The Commonwealth Fund July 2008 National Scorecard on the U.S. Health System Performance is a Political Statement, Not a Valid Measure of U.S. Medical Quality

Friday, July 18, 2008 General News
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NEW YORK, July 17 "Though the Commonwealth Fund report claims to measure the performance of American health care, its conclusions are political, not scientific," says Betsy McCaughey, Ph.D., of the Hudson Institute. McCaughey points out that nowhere in the Commonwealth report is there a measure of how well patients in the U.S. survive major illnesses, compared with patients in other countries. "That is the true measure of a health care system -- what are your chances of recovering from illness?" says McCaughey.

The Executive Director of the Commonwealth Fund tips the organization's hand by reminding the report's readers of the upcoming presidential election. "Voters deserve more reliable, unbiased evidence of the strengths and weaknesses of American health care than what the Commonwealth Fund has put out," says McCaughey.

The report claims to compare countries along "37 core performance indicators." What are these indicators? Not average survival rates after a cancer diagnosis, or survival after a heart attack. Instead the report measures minor procedural matters such as percentage of heart failure patients who leave the hospital with written follow-up instructions.

"What really matters are survival rates -- the likelihood that a heart attack victim leaves the hospital alive," says McCaughey.

In the United States, a woman diagnosed with cancer has a 63% chance of living at least five years after the diagnosis. A man has a 66% chance. Those are the highest survival rates in the world, and these figures reflect the care received by all Americans, not just those with health insurance. In Great Britain, which has had "universal health care for half a century," the survival rates are 53% for women and 45% for men according to the largest ever international survey of cancer survival rates.

Astoundingly, the Commonwealth report gives the U.S. poor marks for "capacity to innovate and improve to achieve excellence." But the report's definition of innovation has nothing to do with new cures and new treatments. It is defined as emphasizing primary care. In fact, the U.S. leads the world in the creation of new cures and breakthrough medical knowledge. In the 1980s, a heart attack victim who made it to the hospital alive still faced a 20% risk of dying during the hospital stay and a 40% risk of dying within a year. Medical innovation has reduced that risk now to less than 5% (Health Affairs, Jan-Feb, 2007).

SOURCE Hudson Institute

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