Additionally, the United States spends more on the administrative framework used to operate its health care system - about 8 percent of health care spending, compared to 1 percent to 3 percent elsewhere.
Despite beliefs to the contrary, "the U.S. has lower rates of physician visits and days spent in the hospital than other nations", said the report. The quality of health care looks pretty good, it finds, while its spending on social services outside of health care, like housing and education, looked fairly typical. For example, America had the lowest life expectancy and the highest infant mortality when compared to the other countries.
But a large and comprehensive review in The Journal of the American Medical Association punctures a lot of those pat explanations. The paper, conducted by a research team led by Ashish Jha, compiled detailed data from the health care systems of the United States and 10 other rich developed nations, and tried to test those hypotheses. The group included nations with single-payer health care systems, like Britain and Canada, and countries with competitive private insurance markets, like Switzerland and the Netherlands. But, after assembling the data from the countries' health ministries, he changed his mind about a number of key assumptions. In the U.S., per capita spending was $1,443. But the research, he said, didn't match his expectations.
Other countries' life expectancy ranged from 80.7-83.9.
Doctors and nurses are also paid more generously in the United States.
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For this study, Woskie and her colleagues pulled together comprehensive data comparing US health care against that of 10 other leading countries - the United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland and Denmark. But the country was below average on measures of how often patients went to the doctor or hospital.
The data are consistent with other evidence that health care systems are beginning to converge, as information and technologies spread around the world among doctors and administrators.
Bruce Landon, a professor of policy and medicine at Harvard Medical School, said that the complaints about rising health care costs are a worldwide issue. However, while the United States spends a bit less on social care than other countries, it's not necessarily an outlier. "They're all struggling with paying for new technology and the cost of the system".
"These data suggest that numerous policy efforts in the United States have not been truly evidence-based". Dr. Jha acknowledged that the numbers may not be ideal but described the effort as careful and more comprehensive than previous comparisons.
Instead, high prices for labor and goods, including drugs, procedures and administrative services, seemed to be the major reasons, according to the analysis.
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But, contrary to popular belief, the researchers did not find that people in the USA use the medical system significantly more often than those in other countries - nor did they find that the way Americans use the medical system accounts for the disconnect in spending.
That's not just because the United States has a complicated insurance setup, either.
The study in the Journal of the American Medical Association (JAMA) compared the United States health system to 10 other high-income countries - Britain, Canada, Germany, Australia, Japan, Sweden, France, Denmark, the Netherlands, and Switzerland.
Margot Sanger-Katz is a domestic correspondent and writes about health care for The Upshot. "But that doesn't mean that you can't still buy fewer pizzas". She was previously a reporter at National Journal and The Concord Monitor and an editor at Legal Affairs and the Yale Alumni Magazine.
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