U.S. Health Care Still Ill, Survey Finds

THURSDAY, July 17 (HealthDay News) -- Access to health care in the United States continues to elude more and more Americans, a new survey shows.

What's more, since the first "scorecard" was done in 2006, the nation's health-care system hasn't improved overall, even though the United States spends more on medical care than any other industrialized nation.

These are some of the findings in the Commonwealth Fund report calledWhy Not The Best? Results From The National Scorecard on U.S. Health System Performance, 2008.

"Despite the best efforts of millions of talented and dedicated health-care professionals, this latest scorecard demonstrates that we are losing ground," Karen Davis, president of the Commonwealth Fund, said during a Wednesday teleconference.

Davis said affordable health insurance must be extended to all. Also, the way Americans pay for health care needs to be changed to reward doctors and hospitals that offer high quality care, she said.

In the report, the authors compared average performance in the United States to performances by top-rated performers across the country and abroad.

"Overall, we find a failure to improve, with steep declines in access with growing numbers of uninsured and underinsured and ever less affordable care," Cathy Schoen, the Commonwealth Fund's senior vice president for research and evaluation, said during the teleconference.

"Overall, the U.S. score averages just 65 out of a possible 100, falling far short of benchmarks with wide gaps in all dimensions of the health system," Schoen said. The score was lower than that achieved in the 2006 scorecard, she added.

Scores for efficiency were particularly low, Schoen said, "held down by fragmented, poorly coordinated care; lack of access that leads to avoidable hospitalizations; variations in costs with no return in quality; lack of investment in information technology; and very high insurance overhead costs."

When it comes to access to and affordability of health care in the United States, the numbers seem to be moving in the wrong direction, according to the scorecard. In 2003, 35 percent of working-age adults either had no health insurance or were underinsured; by 2007, that number had risen to 42 percent.

The United States also lags behind other countries in health-care results, Schoen said. "Even where the U.S. average improved, other countries have improved much more rapidly," she said. "As a result, we are falling further behind the leaders."

For example, the United States is now last among 19 industrialized nations in premature deaths that might have been prevented by better access to health care. In 2006, the United States was 15th on the list.