{"id":240301,"date":"2018-03-13T11:00:51","date_gmt":"2018-03-13T15:00:51","guid":{"rendered":"https:\/\/news.harvard.edu\/gazette\/?p=240301"},"modified":"2023-11-08T20:53:19","modified_gmt":"2023-11-09T01:53:19","slug":"u-s-pays-more-for-health-care-with-worse-population-health-outcomes","status":"publish","type":"post","link":"https:\/\/news.harvard.edu\/gazette\/story\/2018\/03\/u-s-pays-more-for-health-care-with-worse-population-health-outcomes\/","title":{"rendered":"What’s behind high U.S. health care costs"},"content":{"rendered":"\n\t
\"doctor

A Harvard study has found that physicians' salaries and hospital services are in part what's behind the higher costs of U.S. health care.<\/p>

Credit: iStock<\/p><\/figcaption><\/figure>\n\n\t

\n\t\t\t\n\t\t\tHealth\t\t<\/a>\n\t\t\n\t\t

\n\t\tWhat’s behind high U.S. health care costs\t<\/h1>\n\n\t\n\t\t\t<\/div>\n\t\t\n\t
\n\t\t
\n\t\t\t
\n\t\t\t\t\t

\n\t\tKaren Feldscher\t<\/p>\n\t\t\t

\n\t\t\tHarvard Chan School Communications\t\t<\/p>\n\t\t\t\t\t<\/address>\n\t\t<\/div>\n\n\t\t

\n\t\t\tPhysicians' salaries, cost of pharmaceuticals, and administrative expenses top the list\t\t<\/h2>\n\t\t\n<\/header>\n\n\n\n
\n\n\n\t\t

In 2016, the U.S. spent nearly twice as much on health care as other high-income countries, yet had poorer population health outcomes.<\/p>\n

    \n
  • The main drivers of higher health care spending in the U.S. are generally high prices \u2014 for salaries of physicians and nurses, pharmaceuticals, medical devices, and administration.<\/li>\n
  • Contrary to commonly held beliefs, high utilization of health care services and low spending on social services do not appear to play a significant role in higher U.S. health care costs.<\/li>\n
  • In addition, despite poor population health outcomes, quality of health care delivered once people are sick is high in the U.S.<\/li>\n<\/ul>\n

    The new findings, from the Harvard T.H. Chan School of Public Health, the Harvard Global Health Institute, and the London School of Economics, suggest that common explanations why health care costs are so high \u2014 such as the notions that the Americans have too many doctor visits, hospitalizations, procedures, and specialists, and spend too little on social services that could mitigate health care needs \u2014 may be wrong.<\/p>\n\r\n\t\n\n\t

    \"Graphic
    Source: Harvard T.H. Chan School of Public Health, Harvard Global Health Institute, London School of Economics. Credit: Rebecca Coleman\/Harvard Staff\t\t\t<\/figcaption><\/figure>\n\t\n\t\r\n\n

    The study was published today in the Journal of the American Medical Association.<\/p>\n

    \u201cWe know that the U.S. is an outlier in health care costs, spending twice as much as peer nations to deliver care. This gap and the challenges it poses for American consumers, policymakers, and business leaders was a major impetus for health care reform in the U.S., including delivery reforms implemented as part of the Affordable Care Act,\u201d said senior author Ashish Jha, K.T. Li Professor of Global Health at Harvard Chan School and director of the Harvard Global Health Institute (HGHI). \u201cIn addition, the reasons for these substantially higher costs have been misunderstood: These data suggest that many of the policy efforts in the U.S. have not been truly evidence-based.\u201d<\/p>\n

    Using international data primarily from 2013 to 2016, the researchers compared the U.S. with 10 other high-income countries \u2014 the U.K., Canada, Germany, Australia, Japan, Sweden, France, Denmark, the Netherlands, and Switzerland \u2014 on approximately 100 metrics that underpin health care spending.<\/p>\n

    The study confirmed that the U.S. has substantially higher spending, worse population health outcomes, and worse access to care than other wealthy countries. For example, in 2016, the U.S. spent 17.8 percent of its gross domestic product on health care, while other countries ranged from 9.6 percent (Australia) to 12.4 percent (Switzerland). Life expectancy in the U.S. was the lowest of all 11 countries in the study, at 78.8 years; the range for other countries was 80.7 to 83.9 years. The proportion of the U.S. population with health insurance was 90 percent, lower than all the other countries, which ranged from 99 to 100 percent coverage.<\/p>\n

    But commonly held beliefs for these differences appear at odds with the evidence, the study found.<\/p>\n

    Key findings included:<\/strong><\/strong><\/h3>\n

    Belief:<\/strong> <\/strong>The U.S. uses more health care services than peer countries, thus leading to higher costs.<\/p>\n

    Evidence:<\/strong><\/strong>\u00a0The U.S. has lower rates of physician visits and days spent in the hospital than other nations.<\/p>\n

    Belief:<\/strong> <\/strong>The U.S. has too many specialists and not enough primary care physicians.<\/p>\n

    Evidence:<\/strong><\/strong> The primary care versus specialist mix in the U.S. is roughly the same as that of the average of other countries.<\/p>\n

    Belief:\u00a0 <\/strong><\/strong>The U.S. provides too much inpatient hospital care.<\/p>\n

    Evidence:<\/strong><\/strong> Only 19 percent of total health care spending in the U.S. is spent on inpatient services \u2014 among the lowest proportion of similar countries.<\/p>\n

    Belief:\u00a0 <\/strong><\/strong>The U.S. spends too little on social services and this may contribute to higher health care costs among certain populations.<\/p>\n

    Evidence:<\/strong><\/strong>\u00a0The U.S. does spend a bit less on social services than other countries, but it is not an outlier.<\/p>\n

