than by prescriptions and procedures, would also bring gains. And greater equality in health would benefit everyone, something that should be evident in a pandemic.
The authors are columnists of Reuters Breakingviews. Opinions are yours. The translation, of Carlos Gómez Baix, Is the responsibility of Five Days