Wide Variations in Quality and Cost
. Quality and cost vary widely across the U.S., but there is no evidence that higher spending produces higher quality,
yielding the strong suggestion that it is possible-paramount, really-to improve quality and reduce cost.
For example, data show that if all Medicare patients being treated for heart attacks, hip fractures, or colon cancer received the quality of care delivered by the benchmark regions, Medicare would save an estimated 8,400 lives and $900 million annually.
High Administrative Costs
. Insurance administra-tion costs contribute significantly to the high cost of care in the U.S., without contributing to
commensurate gains in quality of care or health outcomes. As a percentage of national health expenditures, U.S. insurance administrative costs are more than three times the rates found in countries with the most integrated insurance systems (France, Finland, and Japan), and 20 to 30 percent higher than those in Germany and Switzerland, two countries where private insurance plays a substantial role. If U.S. administrative costs were on a par with the best countries, we would save $85 billion a year.
Not Enough Reliance on Information Technology
. U.S. physicians lag well behind
their counterparts abroad in use of electronic medical records-a key component of health information technology. Fewer than one of five U.S. doctors said they used electronic records, com-pared with nearly 90 percent in the top two countries.