Case Studies

Cost Anderson 1999 US spent $2799 vs. OECD $1286 (Per Capita) Anderson 2005 US spent $6401 vs. OECD $2925 (Per Capita) Anderson 2008 US spent more than ½ out of pocket & private insurance on HC, Greece & Mexico Access Anderson 1999 1960 ? 6.9 1997 ? 33.3 (Medicare Medicaid & Veterans)1960 ? 85 1997 ? 100 OECD Countries (Pop. covered by Gov?t) Anderson 2008 US 2.7, Canada 2.9, Japan 8.2 vs. OECD 3.5 (Beds Per Capita) Quality Anderson 1996 US .78% vs. OECD .58% (Infant Mortality Rate) Anderson 1999 US 16 vs. OECD 2.8 (MRI Units / Million pop.) US 3.9 vs. OECD 2.0 (FTE Employees / Bed) Anderson 2001 US 74 vs. OECD 30 (Dialysis / 100,000 [1998]) US 223 vs. OECD 54 (Coronary Bypass / 100,000 [1997]) Anderson 2007 US 2.4 vs. OECD 3.2 (MD/ 1000 pop.) US 7.9 vs. OECD 8.1 (Nurses/1000 pop.) US 60.8 vs. OECD 63.1 (Mammography (%women 50-69)) US 66.3 vs. OECD 47.3 (% pop w/ BMI > 25 Kg/m2) Geographic Variation Phelps & Parenle (1990) High Variation in Hospitalization for Dental Extractions (cov = .73) & False Labor in NY State (cov = .75) Wehnberg (1990) Large variation in hsp. Admission rt. For surgical procedures in 16 major university hsp?s. (Where we have greatest presumed medical knowledge.) Physicians Joint venture Mitchell & Scott (1992) 40% of Dr?s in FL have a vested financial stake in HC facilities in which they operate Mitchell & Sunshine (1992) Cost & amt of service Increased, access did not change, quality same or lower Hillman (1990) Dr?s 4X more likely to order Scans if they own machine RAND Keeler (1988) Free Care = $842No Insurance = $482