Numerous challenges exist in being able to provide an accurate depiction of international comparisons of health care system performance, such as limited availability of comparable data. However, international comparisons of health care systems provide a significant initiative in cross-country learning. Through a comprehensive analysis of health care system performance, policy-makers are able to track and identify which areas are exceeding or lacking in outcome expectations. More importantly, comparative analyses of countries provide policy-makers a reason to understand what the drive for the reported performance was to provide direction on where to look for potential explanations of unexpected outcomes (Papanicolas & Smith, 2013).
Understanding unexpected health outcomes, such as the United States spending 17.1% on health care expenditures but not producing better outcomes for better health or longer life expectancy, is challenging (Levitt, Claxton, Cox, Gonzales, & Kamal, 2014). It may be beneficial to understand the different components affecting the cost growth to provide appropriate assessment on the performance of a health system.
Understanding the driving factors for U.S. health care costs
COSTS
1/Medical technology
2/Prescription drugs
3/High administrative costs (19.3% - 24.1% of the total dollar)
4/Complex multiple payers in the U.S.
FEE-FOR-SERVICE
Utilization drives reimbursement.
Fragmentation in care
$158 - $226 billion | Overtreatment/Unnecesary Care
$17 billlion | Medical Errors
Supply & Demand
Primary Care Providers Malpractice Premiums Defensive Medicine
+
=
When unnecessary tests or treatments are ordered for a patient because a provider fears facing a lawsuit.
AGING POPULATION
1/Baby Boomers will be responsible for 52% of growth in the next 25 years.
2/Medicare enrollment growth will cost an average 1.6 million annually.
3/Estimated U.S. enrollment will reach 81 million beneficiaries by 2030.
4/Medicare estimated $38,975/person in their last year of life.