U.S. Healthcare Cost Containment: Lessons From 4 Other High-Income Countries

Healthcare per capita spending in the United States is among the highest in the world, and according to a new article in the journal Health Affairs, the United States can contain healthcare costs better by looking to four similar industrialized countries.

For the study, several researchers and academics reviewed the cost containment strategies used in Canada, England, France and Germany.

They found that the four high-income countries generally were in sync on many initiatives. For example, the four countries were mostly reluctant to employ budget shifting strategies — that is, shifting costs onto households or moving costs from one part of the government to another (e.g., federal to state). In addition, Canada, England, France and Germany have endorsed some type of universal coverage. France and Germany have tried to secure healthcare for all, and according the report, the United States is mildly in the same boat with new healthcare reform measures.

Researchers said all four counties have also moved gradually toward "activity-based payments," or performance-based payments, which the United States is also gradually moving toward. Canada, England, France and Germany have also made concerted efforts to create "central mechanisms to set prices for healthcare," according to the report. For example, the studied counties have tried to lower pharmaceutical costs by establishing prices and policies and promoting the use of more generic drugs.

However, the study's authors noted that many of the strategies used by the other countries need to be viewed with a critical eye. For example, activity-based payments have been championed to improve efficiency, quality and transparency, but they do not reduce costs in the short term. Rather, activity-based payments and similar strategies are more likely to contain healthcare costs if a country establishes controls over volumes and prices.

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