    Belief:<\/strong><\/strong>\u00a0The quality of health care is much lower in the U.S. than in other countries.<\/p>\n

    Evidence:<\/strong><\/strong>\u00a0Overall, quality of care in the U.S. isn\u2019t markedly different from that of other countries, and in fact excels in many areas. For example, the U.S. appears to have the best outcomes for those who have heart attacks or strokes, but is below average for avoidable hospitalizations for patients with diabetes and asthma.<\/p>\n

    What does explain higher spending in the U.S. is administrative complexity and high prices across a wide range of health care services. For example, the findings showed that:<\/p>\n

      \n
    • Administrative costs of care \u2014 activities related to planning, regulating, and managing health systems and services \u2014 accounted for 8 percent of total health care costs, compared with a range of 1 to 3 percent for other countries.<\/li>\n
    • Per capita spending for pharmaceuticals was $1,443 in the U.S., compared with a range of $466 to $939 in other nations. For several commonly used brand-name pharmaceuticals, the U.S. had substantially higher prices than other countries, often double the next-highest price.<\/li>\n
    • The average salary for a general practice physician in the U.S. was $218,173, while in other countries the salary range was $86,607 to $154,126.<\/li>\n<\/ul>\n

      \u201cAs the U.S. continues to struggle with high health care spending, it is critical that we make progress on curtailing these costs. International comparisons are very valuable \u2014 they allow for reflection on national performance and serve to promote accountability,\u201d said first author Irene Papanicolas, visiting assistant professor in the Department of Health Policy and Management at Harvard Chan School.<\/p>\n

      Liana Woskie, <\/em>assistant director of the Harvard Global Health Institute\u2019s strategic initiative on quality, <\/em>was a co-author of the study.<\/em><\/p>\n\n\n\n<\/div>\n\n\t\t","protected":false},"excerpt":{"rendered":"

