Slowdown In US Health Care Costs Largely Due to Flat Physician Reimbursement, Use of Generic Drugs Interview with: 
M Luca Lorenzoni
OECD Organisation for Economic Co-operation and Development
Health Accounts, Asian Health and Social Policy Outreach
ELS/Health Division

MedicalResearch: What are the main findings of the study?

  • The United States is an outlier in the scenery of OECD as it ranks first for health care expenditure, but last for coverage.
  • The slowdown in US health care spending during the past decade brought the growth rate closer to that of other high-spending countries -Canada, France, Germany, the Netherlands and Switzerland- at around 1%. Previously in 2002, the US’s health expenditure growth was around 7%, much higher than the approximate 3% which was the average for the other countries examined in the study
  • Higher health-sector prices (e.g., hospital care and prescription drugs) are thought to be the main driver of expenditure differences between the US and other high-spending countries, and recent price dynamics largely explain declines in health expenditure growth.

MedicalResearch: What should clinicians and patients take away from your report?

Answer:  The higher health spending reported in the US is not simply a result of the country’s greater wealth or the age structure of its population. Even the large prevalence of risk factors – including obesity- explains only a small part of the reported differences. Overall, the quality of the care provided does not seem to explain the higher health expenditure in the US. High health sector prices mean that patients in the United States are not receiving as much health care as the exceptional levels of expenditure would seem to suggest.

Given that the gains which have been made in reducing health care spending are largely attributable to price dynamics (such as reduced or no growth in physician reimbursement rates, and high use of cheaper generic drugs), future economic recovery might reverse the progress that has been made in recent years in the US.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Answer:  More evidence is needed to better understand the complex causal pathways that link health spending and use with health outcomes. This could avoid possible detrimental effects on population health from tightened controls on health-care expenditure.

Dramatic slowdown in growth of US health expenditure over last decade closes gap between USA and other high-spending countries

The Lancet, Early Online Publication, 1 July 2014
Luca Lorenzoni MSc, Annalisa Belloni MSca, Franco Sassi PhD



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