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Connecticut
Coalition for |
Quality of U.S. Health Care |
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Urban Institute
August 2009
How Does the Quality of U.S. Health Care Compare Internationally?
By Elizabeth Docteur and Robert A. Berenson
This brief brings together available evidence on how quality of care in the
United States compares to that of other countries and comments on the
implications of the evidence for the health reform debate. By exploring how
the quality of our care compares internationally, we can address the
underlying attitudes and concerns that people have about health reform.
While the evidence base is incomplete and suffers from other limitations, it
does not provide support for the oft-repeated claim that the “U.S. health
care is the best in the world.” In fact, there is no hard evidence that
identifies particular areas in which U.S. health care quality is truly
exceptional.
Instead, the picture that emerges from the information available on technical
quality and related aspects of health system performance is a mixed bag, with
the United States doing relatively well in some areas — such as cancer care
— and less well in others — such as mortality from conditions amenable to
prevention and treatment. Many Americans would be surprised by the findings
from studies showing that U.S. health care is not clearly superior to that
received by Canadians, and that in some respects Canadian care has been shown
to be of higher quality.
Like other countries, the United States has been found to have both strengths
and weaknesses in terms of the quality of care available, and the quality of
care the population receives. The main ways in which the United States differs
from other developed countries are in the very high costs of its health care
and the share of its population that is uninsured.
Comment: This paper (14 pages) brings together numerous credible studies
on the quality of health care in the United States, as compared with other
nations. Anyone reading this message already knows that the United States is
paying enough for exceptional care for everyone, but many of us are not
receiving it. On average, our health care is mediocre.
This resource can be useful in informing those who would reject efforts at
reform because we already have "the best health care in the world."
It would be a shame if we continued to waste funds to preserve a system that
provides high quality care for a few when an improved financing system would
enable us to improve the allocation of those funds so that we could provide
high quality care for everyone.
Don McCanne, PNHP |
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