      A Harvard study confirmed that the U.S. has substantially higher spending on health care, worse population health outcomes, and worse access to care than other wealthy countries; but there\u2019s more to it than that.<\/p>\n","protected":false},"author":105622744,"featured_media":240336,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"gz_ga_pageviews":217,"gz_ga_lastupdated":"2024-12-14 04:05","document_color_palette":"crimson","author":"Karen Feldscher","affiliation":"Harvard Chan School Communications","_category_override":"","_yoast_wpseo_primary_category":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[39644],"tags":[40075,3143,15738,16124,16535,40077,40074,21989,27388,40076,40078],"gazette-formats":[],"series":[],"class_list":["post-240301","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","tag-administrative-costs","tag-affordable-care-act","tag-harvard-global-health-institute","tag-harvard-t-h-chan-school-of-public-health","tag-health-care-costs","tag-high-costs","tag-high-salaries","tag-london-school-of-economics","tag-pharmaceuticals","tag-poor-health","tag-social-services"],"yoast_head":"\nU.S. pays more for health care with worse population health outcomes — Harvard Gazette<\/title>\n<meta name=\"description\" content=\"A Harvard study confirmed that the U.S. has substantially higher spending on health care, worse population health outcomes, and worse access to care than other wealthy countries; but there\u2019s more to it than that.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/news.harvard.edu\/gazette\/story\/2018\/03\/u-s-pays-more-for-health-care-with-worse-population-health-outcomes\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"U.S. pays more for health care with worse population health outcomes\" \/>\n<meta property=\"og:description\" content=\"A Harvard study confirmed that the U.S. has substantially higher spending on health care, worse population health outcomes, and worse access to care than other wealthy countries; but there\u2019s more to it than that.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/news.harvard.edu\/gazette\/story\/2018\/03\/u-s-pays-more-for-health-care-with-worse-population-health-outcomes\/\" \/>\n<meta property=\"og:site_name\" content=\"Harvard Gazette\" \/>\n<meta property=\"article:published_time\" content=\"2018-03-13T15:00:51+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-11-09T01:53:19+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/news.harvard.edu\/gazette\/wp-content\/uploads\/2018\/03\/medical-costs1.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"2500\" \/>\n\t<meta property=\"og:image:height\" content=\"1667\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"harvardgazette\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:title\" content=\"U.S. pays more for health care with worse population health outcomes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/news.harvard.edu\/gazette\/story\/2018\/03\/u-s-pays-more-for-health-care-with-worse-population-health-outcomes\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/news.harvard.edu\/gazette\/story\/2018\/03\/u-s-pays-more-for-health-care-with-worse-population-health-outcomes\/\"},\"author\":{\"name\":\"harvardgazette\",\"@id\":\"https:\/\/news.harvard.edu\/gazette\/#\/schema\/person\/78d028cf624923e92682268709ffbc4b\"},\"headline\":\"What’s behind high U.S. health care costs\",\"datePublished\":\"2018-03-13T15:00:51+00:00\",\"dateModified\":\"2023-11-09T01:53:19+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/news.harvard.edu\/gazette\/story\/2018\/03\/u-s-pays-more-for-health-care-with-worse-population-health-outcomes\/\"},\"wordCount\":941,\"publisher\":{\"@id\":\"https:\/\/news.harvard.edu\/gazette\/#organization\"},\"image\":{\"@id\":\"https:\/\/news.harvard.edu\/gazette\/story\/2018\/03\/u-s-pays-more-for-health-care-with-worse-population-health-outcomes\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/news.harvard.edu\/wp-content\/uploads\/2018\/03\/medical-costs1.jpg\",\"keywords\":[\"administrative costs\",\"Affordable Care Act\",\"Harvard Global Health Institute\",\"Harvard T.H. 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act\",\"harvard global health institute\",\"harvard t.h. chan school of public health\",\"health care costs\",\"high costs\",\"high salaries\",\"london school of economics\",\"pharmaceuticals\",\"poor health\",\"social services\"],\"dateCreated\":\"2018-03-13T15:00:51Z\",\"datePublished\":\"2018-03-13T15:00:51Z\",\"dateModified\":\"2023-11-09T01:53:19Z\"}<\/script>","tracker_url":"https:\/\/cdn.parsely.com\/keys\/news.harvard.edu\/p.js"},"jetpack_featured_media_url":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2018\/03\/medical-costs1.jpg","has_blocks":true,"block_data":{"0":{"blockName":"harvard-gazette\/article-header","attrs":{"blockColorPalette":"","coloredHeading":"","creditText":"Credit: iStock","displayDetails":"","displayTitle":"","categoryId":39644,"mediaAlt":"doctor and nurse looking at chart","mediaCaption":"A Harvard study has found that physicians' salaries and hospital services are in part what's behind the higher costs of U.S. health care.","mediaId":240336,"mediaSize":"full","mediaType":"image","mediaUrl":"https:\/\/news.harvard.edu\/gazette\/wp-content\/uploads\/2018\/03\/medical-costs1.jpg","poster":"","title":"What’s behind high U.S. health care costs","subheading":"Physicians' salaries, cost of pharmaceuticals, and administrative expenses top the list","centeredImage":true,"className":"is-style-full-width-text-below","mediaHeight":1667,"mediaWidth":2500,"backgroundFixed":false,"backgroundTone":"light","coloredBackground":false,"displayOverlay":true,"fadeInText":false,"isAmbient":false,"mediaLength":"","mediaPosition":"","posterText":"","titleAbove":false,"useUncroppedImage":false,"lock":[],"metadata":[]},"innerBlocks":[],"innerHTML":"<figure class=\"wp-block-image\"><img alt=\"doctor and nurse looking at chart\" height=\"1667\" loading=\"eager\" src=\"https:\/\/news.harvard.edu\/gazette\/wp-content\/uploads\/2018\/03\/medical-costs1.jpg\" width=\"2500\"\/><figcaption class=\"wp-element-caption\"><p class=\"wp-element-caption--caption\">A Harvard study has found that physicians' salaries and hospital services are in part what's behind the higher costs of U.S. health care.<\/p><p class=\"wp-element-caption--credit\">Credit: iStock<\/p><\/figcaption><\/figure>\n","innerContent":["<figure class=\"wp-block-image\"><img alt=\"doctor and nurse looking at chart\" height=\"1667\" loading=\"eager\" src=\"https:\/\/news.harvard.edu\/gazette\/wp-content\/uploads\/2018\/03\/medical-costs1.jpg\" width=\"2500\"\/><figcaption class=\"wp-element-caption\"><p class=\"wp-element-caption--caption\">A Harvard study has found that physicians' salaries and hospital services are in part what's behind the higher costs of U.S. health care.