Americans Not Happy About Health Care

Medical Authors and Editors: Barbara K. Hecht, Ph.D. and Frederick Hecht, M.D.

October 28, 2004 -- A very important report has been released today by the Commonwealth Fund concerning primary health care and the news is not good for the United States. Americans are most unhappy about the care they receive.

Primary Care

Primary care is at the center of medical care systems. It provides an entry point to health care, delivers core medical and preventive care, and helps patients coordinate and integrate care. Ready access to effective primary care also offers the potential to reduce disparities in care, increasing people's opportunities to live healthy, productive lives. The challenge is how to redesign primary care to make care more accessible, continuous, coordinated, patient-centered and engage patients in their own care

The Survey

A survey was done by the Commonwealth Fund of primary care experiences in 5 industrialized countries -- Australia, Canada, New Zealand, the UK, and US. Shortfalls were found in the delivery of safe, effective, timely, and patient-centered care. Delays in lab test results and test errors raise safety concerns. Failures to communicate, to engage patients, and to promote health are widespread. Aside from clinical preventive care, the US performed poorly on most care dimensions, with notable cost-related access concerns and short-term physician relationships.

Quote from the Report

"Across multiple dimensions of care, the US stands out for its relatively poor performance," according to the study. "With the exception of preventive measures, the US primary care system ranked either last or significantly lower than the leaders on almost all dimensions of patient-centered care: access, coordination, and physician-patient experiences. These findings stand in stark contrast to US spending rates that outstrip those of the rest of the world."

"The performance in other countries indicates that it is possible to do better," continues the report. "However, moving to a higher-performing health care system is likely to require system redesign and innovative policies. "


This report is food for thought. It is put on the table less than a week before the US presidential election. In the current issue of The New England Journal of Medicine, President Bush and Senator Kerry speak out on "Health Care Coverage and Drug Costs." The outcome of the election may well affect health care in the US.

Reference Source: Press release, New Commonwealth Fund Survey

For more on health concerns in the United States, please visit the Healthcare Issues Center.

Last Editorial Review: 10/28/2004