The U.S. spends twice per capita what other industrialized countries spend for health care, yet the present system is not always as effective. This lack of effective health care is seen in the 45 percent of recommended care that is not provided, even with third-party payment. The U.S. has the highest number of deaths that could have been prevented with timely and effective care out of all the 19 industrialized nations. The U.S. system is doing a poor job of chronic disease management with regard to diabetes and hypertension; achieving the level of control seen in the best health plans would prevent up to 39,000 deaths annually. Only half of adults receive all age-appropriate preventive care; this shortage could lead to chronic disease. Mental health issues have until recently gone largely ignored by health insurance; one-third of adults with major depression never receive care.
The present U.S. system is not always timely or patient-centered; 46 percent of patients report having same- or next-day appointments when ill, while the benchmark in other countries is as high as 81 percent. U.S. adults are more likely than adults in seven other countries to go to emergency rooms to receive after-hours healthcare; 21 percent of these U.S. adults went to the emergency room for a condition that could have been treated by their physicians, if they had primary care physicians. In Germany, this rate is at 6 percent, 15 percent lower than for Americans.
Currently, the U.S. health care system is lacking primary care physicians. Seventy-three percent of adults report difficulty with access to primary care, compared with 61 percent in 2005; in 2005, 35 percent of non-elderly adults had no access to primary care physicians. To provide primary preventive care for 70 million more adults, to achieve an 80 percent benchmark goal, more primary care physicians are needed. Because of this shortage in primary care physicians, care is not always coordinated. Twenty-two percent of U.S. adults suffering from health issues reported that test results or records were unavailable at the time of their appointments. U.S. patients were five times more likely than patients in the Netherlands to say that doctors unnecessarily repeated tests. Coordination of care at the time of hospital discharge is proven to prevent complications and readmissions to the hospital, cutting down the cost of duplicate visits.
The current system is not efficient due to high administrative costs associated with private insurance. Insurance administrative costs are three times higher in the U.S. than in the most health care efficient countries, which are Finland, Japan, and Austria. Lowering administrative costs to those of the benchmark countries would save the U.S. health care system $100 billion a year. From 2000 to 2006, per capita administrative costs rose 68 percent, from $289 to $485, and health care expenditures increased 47 percent over the same period.