<\/p><p class=\"wp-element-caption--credit\">Credit: iStock<\/p><\/figcaption><\/figure>\n"],"rendered":"<header\n\tclass=\"wp-block-harvard-gazette-article-header alignfull article-header is-style-full-width-text-below centered-image\"\n\tstyle=\" \"\n>\n\t<figure class=\"wp-block-image\"><img alt=\"doctor and nurse looking at chart\" height=\"1667\" loading=\"eager\" src=\"https:\/\/news.harvard.edu\/gazette\/wp-content\/uploads\/2018\/03\/medical-costs1.jpg\" width=\"2500\"\/><figcaption class=\"wp-element-caption\"><p class=\"wp-element-caption--caption\">A Harvard study has found that physicians' salaries and hospital services are in part what's behind the higher costs of U.S. health care.<\/p><p class=\"wp-element-caption--credit\">Credit: iStock<\/p><\/figcaption><\/figure>\n\n\t<div class=\"article-header__content\">\n\t\t\t<a\n\t\t\tclass=\"article-header__category\"\n\t\t\thref=\"https:\/\/news.harvard.edu\/gazette\/section\/health\/\"\n\t\t>\n\t\t\tHealth\t\t<\/a>\n\t\t\n\t\t<h1 class=\"article-header__title wp-block-heading \">\n\t\tWhat’s behind high U.S. health care costs\t<\/h1>\n\n\t\n\t\t\t<\/div>\n\t\t\n\t<div class=\"article-header__meta\">\n\t\t<div class=\"wp-block-post-author\">\n\t\t\t<address class=\"wp-block-post-author__content\">\n\t\t\t\t\t<p class=\"author wp-block-post-author__name\">\n\t\tKaren Feldscher\t<\/p>\n\t\t\t<p class=\"wp-block-post-author__byline\">\n\t\t\tHarvard Chan School Communications\t\t<\/p>\n\t\t\t\t\t<\/address>\n\t\t<\/div>\n\n\t\t<time class=\"article-header__date\" datetime=\"2018-03-13\">\n\t\t\tMarch 13, 2018\t\t<\/time>\n\n\t\t<span class=\"article-header__reading-time\">\n\t\t\t5 min read\t\t<\/span>\n\t<\/div>\n\n\t\n\t\t\t<h2 class=\"article-header__subheading wp-block-heading\">\n\t\t\tPhysicians' salaries, cost of pharmaceuticals, and administrative expenses top the list\t\t<\/h2>\n\t\t\n<\/header>\n"},"2":{"blockName":"core\/group","attrs":{"templateLock":false,"metadata":{"name":"Article content"},"align":"wide","layout":{"type":"constrained","justifyContent":"center"},"tagName":"div","lock":[],"className":"","style":[],"backgroundColor":"","textColor":"","gradient":"","fontSize":"","fontFamily":"","borderColor":"","ariaLabel":"","anchor":""},"innerBlocks":[{"blockName":"core\/freeform","attrs":{"content":"","lock":[],"metadata":[]},"innerBlocks":[],"innerHTML":"\n\t\t<p>In 2016, the U.S. spent nearly twice as much on health care as other high-income countries, yet had poorer population health outcomes.<\/p>\n<ul>\n<li>The main drivers of higher health care spending in the U.S. are generally high prices \u2014 for salaries of physicians and nurses, pharmaceuticals, medical devices, and administration.<\/li>\n<li>Contrary to commonly held beliefs, high utilization of health care services and low spending on social services do not appear to play a significant role in higher U.S. health care costs.<\/li>\n<li>In addition, despite poor population health outcomes, quality of health care delivered once people are sick is high in the U.S.<\/li>\n<\/ul>\n<p>The new findings, from the Harvard T.H. Chan School of Public Health, the Harvard Global Health Institute, and the London School of Economics, suggest that common explanations why health care costs are so high \u2014 such as the notions that the Americans have too many doctor visits, hospitalizations, procedures, and specialists, and spend too little on social services that could mitigate health care needs \u2014 may be wrong.<\/p>\n","innerContent":["\n\t\t<p>In 2016, the U.S. spent nearly twice as much on health care as other high-income countries, yet had poorer population health outcomes.<\/p>\n<ul>\n<li>The main drivers of higher health care spending in the U.S. are generally high prices \u2014 for salaries of physicians and nurses, pharmaceuticals, medical devices, and administration.<\/li>\n<li>Contrary to commonly held beliefs, high utilization of health care services and low spending on social services do not appear to play a significant role in higher U.S. health care costs.<\/li>\n<li>In addition, despite poor population health outcomes, quality of health care delivered once people are sick is high in the U.S.<\/li>\n<\/ul>\n<p>The new findings, from the Harvard T.H. Chan School of Public Health, the Harvard Global Health Institute, and the London School of Economics, suggest that common explanations why health care costs are so high \u2014 such as the notions that the Americans have too many doctor visits, hospitalizations, procedures, and specialists, and spend too little on social services that could mitigate health care needs \u2014 may be wrong.<\/p>\n"],"rendered":"\n\t\t<p>In 2016, the U.S. spent nearly twice as much on health care as other high-income countries, yet had poorer population health outcomes.<\/p>\n<ul>\n<li>The main drivers of higher health care spending in the U.S. are generally high prices \u2014 for salaries of physicians and nurses, pharmaceuticals, medical devices, and administration.<\/li>\n<li>Contrary to commonly held beliefs, high utilization of health care services and low spending on social services do not appear to play a significant role in higher U.S. health care costs.<\/li>\n<li>In addition, despite poor population health outcomes, quality of health care delivered once people are sick is high in the U.S.<\/li>\n<\/ul>\n<p>The new findings, from the Harvard T.H. Chan School of Public Health, the Harvard Global Health Institute, and the London School of Economics, suggest that common explanations why health care costs are so high \u2014 such as the notions that the Americans have too many doctor visits, hospitalizations, procedures, and specialists, and spend too little on social services that could mitigate health care needs \u2014 may be wrong.