President's Message
The Best Health System
in the World

1. What's Wrong: A Snapshot
2. Lessons from the Scorecard
3. What's Right: A Blueprint for Change

Printable version of this article
(18 pages)

4. Efficiency
The U.S. spends 16 percent of its gross domestic product on health care—twice as much as the typical industrialized nation, and growth in health spending in recent years has outpaced that of other major countries. On eight efficiency indicators, the Commission scorecard averages 51 out of 100—in other words, average U.S. performance would have to double to reach the best benchmarks.
Overuse, Misuse of Care. Duplication, overuse or inappropriate care—sometimes the result of our fragmented health system—contribute to high costs in the United States. U.S. adults are more likely to report that medical records and test results are not available when needed, and that tests are duplicated or unnecessary. Care that is not evidence-based, such as imaging tests for lower-back pain with no apparent risk factors or signs of serious pathology, adds unnecessarily to costs.
Too Many Admissions and Readmissions. Inadequate access to primary care, whether during regular office hours or after-hours, contributes to expensive visits to the emergency room or admission to the hospital. Americans are more likely to report use of emergency rooms for conditions that could have been treated by a primary care physician, if available. Hospitalization for potentially preventable conditions such as congestive heart failure, diabetes, and pediatric asthma vary two- to four-fold. Bringing national rates of preventable hospitalizations down by 10 percent to 20 percent could save $4 billion to $8 billion annually.
 
 
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