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09.20.11.NHE international perspective

09.20.11.NHE international perspective - International...

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International Perspective on U.S. Health Care Costs and Value HCMG 101 Daniel Polsky September 20, 2011
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Review U.S. health care spending High Growing much faster than inflation and GDP Medical technology and the health insurance system are the two leading catalysts of rising spending. Hard to change these trends Temporary or ineffective efforts
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Is more better? Isn’t it a good thing for our society to be spending more resources to the sector that cares for the aged and sick? How much should our society spend on medical care? It depends on the value we get in return
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Does the U.S. receive value for the money spent on health care? Today’s Objective: International comparison perspective Consumer sovereignty perspective Thursday’s Objective: Perspective of David Cutler: “your money or your life”
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International Comparisons 1. How does our spending compare to the health spending of other countries? 2. Why is it more that other countries? 3. Do we get what we pay for?
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International Comparisons 1. How does health care spending in the U.S. compare to the health spending of other countries?
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Per Capita Total Health Care Expenditures, U.S. and Selected Countries, 2007 * Differences in methodology; see "Comparability over time" at http://www.ecosante.org/OCDEENG/411.html and "Notes on Data  Comparability" at http://www.ecosante.org/OCDEENG/529.html. ^OECD estimate. Notes:  Amounts in U.S. $ Purchasing Power Parity. More information available at www.oecd.org/std/ppp. Source:  Organization for Economic Co-operation and Development. OECD Health Data 2009, from the SourceOECD Internet subscription  database updated June, 2009.  Copyright OECD 2009, http://www.oecd.org/health/healthdata. 0 2 4 6 8 10 12
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Health Care Spending per Capita, 1980-2008 Source: OECD Health Data 2010 Adjusted for Differences in Cost of Living
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International Comparisons 1. How does our spending compare to the health spending of other countries? 2. Why is it more that other countries?
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Why is US Spending So High? Is it our high GDP? Higher ability to pay for health care typically leads to more spending in health care GDP explains 90% of differences in health spending between OECD countries Yet the high US spending is still an outlier Is health care a luxury good? Source: Reinhardt, Hussey, and Anderson, 2004.
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Total Health Spending as a % of GDP, 2007 2007: US spent 16% of GDP on health care Source: OECD Health Data 2009-Version: June 09 0 2 4 6 8 10 12
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Other Reasons Why U.S. Spending is So high? Capacity of health system Distribution of market power and prices Administrative complexity and costs Unwillingness by U.S. to ration health care (i.e., ration medical technology) Source: Reinhardt, Hussey, and Anderson, 2004.
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U.S. Spending High: Capacity Health care system capacity Other countries have more hospital beds per capita More physicians and nurses per capita Greater supply increases competition and drives prices down
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US Has Have Fewer Hospital Days 0 2
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