<\/p>\n"},{"blockName":"core\/image","attrs":{"sizeSlug":"full","align":"center","id":240339,"caption":"Source: Harvard T.H. Chan School of Public Health, Harvard Global Health Institute, London School of Economics. Credit: Rebecca Coleman\/Harvard Staff","blob":"","url":"https:\/\/news.harvard.edu\/gazette\/wp-content\/uploads\/2018\/03\/healthcare.jpg","alt":"Graphic of health care costs","lightbox":[],"title":"","href":"","rel":"","linkClass":"","width":"","height":"","aspectRatio":"","scale":"","linkDestination":"","linkTarget":"","lock":[],"metadata":[],"className":"","style":[],"borderColor":"","anchor":""},"innerBlocks":[],"innerHTML":"\n\n\t<figure class=\"wp-block-image aligncenter size-full is-resized\"><img src=\"https:\/\/news.harvard.edu\/gazette\/wp-content\/uploads\/2018\/03\/healthcare.jpg\" alt=\"Graphic of health care costs\" class=\"wp-image-240339\"><figcaption class=\"wp-element-caption\">Source: Harvard T.H. Chan School of Public Health, Harvard Global Health Institute, London School of Economics. Credit: Rebecca Coleman\/Harvard Staff\t\t\t<\/figcaption><\/figure>\n\t","innerContent":["\n\n\t<figure class=\"wp-block-image aligncenter size-full is-resized\"><img src=\"https:\/\/news.harvard.edu\/gazette\/wp-content\/uploads\/2018\/03\/healthcare.jpg\" alt=\"Graphic of health care costs\" class=\"wp-image-240339\"><figcaption class=\"wp-element-caption\">Source: Harvard T.H. Chan School of Public Health, Harvard Global Health Institute, London School of Economics. Credit: Rebecca Coleman\/Harvard Staff\t\t\t<\/figcaption><\/figure>\n\t"],"rendered":"\n\n\t<figure class=\"wp-block-image aligncenter size-full is-resized\"><img src=\"https:\/\/news.harvard.edu\/gazette\/wp-content\/uploads\/2018\/03\/healthcare.jpg\" alt=\"Graphic of health care costs\" class=\"wp-image-240339\"><figcaption class=\"wp-element-caption\">Source: Harvard T.H. Chan School of Public Health, Harvard Global Health Institute, London School of Economics. Credit: Rebecca Coleman\/Harvard Staff\t\t\t<\/figcaption><\/figure>\n\t"},{"blockName":"core\/freeform","attrs":{"content":"","lock":[],"metadata":[]},"innerBlocks":[],"innerHTML":"\n<p>The study was published today in the Journal of the American Medical Association.<\/p>\n<p>\u201cWe know that the U.S. is an outlier in health care costs, spending twice as much as peer nations to deliver care. This gap and the challenges it poses for American consumers, policymakers, and business leaders was a major impetus for health care reform in the U.S., including delivery reforms implemented as part of the Affordable Care Act,\u201d said senior author Ashish Jha, K.T. Li Professor of Global Health at Harvard Chan School and director of the Harvard Global Health Institute (HGHI). \u201cIn addition, the reasons for these substantially higher costs have been misunderstood: These data suggest that many of the policy efforts in the U.S. have not been truly evidence-based.\u201d<\/p>\n<p>Using international data primarily from 2013 to 2016, the researchers compared the U.S. with 10 other high-income countries \u2014 the U.K., Canada, Germany, Australia, Japan, Sweden, France, Denmark, the Netherlands, and Switzerland \u2014 on approximately 100 metrics that underpin health care spending.<\/p>\n<p>The study confirmed that the U.S. has substantially higher spending, worse population health outcomes, and worse access to care than other wealthy countries. For example, in 2016, the U.S. spent 17.8 percent of its gross domestic product on health care, while other countries ranged from 9.6 percent (Australia) to 12.4 percent (Switzerland). Life expectancy in the U.S. was the lowest of all 11 countries in the study, at 78.8 years; the range for other countries was 80.7 to 83.9 years. The proportion of the U.S. population with health insurance was 90 percent, lower than all the other countries, which ranged from 99 to 100 percent coverage.<\/p>\n<p>But commonly held beliefs for these differences appear at odds with the evidence, the study found.<\/p>\n<h3 class=\"wp-block-heading\"><strong><strong>Key findings included:<\/strong><\/strong><\/h3>\n<p><strong><strong>Belief:<\/strong> <\/strong>The U.S. uses more health care services than peer countries, thus leading to higher costs.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong>\u00a0The U.S. has lower rates of physician visits and days spent in the hospital than other nations.<\/p>\n<p><strong><strong>Belief:<\/strong> <\/strong>The U.S. has too many specialists and not enough primary care physicians.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong> The primary care versus specialist mix in the U.S. is roughly the same as that of the average of other countries.<\/p>\n<p><strong><strong>Belief:\u00a0 <\/strong><\/strong>The U.S. provides too much inpatient hospital care.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong> Only 19 percent of total health care spending in the U.S. is spent on inpatient services \u2014 among the lowest proportion of similar countries.<\/p>\n<p><strong><strong>Belief:\u00a0 <\/strong><\/strong>The U.S. spends too little on social services and this may contribute to higher health care costs among certain populations.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong>\u00a0The U.S. does spend a bit less on social services than other countries, but it is not an outlier.<\/p>\n<p><strong><strong>Belief:<\/strong><\/strong>\u00a0The quality of health care is much lower in the U.S. than in other countries.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong>\u00a0Overall, quality of care in the U.S. isn\u2019t markedly different from that of other countries, and in fact excels in many areas. For example, the U.S. appears to have the best outcomes for those who have heart attacks or strokes, but is below average for avoidable hospitalizations for patients with diabetes and asthma.<\/p>\n<p>What does explain higher spending in the U.S. is administrative complexity and high prices across a wide range of health care services. For example, the findings showed that:<\/p>\n<ul>\n<li>Administrative costs of care \u2014 activities related to planning, regulating, and managing health systems and services \u2014 accounted for 8 percent of total health care costs, compared with a range of 1 to 3 percent for other countries.<\/li>\n<li>Per capita spending for pharmaceuticals was $1,443 in the U.S., compared with a range of $466 to $939 in other nations. For several commonly used brand-name pharmaceuticals, the U.S. had substantially higher prices than other countries, often double the next-highest price.<\/li>\n<li>The average salary for a general practice physician in the U.S. was $218,173, while in other countries the salary range was $86,607 to $154,126.<\/li>\n<\/ul>\n<p>\u201cAs the U.S. continues to struggle with high health care spending, it is critical that we make progress on curtailing these costs. International comparisons are very valuable \u2014 they allow for reflection on national performance and serve to promote accountability,\u201d said first author Irene Papanicolas, visiting assistant professor in the Department of Health Policy and Management at Harvard Chan School.<\/p>\n<p><em>Liana Woskie, <\/em><em>assistant director of the Harvard Global Health Institute\u2019s strategic initiative on quality, <\/em><em>was a co-author of the study.<\/em><\/p>\n\n","innerContent":["\n<p>The study was published today in the Journal of the American Medical Association.<\/p>\n<p>\u201cWe know that the U.S. is an outlier in health care costs, spending twice as much as peer nations to deliver care. This gap and the challenges it poses for American consumers, policymakers, and business leaders was a major impetus for health care reform in the U.S., including delivery reforms implemented as part of the Affordable Care Act,\u201d said senior author Ashish Jha, K.T. Li Professor of Global Health at Harvard Chan School and director of the Harvard Global Health Institute (HGHI). \u201cIn addition, the reasons for these substantially higher costs have been misunderstood: These data suggest that many of the policy efforts in the U.S. have not been truly evidence-based.