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Controlling Health Spending: Lessons from Abroad

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The United States stands out from all other industrialized countries due to its high health care expenditures and its failure to provide universal health insurance coverage. In a commentary in the New England Journal of Medicine, Commonwealth Fund President Karen Davis points out lessons the U.S. could learn from other countries to stem spending and improve value. There is no single strategy that will transform the U.S. health care system, Davis argues, but a series of coordinated policy changes could bend the curve of projected spending—up to $1.5 trillion over a 10-year period. One option is to create a system for generating information about the effectiveness of medical treatments to compare their costs and benefits, as Britain and Australia have done. Additional strategies include adopting health information technologies, developing a system of patient-centered medical homes for primary care, negotiating pharmaceutical prices, and moving to a bundled episode-of-care payment system that combines hospital and physician services for episodes of acute care. Moving forward will require a presidential administration committed to change and a policy process that moves more quickly and flexibly. There is abundant evidence among other countries—and within the U.S.—Davis concludes, that higher quality, better access, and lower costs can be achieved simultaneously.

Publication Details



K. Davis, "Slowing the Growth of Health Care Costs--Learning from International Experience," New England Journal of Medicine, Oct. 23, 2008 359(17):1751–55.