Our view: Why we need reform

We need better value for our health care dollars.

A Commonwealth Fund report produced in May 2007 compares the U.S. system to that of other countries.

Here's the overall conclusion:

"Compared with five other nations -- Australia, Canada, Germany, New Zealand, the United Kingdom -- the U.S. health care system ranks last or next to last. ..."

That's taking into account quality, access, efficiency, fairness and healthy lives.

One of the most telling statistics is this one: The researchers found that more people under age 75 whose deaths might have prevented by proper health care died in the U.S. than in 14 other developed countries.

The rate of such deaths in the U.S. was 115 per 100,000 people. That's almost 50 percent higher than the best country, France, which had 75 per 100,000.

Meantime, health care spending in the U.S. makes up a greater share of the gross domestic product than in any other country studied: 16 percent in 2004, while Japan, United Kingdom and New Zealand spent between 8 percent and 9 percent.

More specifics:

• The U.S. does well on preventive care -- 85 percent of patients reported receiving recommended care for hypertension and 56 percent for diabetes, for example. That was second best among the six countries.

• But we scored low on chronic care management and safe, coordinated, patient-centered care, and that pulled our overall quality score down. For example, only 29 percent of U.S. primary care physicians surveyed said they take a team approach to patients -- the least among the six countries. The best country: the United Kingdom, at 81 percent.

Only 36 percent of the U.S. doctors routinely used professionals other than doctors to help manage patients with multiple chronic diseases, compared to 73 percent of doctors in the U.K.

• The U.S. had the highest rate of deaths due to surgical or medical mishaps, at 0.7 per 100,000 population compared to 0.2 per 100,000 in Japan and The Netherlands.

• The U.S. had the highest rate of infant deaths, at seven per 100,000. Germany, the best country, had 4.2.

• The U.S. had the highest rate of patients with serious conditions who did not visit a doctor due to cost, at 34 percent. In the UK, it was 4 percent.

The U.S. health care system is seriously flawed. The goals are clear: fairness -- everyone needs to be covered by health insurance -- better quality and lower cost.

People can argue about the details, but we need the health care reform effort.

BOTTOM LINE: The U.S. health care system doesn't measure up against other developed countries.