In its second National Scorecard on Health System Performance the Fund gives the U.S. system 65 points out of 100. The New York Times kindly calls this a "D" but it doesn't read like a passing grade:
Even more troubling, the U.S. health system is on the wrong track. Overall, performance has not improved since the first National Scorecard was issued in 2006. Of greatest concern, access to health care has significantly declined. As of 2007, more than 75 million adults—42 percent of all adults ages 19 to 64—were either uninsured during the year or underinsured, up from 35 percent in 2003. At the same time, the U.S. failed to keep pace with gains in health outcomes achieved by the leading countries. The U.S. now ranks last out of 19 countries on a measure of mortality amenable to medical care, falling from 15th as other countries raised the bar on performance. Up to 101,000 fewer people would die prematurely if the U.S. could achieve leading, benchmark country rates.
Conservative activists have begun taking notice, with bloggers calling the Fund (originally founded by a Standard Oil heiress) socialist by noting that if you have good coverage or cash then care is fantastic.
They also call Americans overinsured, and state that billions are wasted because consumers can't force doctors and hospitals to compete more on price.
Here's some fodder for their anger. Guess which country ranks tops, according to the fund, in keeping people alive? France. (Japan and Australia are right behind it.)
But the Fund is not backing down from the conservative challenge. A chart accompanying the report shows the U.S. falling behind on healthy lives, quality of care and (especially) access, more than offsetting improvements in efficiency and equity.
The U.S. spends twice per capita what other major industrialized countries spend on health care, and costs continue to rise faster than income. We are headed toward $1 of every $5 of national income going toward health care. We should expect a better return on this investment.
National leadership is urgently needed to yield greater value for the resources devoted to health care.
How business reacts to these arguments between the Fund and its ideological critics will, I believe, determine whether change results. If Larry Kudlow starts giving the Fund a respectful listen, you will know which way the wind is blowing.