International Comparisons of Health Care - Overviews Of Selected Health Care Systems The OECD international health data enable researchers to compare health systems to one another in terms of health care costs and quality. In May 2004 Peter Hussey, Gerard Anderson, Robin Osborn, Colin Feek, Vivienne McLaughlin, John Millar, and Arnold Epstein published "How Does the Quality of Care Compare in Five Countries?" (Health Affairs, vol. 23, Issue 3, 2004). The investigators considered how well five countries—Australia, Canada, England, New Zealand, and the United States—performed on twenty-one measures of health care quality developed by the Commonwealth Fund International Working Group on Quality Indicators. The measures included survival rates for selected cancers, kidney and liver transplant, acute myocardial infarction (heart attack), and ischemic stroke; avoidable outcomes such as suicide, asthma mortality, and the incidence of pertussis (whooping cough) and hepatitis B; and process measures such as rates of screening for breast and cervical cancer as well as influenza and polio vaccination rates. The measures were selected by the group of health care quality experts as key indicators of health system performance, and also because they identify opportunities for improving health and health care.
The investigators concluded that no one country delivers the best or worst medical care and observed that there was room for improvement in health care delivery in every nation. For example, while the United states spends the most money on health care and boasts the highest five-year survival rates for breast cancer, it had higher mortality rates for asthma than Australia or England and the lowest five-year survival rates for kidney transplants. Australia had higher rates of breast cancer screening than other countries and the lowest mortality rates for persons suffering from acute myocardial infarction but also the lowest five-year survival rates for childhood leukemia and a higher incidence of pertussis than other nations.
Canada had the highest five-year survival rates for childhood leukemia and the highest polio vaccination rate; however, it also reported the second-highest incidence of pertussis and the highest rates for ischemic stroke. England had the lowest five-year survival rates for breast cancer and lower survival rates for colorectal cancer than other countries but boasts the highest polio vaccination rates and among the lowest rates for suicide. New Zealand reported the highest five-year survival rates for colorectal cancer and non-Hodgkins lymphoma but also suffered the highest suicide rates, particularly among young people aged fifteen to nineteen, as well as the highest mortality rates for ischemic stroke.
Another article in the May 2004 issue of Health Affairs, "U.S. Health Care Spending in an International Context" by renowned political economist Uwe Reinhardt and his public health colleagues Peter Hussey and Gerard Anderson, found that the United States spent $4,887 per capita on health care in 2001, far outstripping other OECD countries, and averaging $2,000 more per capita than Canada, the next-highest spending country of the five quality indicator nations, which spent $2,792. Australia spent $2,513 per capita, the U.K. $1,992, and New Zealand $1,710.
The authors cited several factors contributing to higher U.S. health costs—a fragmented financing system that generates higher administrative costs; and health care providers with greater market power than health care purchasers, which allows prices to rise above levels of other countries where the government intervenes to control prices. They also noted that the U.S. health system provides a more specialized, intensive form of care…