\u201d<\/p>\n<p>Using international data primarily from 2013 to 2016, the researchers compared the U.S. with 10 other high-income countries \u2014 the U.K., Canada, Germany, Australia, Japan, Sweden, France, Denmark, the Netherlands, and Switzerland \u2014 on approximately 100 metrics that underpin health care spending.<\/p>\n<p>The study confirmed that the U.S. has substantially higher spending, worse population health outcomes, and worse access to care than other wealthy countries. For example, in 2016, the U.S. spent 17.8 percent of its gross domestic product on health care, while other countries ranged from 9.6 percent (Australia) to 12.4 percent (Switzerland). Life expectancy in the U.S. was the lowest of all 11 countries in the study, at 78.8 years; the range for other countries was 80.7 to 83.9 years. The proportion of the U.S. population with health insurance was 90 percent, lower than all the other countries, which ranged from 99 to 100 percent coverage.<\/p>\n<p>But commonly held beliefs for these differences appear at odds with the evidence, the study found.<\/p>\n<h3 class=\"wp-block-heading\"><strong><strong>Key findings included:<\/strong><\/strong><\/h3>\n<p><strong><strong>Belief:<\/strong> <\/strong>The U.S. uses more health care services than peer countries, thus leading to higher costs.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong>\u00a0The U.S. has lower rates of physician visits and days spent in the hospital than other nations.<\/p>\n<p><strong><strong>Belief:<\/strong> <\/strong>The U.S. has too many specialists and not enough primary care physicians.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong> The primary care versus specialist mix in the U.S. is roughly the same as that of the average of other countries.<\/p>\n<p><strong><strong>Belief:\u00a0 <\/strong><\/strong>The U.S. provides too much inpatient hospital care.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong> Only 19 percent of total health care spending in the U.S. is spent on inpatient services \u2014 among the lowest proportion of similar countries.<\/p>\n<p><strong><strong>Belief:\u00a0 <\/strong><\/strong>The U.S. spends too little on social services and this may contribute to higher health care costs among certain populations.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong>\u00a0The U.S. does spend a bit less on social services than other countries, but it is not an outlier.<\/p>\n<p><strong><strong>Belief:<\/strong><\/strong>\u00a0The quality of health care is much lower in the U.S. than in other countries.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong>\u00a0Overall, quality of care in the U.S. isn\u2019t markedly different from that of other countries, and in fact excels in many areas. For example, the U.S. appears to have the best outcomes for those who have heart attacks or strokes, but is below average for avoidable hospitalizations for patients with diabetes and asthma.<\/p>\n<p>What does explain higher spending in the U.S. is administrative complexity and high prices across a wide range of health care services. For example, the findings showed that:<\/p>\n<ul>\n<li>Administrative costs of care \u2014 activities related to planning, regulating, and managing health systems and services \u2014 accounted for 8 percent of total health care costs, compared with a range of 1 to 3 percent for other countries.<\/li>\n<li>Per capita spending for pharmaceuticals was $1,443 in the U.S., compared with a range of $466 to $939 in other nations. For several commonly used brand-name pharmaceuticals, the U.S. had substantially higher prices than other countries, often double the next-highest price.<\/li>\n<li>The average salary for a general practice physician in the U.S. was $218,173, while in other countries the salary range was $86,607 to $154,126.<\/li>\n<\/ul>\n<p>\u201cAs the U.S. continues to struggle with high health care spending, it is critical that we make progress on curtailing these costs. International comparisons are very valuable \u2014 they allow for reflection on national performance and serve to promote accountability,\u201d said first author Irene Papanicolas, visiting assistant professor in the Department of Health Policy and Management at Harvard Chan School.<\/p>\n<p><em>Liana Woskie, <\/em><em>assistant director of the Harvard Global Health Institute\u2019s strategic initiative on quality, <\/em><em>was a co-author of the study.<\/em><\/p>\n\n"],"rendered":"\n<p>The study was published today in the Journal of the American Medical Association.<\/p>\n<p>\u201cWe know that the U.S. is an outlier in health care costs, spending twice as much as peer nations to deliver care. This gap and the challenges it poses for American consumers, policymakers, and business leaders was a major impetus for health care reform in the U.S., including delivery reforms implemented as part of the Affordable Care Act,\u201d said senior author Ashish Jha, K.T. Li Professor of Global Health at Harvard Chan School and director of the Harvard Global Health Institute (HGHI). \u201cIn addition, the reasons for these substantially higher costs have been misunderstood: These data suggest that many of the policy efforts in the U.S. have not been truly evidence-based.\u201d<\/p>\n<p>Using international data primarily from 2013 to 2016, the researchers compared the U.S. with 10 other high-income countries \u2014 the U.K., Canada, Germany, Australia, Japan, Sweden, France, Denmark, the Netherlands, and Switzerland \u2014 on approximately 100 metrics that underpin health care spending.<\/p>\n<p>The study confirmed that the U.S. has substantially higher spending, worse population health outcomes, and worse access to care than other wealthy countries. For example, in 2016, the U.S. spent 17.8 percent of its gross domestic product on health care, while other countries ranged from 9.6 percent (Australia) to 12.4 percent (Switzerland). Life expectancy in the U.S. was the lowest of all 11 countries in the study, at 78.8 years; the range for other countries was 80.7 to 83.9 years. The proportion of the U.S. population with health insurance was 90 percent, lower than all the other countries, which ranged from 99 to 100 percent coverage.<\/p>\n<p>But commonly held beliefs for these differences appear at odds with the evidence, the study found.<\/p>\n<h3 class=\"wp-block-heading\"><strong><strong>Key findings included:<\/strong><\/strong><\/h3>\n<p><strong><strong>Belief:<\/strong> <\/strong>The U.S. uses more health care services than peer countries, thus leading to higher costs.