Signs of improvement in US health costs, coverage


PARIS — Health costs in the United States surged in the decade before 2010 along with the tally of Americans without medical insurance, but both trends then improved, a study said Monday. From 2000 to 2009, the annual bill per person, public and private spending combined, soared from US$5,152 (3,762 euros) to US$7,010 but from 2009 to 2011 only slightly, to US$7,212. In 2002, the annual increase was about seven percent — more than twice the rate in five other advanced economies — but fell in 2011 to about one percent, putting the United States on a par with Canada, France, Germany, the Netherlands and Switzerland, according to an investigation published in The Lancet medical journal.

Though the numbers improved, the U.S. medical system remained at the bottom in terms of public access to health services, it added. From 2000 to 2010, the number of people without health insurance rose “dramatically” from 36.6 million to almost 50 million, mainly as a result of the economic downturn and unprecedented levels of immigration, the report found. In 2011, after U.S. President Barack Obama’s Affordable Care Act took effect, the number of uninsured fell back by 1.3 million, “although more data are needed before this trend reversal can be interpreted as true,” it said. The study compared the United States with five other countries monitored from 2000 to 2011. It found spending in Canada rose from US$2,757 to US$3,796 per person per year; in France from US$2,784 to US$3,359; in Germany from US$3,027 to US$3,808; in the Netherlands from US$2,549 to US$4,110; and in Switzerland from US$3,553 to US$4,338. The investigation, authored by experts at the Organisation for Economic Cooperation and Development (OECD), said the main reasons for the huge gap were higher hospital costs and bills for prescription drugs in the United States than in other countries. Health administration charges, too, were usually far higher — three times greater than in Canada, for instance. The study praised the United States for making “great efforts” to lift itself off the bottom of the OECD’s health coverage table and to contain growth in spending. But it warned further commitment was needed if U.S. economic recovery was sustained, which could push the health bill up once more with higher insurance premiums. “The USA is an outlier in the scenery of OECD healthcare systems, for its staggering levels of expenditure, the extent of fragmentation of its system and the sheer complexity of its administration, the power of vested interests, and the large number of people left without adequate health coverage,” the paper said.