US healthcare is expensive, but it is supposed to be the best for those who can afford it. However, a new study published in JAMA Internal Medicine shows how little even the wealthiest benefit. Although white citizens living in the richest 1% and 5% of counties have better health data than poor ones, they lag behind the average citizens of other countries in key areas.
The US spent 18% of GDP on health in 2018, according to Peterson-KFF. Average spending in comparable countries was only 10%. And the richest quintile of the US population spends 43% more than the poorest, according to a 2016 study published in Health Affairs. That explains why rich Americans are thought to receive the best care in the world.
But that may not be true. The JAMA study shows, for example, that maternal mortality in the richest 1% of counties is around 10 per 100,000 births, less than half the rate in the country; but the average among 12 developed nations is 3 per 100,000. Something similar occurs with survival 30 days after suffering a heart attack.
Of course, the United States ranks among the best in breast cancer survival, for example. And the populations are not the same: Americans are generally fatter and more sedentary than other nationalities.
Still, it is further proof that something is wrong. Having a referral doctor would help. An official survey shows that Americans with complex conditions have an average of more than 12 doctors, increasing the chances of drug interactions or patients being ignored. The situation could improve with more home visits by nurses.
Evaluating and paying doctors based on results, rather than prescriptions and procedures, would also pay off. And greater health equity would benefit everyone, something that should be evident in a pandemic.