The best way of evaluating metrics lies in comparing them against the numbers in similar settings. Regarding the U.S. healthcare system performance and cost-efficiency, a comparison should be made against the other economically developed countries. Japan and Germany represent the cases of well-funded Asian and European healthcare system models, respectively. A comparison of such metrics as expenditures, life expectancy, equity, and determinants of health would let make a conclusion about the U.S. healthcare system condition.
In regard to spending on health, the United States takes the leading place among the developed countries. The total spending on health in the U.S. constitutes 17,8% of the GDP. In comparison, Germany spends 11,3% of its GDP on health, and Japan — 10,9%. Furthermore, the U.S. had the highest expenditures percentage in the outpatient care (42%) and administration (8%) categories among the developed countries. Meanwhile, Germany spent 23% of its healthcare budget on outpatient care and 5% on administrative needs. In the Japanese case, these numbers reached 27% and 1%, respectively (Papanicolas et al., 2018, p. 1026). It should also be noted that the total per capita pharmaceutical spending in the U.S reached $1,443 compared to $837 in Japan and $667 in Germany (Papanicolas et al., 2018, p. 1035). Therefore, the problems of the U.S. healthcare system cannot be associated with low spending.
In terms of life expectancy, the United States had the worst numbers among the developed countries. The mean life expectancy in the U.S reached 78,8 years, compared to 80,7 in Germany and 83,9 in Japan. The U.S. system demonstrated poor results in equity — for instance, 43% of patients with below-average income experienced unmet needs (Papanicolas et al., 2018, p. 1037). Regarding the health determinants, 70,1% of the U.S. population aged 15 or more were obese or overweight. Meanwhile, this number reached 60% and 23,8% in Germany and Japan, respectively (Papanicolas et al., 2018, p. 1026). In other categories, the U.S. healthcare system performed on par with other developed countries, including Germany and Japan.
Overall, the U.S. healthcare system appeared to be highly cost-inefficient. In particular, administrative and pharmaceutical costs were significantly higher than in Germany and Japan. Furthermore, an alarming number of U.S. citizens aged over 15 are overweight. Additionally, the U.S. system demonstrated poor equity, as the needs of many patients with below-average income remained unmet. Therefore, the efforts should be directed at administrative and pharmaceutical cost reduction, disparity elimination, and nutrition health promotion.
Reference
Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. JAMA, 319(10), 1024-1039.