Restructure Medicare & Medicaid: In Addition to Life Expectancy, USA Falls
Behind OECD Averages in Many Other Health Indicators
OECD USA Ranking 2007 Health Indicators USA Median (1 = Best, 30 = Worst) RED = Below Average
Obesity (% of total population) 34 15 30 Infant Mortality (per 1,000 live births) 7 4 27 Medical Resources Available (per 1,000 population)
Total Hospital Beds 3 6 25
Practicing Physicians 2 3 22
Doctors’ Consultations per Year 4, 6 19
MRI Machines* (per million population) 26 9 1 Cause of Death (per 100,000 population)
Heart Attack 216 178 22
Respiratory Diseases 60 45 21
Diabetes 20 12 20
Cancer 158 159 14
Stroke 33 45 8 KP Note: *MRI is Magnetic Resonance Imaging. Source: OECD. i USA Inc. | What Might a Turnaround Expert Consider? 317
Restructure Medicare & Medicaid: Effectiveness Research Could Improve
Efficiency (i.e., Outputs Track Inputs)
e Comparative Effectiveness evaluates different options for treating a condition for a specific set of patients’
— Either relative benefits and risks of various treatment options (technology assessment, evidence-based medicine), or
— Both clinical effectiveness and relative cost (cost-benefit analysis).
e Without rigorous data about comparative effectiveness, according to the CBO:
— Treatment decisions often depend on anecdotal evidence, conjecture, and the experience/judgment of involved physicians.
— Treatments and types of care vary widely from one area of the country to another. e To affect healthcare spending meaningfully, comparative effectiveness must alter
doctor and patient behavior, potentially through reimbursement scheme changes, the CBO notes.
e Note that by law, Medicare is effectively precluded from considering costs when
making coverage decisions.
K P Source: “Research on the Comparative Effectiveness of Medical Treatments”, A CBO Paper, December 2007. www.kpcb.com ne. at Might a Turnaround Expert Consider? B kpeb USA Inc. | What Might a T dE Consider? 318
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