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong>\u00a0The U.S. has lower rates of physician visits and days spent in the hospital than other nations.<\/p>\n<p><strong><strong>Belief:<\/strong> <\/strong>The U.S. has too many specialists and not enough primary care physicians.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong> The primary care versus specialist mix in the U.S. is roughly the same as that of the average of other countries.<\/p>\n<p><strong><strong>Belief:\u00a0 <\/strong><\/strong>The U.S. provides too much inpatient hospital care.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong> Only 19 percent of total health care spending in the U.S. is spent on inpatient services \u2014 among the lowest proportion of similar countries.<\/p>\n<p><strong><strong>Belief:\u00a0 <\/strong><\/strong>The U.S. spends too little on social services and this may contribute to higher health care costs among certain populations.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong>\u00a0The U.S. does spend a bit less on social services than other countries, but it is not an outlier.<\/p>\n<p><strong><strong>Belief:<\/strong><\/strong>\u00a0The quality of health care is much lower in the U.S. than in other countries.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong>\u00a0Overall, quality of care in the U.S. isn\u2019t markedly different from that of other countries, and in fact excels in many areas. For example, the U.S. appears to have the best outcomes for those who have heart attacks or strokes, but is below average for avoidable hospitalizations for patients with diabetes and asthma.<\/p>\n<p>What does explain higher spending in the U.S. is administrative complexity and high prices across a wide range of health care services. For example, the findings showed that:<\/p>\n<ul>\n<li>Administrative costs of care \u2014 activities related to planning, regulating, and managing health systems and services \u2014 accounted for 8 percent of total health care costs, compared with a range of 1 to 3 percent for other countries.<\/li>\n<li>Per capita spending for pharmaceuticals was $1,443 in the U.S., compared with a range of $466 to $939 in other nations. For several commonly used brand-name pharmaceuticals, the U.S. had substantially higher prices than other countries, often double the next-highest price.<\/li>\n<li>The average salary for a general practice physician in the U.S. was $218,173, while in other countries the salary range was $86,607 to $154,126.<\/li>\n<\/ul>\n<p>\u201cAs the U.S. continues to struggle with high health care spending, it is critical that we make progress on curtailing these costs. International comparisons are very valuable \u2014 they allow for reflection on national performance and serve to promote accountability,\u201d said first author Irene Papanicolas, visiting assistant professor in the Department of Health Policy and Management at Harvard Chan School.<\/p>\n<p><em>Liana Woskie, <\/em><em>assistant director of the Harvard Global Health Institute\u2019s strategic initiative on quality, <\/em><em>was a co-author of the study.<\/em><\/p>\n\n"}],"innerHTML":"\n<div class=\"wp-block-group alignwide\">\n\n\r\n\t\n\t\r\n\n\n<\/div>\n","innerContent":["\n<div class=\"wp-block-group alignwide\">\n\n","\r\n\t","\n\t\r\n","\n\n<\/div>\n"],"rendered":"\n<div class=\"wp-block-group alignwide has-global-padding is-content-justification-center is-layout-constrained wp-block-group-is-layout-constrained\">\n\n\n\t\t<p>In 2016, the U.S. spent nearly twice as much on health care as other high-income countries, yet had poorer population health outcomes.<\/p>\n<ul>\n<li>The main drivers of higher health care spending in the U.S. are generally high prices \u2014 for salaries of physicians and nurses, pharmaceuticals, medical devices, and administration.<\/li>\n<li>Contrary to commonly held beliefs, high utilization of health care services and low spending on social services do not appear to play a significant role in higher U.S. health care costs.<\/li>\n<li>In addition, despite poor population health outcomes, quality of health care delivered once people are sick is high in the U.S.<\/li>\n<\/ul>\n<p>The new findings, from the Harvard T.H. Chan School of Public Health, the Harvard Global Health Institute, and the London School of Economics, suggest that common explanations why health care costs are so high \u2014 such as the notions that the Americans have too many doctor visits, hospitalizations, procedures, and specialists, and spend too little on social services that could mitigate health care needs \u2014 may be wrong.<\/p>\n\r\n\t\n\n\t<figure class=\"wp-block-image aligncenter size-full is-resized\"><img src=\"https:\/\/news.harvard.edu\/gazette\/wp-content\/uploads\/2018\/03\/healthcare.jpg\" alt=\"Graphic of health care costs\" class=\"wp-image-240339\"><figcaption class=\"wp-element-caption\">Source: Harvard T.H. Chan School of Public Health, Harvard Global Health Institute, London School of Economics. Credit: Rebecca Coleman\/Harvard Staff\t\t\t<\/figcaption><\/figure>\n\t\n\t\r\n\n<p>The study was published today in the Journal of the American Medical Association.<\/p>\n<p>\u201cWe know that the U.S. is an outlier in health care costs, spending twice as much as peer nations to deliver care. This gap and the challenges it poses for American consumers, policymakers, and business leaders was a major impetus for health care reform in the U.S., including delivery reforms implemented as part of the Affordable Care Act,\u201d said senior author Ashish Jha, K.T. Li Professor of Global Health at Harvard Chan School and director of the Harvard Global Health Institute (HGHI). \u201cIn addition, the reasons for these substantially higher costs have been misunderstood: These data suggest that many of the policy efforts in the U.S. have not been truly evidence-based.\u201d<\/p>\n<p>Using international data primarily from 2013 to 2016, the researchers compared the U.S. with 10 other high-income countries \u2014 the U.K., Canada, Germany, Australia, Japan, Sweden, France, Denmark, the Netherlands, and Switzerland \u2014 on approximately 100 metrics that underpin health care spending.<\/p>\n<p>The study confirmed that the U.S. has substantially higher spending, worse population health outcomes, and worse access to care than other wealthy countries. For example, in 2016, the U.S. spent 17.8 percent of its gross domestic product on health care, while other countries ranged from 9.6 percent (Australia) to 12.4 percent (Switzerland). Life expectancy in the U.S. was the lowest of all 11 countries in the study, at 78.8 years; the range for other countries was 80.7 to 83.9 years. The proportion of the U.S. population with health insurance was 90 percent, lower than all the other countries, which ranged from 99 to 100 percent coverage.