The Commonwealth Fund annual report pinpoints high cost of US health care

This week, The Commonwealth Fund released their 2018 Annual Report. The report demonstrates progress towards the goal of advancing access to high-quality, affordable health care for all.“The Year in Numbers,” another feature of the report, highlights Fund research on the drivers of U.S. prescription drug costs, the state of health insurance coverage, the impact of Medicaid work requirements, the challenges low-income patients face, to name a few. 

A number of noteworthy data points are highlighted in the report. 

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The US spends 203% more per capita on prescription drugs compared to 10 other high-income countries. The Fund report finds that spending 2 times the amount on drugs is not because Americans use larger quantities than other countries, it is because they use more expensive medications and the prices for these drugs are much higher than in other countries. 

Americans on average pay $218,173 in primary care costs. This is more than double what other countries pay per person. The high costs are a result of several factors. Doctors and medical professionals make more money in the US than they would in other high-income countries. Medical procedures and devices are also more expensive in the US compared to costs in other countries, the report finds. 

“The mean price of a dual-chamber pacemaker in 2014 was $1,400 in Germany, but $4,200 in the U.S. Meanwhile, outlays for health care administration are two-and-a-half times greater in the U.S. as a percentage of national health expenditures. To reduce health care spending, experts say that U.S. policymakers need to focus on lowering prices and administrative costs, rather than simply reducing the use of health care,” the report explains. 

12.4% of American adults do not have health insurance 2018 Fund data shows. The data comes from the Fund’s Health Insurance Survey

“Since 2010, when the ACA was enacted, more people have health insurance, but a higher share of U.S. adults are “underinsured,” meaning they have high health plan deductibles and out-of-pocket medical expenses relative to their income,” the report concludes.  

The annual report also shows that there was a 50% increase in the combined deaths from alcohol, drugs and suicide in the US. The increase occurred between 2005-2016. The report notes that this increase occurred during the years when the opioid crisis was not yet a large policy priority, but suggests that individual state policy responses to the increase of opioid use helped to mitigate a potentially higher increase overall. 

29 states have yet to implement any of the ACA consumer protection requirements. The report notes that even if the Texas court does not uphold the ACA, state’s would still be the primary regulators of health insurance. 

The report showed the disparities between urban and rural health care. In urban areas, the rate of physicians per 100,000 is higher than that in rural areas. 

“According to the Centers for Disease Control and Prevention, there are 40 physicians per 100,000 people in rural America, compared with 53 per 100,000 in large U.S. cities,” the report explains. 

The Commonwealth Fund will use the data in the report to inform public discussion, analyze candidate’s health care proposals during the 2020 presidential election and determine how these proposals will affect cost, access and quality of care.