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Does US Have Most Advanced Health System? Apparently Not

Does US Have Most Advanced Health System? Apparently Not

May 20, 2006

We know the US health system is the least efficient on the planet, the costliest, and the least equitable. The one thing I always thought was true was that we have the most technologically advanced health system on the planet.

Wrong again. Boy, am I dumb.

An article in the May/June Health Affairs (subscription required) by Gerard Anderson et al concludes: "The United States lags as much as a dozen years behind other industrialized countries in Health Information Technology [HIT] adoption -- countries where national governments have played major roles in establishing the rule, and health insurers have paid more of the costs."

Listed below for six countries: 1. Initial year of national effort; 2. Expected year of completion; 3. Total national investment as of 2005; 4. Total investment per capita:

US: 2006; 2016; $125M; $0.43
Australia: 2000; no date; $97M; $4.93
Canada: 1997; 2009; $1.08B; $31.85
Germany: 1993; 2006; $1.88B; $21.20
Norway: 1997; 2007; $52M; $11.43
UK: 2002; 2014; $11.5B; $192.79

43 cents. In Massachusetts, we are way ahead of the rest of the country, mostly thanks to Blue Cross which invested $50 million to set up the Mass. e-Health Collaborative. That project aims to wire up physicians in three communites (Brockton, Newburyport, North Adams) within two years. Nothing clear beyond that right now.

Anderson writes: "In all of the countries, the cost of implementing an HIT program is borne by the government or health insurers, or both. It is recognized in these countries that the benefits and cost savings accrue primarily to patients and insurers, not to providers. Economists recognize that use of IT in health care has a strong public goods component, which means that a particular stakeholder often does not reap the full social benefits produced by new HIT investment. Consequently, according to economic theory, the private sector will underinvest in IT relative to its social benefits..."

One last note from Anderson: "One suggestion for lowering health spending and improving health outcomes is the adoption of HIT. However, in all countries, we found no evidence that the savings from these initiatives have been rigorously evaluated. Nevertheless, many industrialized countries are proceeding to implement HIT because they are convinced that it both saves costs and improves quality."

Health info technology is the right thing to do. And, it's not the solution to rising costs many folks want to believe.