<\/p>\n<p>But commonly held beliefs for these differences appear at odds with the evidence, the study found.<\/p>\n<h3 class=\"wp-block-heading\"><strong><strong>Key findings included:<\/strong><\/strong><\/h3>\n<p><strong><strong>Belief:<\/strong> <\/strong>The U.S. uses more health care services than peer countries, thus leading to higher costs.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong>\u00a0The U.S. has lower rates of physician visits and days spent in the hospital than other nations.<\/p>\n<p><strong><strong>Belief:<\/strong> <\/strong>The U.S. has too many specialists and not enough primary care physicians.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong> The primary care versus specialist mix in the U.S. is roughly the same as that of the average of other countries.<\/p>\n<p><strong><strong>Belief:\u00a0 <\/strong><\/strong>The U.S. provides too much inpatient hospital care.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong> Only 19 percent of total health care spending in the U.S. is spent on inpatient services \u2014 among the lowest proportion of similar countries.<\/p>\n<p><strong><strong>Belief:\u00a0 <\/strong><\/strong>The U.S. spends too little on social services and this may contribute to higher health care costs among certain populations.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong>\u00a0The U.S. does spend a bit less on social services than other countries, but it is not an outlier.<\/p>\n<p><strong><strong>Belief:<\/strong><\/strong>\u00a0The quality of health care is much lower in the U.S. than in other countries.<\/p>\n<p><strong><strong>Evidence:<\/strong><\/strong>\u00a0Overall, quality of care in the U.S. isn\u2019t markedly different from that of other countries, and in fact excels in many areas. For example, the U.S. appears to have the best outcomes for those who have heart attacks or strokes, but is below average for avoidable hospitalizations for patients with diabetes and asthma.<\/p>\n<p>What does explain higher spending in the U.S. is administrative complexity and high prices across a wide range of health care services. For example, the findings showed that:<\/p>\n<ul>\n<li>Administrative costs of care \u2014 activities related to planning, regulating, and managing health systems and services \u2014 accounted for 8 percent of total health care costs, compared with a range of 1 to 3 percent for other countries.<\/li>\n<li>Per capita spending for pharmaceuticals was $1,443 in the U.S., compared with a range of $466 to $939 in other nations. For several commonly used brand-name pharmaceuticals, the U.S. had substantially higher prices than other countries, often double the next-highest price.<\/li>\n<li>The average salary for a general practice physician in the U.S. was $218,173, while in other countries the salary range was $86,607 to $154,126.<\/li>\n<\/ul>\n<p>\u201cAs the U.S. continues to struggle with high health care spending, it is critical that we make progress on curtailing these costs. International comparisons are very valuable \u2014 they allow for reflection on national performance and serve to promote accountability,\u201d said first author Irene Papanicolas, visiting assistant professor in the Department of Health Policy and Management at Harvard Chan School.<\/p>\n<p><em>Liana Woskie, <\/em><em>assistant director of the Harvard Global Health Institute\u2019s strategic initiative on quality, <\/em><em>was a co-author of the study.<\/em><\/p>\n\n\n\n<\/div>\n"}},"jetpack-related-posts":[{"id":122970,"url":"https:\/\/news.harvard.edu\/gazette\/story\/2012\/11\/green-light-for-obamacare\/","url_meta":{"origin":240301,"position":0},"title":"Green light for Obamacare","author":"harvardgazette","date":"November 9, 2012","format":false,"excerpt":"Health care specialists discussed post-election Obamacare, including potential bumps in the road, in a panel talk at the Harvard School of Public Health.","rel":"","context":"In "Health"","block_context":{"text":"Health","link":"https:\/\/news.harvard.edu\/gazette\/section\/health\/"},"img":{"alt_text":"","src":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2012\/11\/blendon_mcdonough.jpg?resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2012\/11\/blendon_mcdonough.jpg?resize=350%2C200 1x, https:\/\/news.harvard.edu\/wp-content\/uploads\/2012\/11\/blendon_mcdonough.jpg?resize=525%2C300 1.5x"},"classes":[]},{"id":175650,"url":"https:\/\/news.harvard.edu\/gazette\/story\/2015\/11\/improvements-in-u-s-diet-lower-premature-deaths\/","url_meta":{"origin":240301,"position":1},"title":"Improvements in U.S. diet lower premature deaths","author":"harvardgazette","date":"November 2, 2015","format":false,"excerpt":"Two new studies from the Harvard T.H. 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The second found intervention in childhood obesity less costly than the health care that followed.","rel":"","context":"In "Health"","block_context":{"text":"Health","link":"https:\/\/news.harvard.edu\/gazette\/section\/health\/"},"img":{"alt_text":"","src":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2015\/10\/health-eating-plage.jpg?resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2015\/10\/health-eating-plage.jpg?resize=350%2C200 1x, https:\/\/news.harvard.edu\/wp-content\/uploads\/2015\/10\/health-eating-plage.jpg?resize=525%2C300 1.5x"},"classes":[]},{"id":113325,"url":"https:\/\/news.harvard.edu\/gazette\/story\/2012\/06\/balky-states-likely-to-join-medicaid-expansion\/","url_meta":{"origin":240301,"position":2},"title":"Balky states likely to join Medicaid expansion","author":"harvardgazette","date":"June 29, 2012","format":false,"excerpt":"Experts speaking at The Forum at Harvard School of Public Health discussed the 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2021","format":false,"excerpt":"A new health and economic model clearly shows why it\u2019s imperative that food manufacturers reduce the amount of added sugar in their products.","rel":"","context":"In "Health"","block_context":{"text":"Health","link":"https:\/\/news.harvard.edu\/gazette\/section\/health\/"},"img":{"alt_text":"Sugar.","src":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2021\/08\/mathilde-langevin-Q5xjxSfs1Lk-unsplash_2500.jpg?resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/news.harvard.edu\/wp-content\/uploads\/2021\/08\/mathilde-langevin-Q5xjxSfs1Lk-unsplash_2500.jpg?resize=350%2C200 1x, https:\/\/news.harvard.edu\/wp-content\/uploads\/2021\/08\/mathilde-langevin-Q5xjxSfs1Lk-unsplash_2500.jpg?resize=525%2C300 1.5x, https:\/\/news.harvard.edu\/wp-content\/uploads\/2021\/08\/mathilde-langevin-Q5xjxSfs1Lk-unsplash_2500.jpg?resize=700%2C400 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