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1. Mental Health Conditions and Substance Use: Comparing U.S. Needs and Treatment Capacity with Those in Other High-Income Countries

Author:
Melinda K. Abrams, Reginald D. Williams II, Katharine Fields, and Roosa Tikkanen
Publication Date:
05-2021
Content Type:
Special Report
Institution:
The Commonwealth Fund
Abstract:
About one-quarter of U.S. adults report having a mental health diagnosis such as anxiety or depression or experiencing emotional distress. This is one of the highest rates among 11 high-income countries. While U.S. adults are among the most willing to seek professional help for emotional distress, they are among the most likely to report access or affordability issues. Emotional distress is associated with social and economic needs in all countries. Nearly half of U.S. adults who experience emotional distress report such worries, a higher share than seen in other countries. The United States has some of the worst mental health–related outcomes, including the highest suicide rate and second-highest drug-related death rate. The U.S. has a relatively low supply of mental health workers, particularly psychologists and psychiatrists. Just one-third of U.S. primary care practices have mental health professionals on their team, compared to more than 90 percent in the Netherlands and Sweden.
Topic:
Health, Health Care Policy, Mental Health, Drugs, and Substance Abuse
Political Geography:
United States, Europe, and Global Focus

2. Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries

Author:
Laurie Zephyrin, Molly FitzGerald, Munira Z. Gunja, and Roosa Tikkanen
Publication Date:
11-2020
Content Type:
Policy Brief
Institution:
The Commonwealth Fund
Abstract:
The U.S. has the highest maternal mortality rate among developed countries. Obstetrician-gynecologists (ob-gyns) are overrepresented in its maternity care workforce relative to midwives, and there is an overall shortage of maternity care providers (both ob-gyns and midwives) relative to births. In most other countries, midwives outnumber ob-gyns by severalfold, and primary care plays a central role in the health system. Although a large share of its maternal deaths occur postbirth, the U.S. is the only country not to guarantee access to provider home visits or paid parental leave in the postpartum period.
Topic:
Health, Health Care Policy, Women, and Reproductive Health
Political Geography:
United States and Global Focus

3. Do Americans Face Greater Mental Health and Economic Consequences from COVID-19? Comparing the U.S. with Other High-Income Countries

Author:
Michelle M. Doty, Eric C. Schneider, Roosa Tikkanen, Arnav Shah, and Reginald D. Williams II
Publication Date:
08-2020
Content Type:
Special Report
Institution:
The Commonwealth Fund
Abstract:
With more than 4 million confirmed cases and 150,000 deaths as of August, the United States is failing to control the COVID-19 pandemic. At a time when many nations are reopening their economies and societies, the U.S. is struggling in its attempts to do the same. To examine the early impact of the pandemic on the well-being of adults in the U.S. and abroad, the Commonwealth Fund joined the survey research firm SSRS to interview 8,259 adults age 18 and older between March and May 2020. It is the latest in the Commonwealth Fund’s series of cross-national comparisons featuring the United States and nine other high-income countries that participate in the Fund’s annual International Health Policy Survey. The following exhibits illustrate COVID-19’s effects on people’s mental health and economic security and compare levels of public trust in national leaders in responding to the pandemic.
Topic:
Health, Health Care Policy, Mental Health, and Public Health
Political Geography:
United States, Europe, and Global Focus

4. Bundled-Payment Models Around the World: How They Work and What Their Impact Has Been

Author:
Meredith B. Rosenthal, Paul F. van Gils, Caroline A. Baan, Eline F. de Vries, and Jeroen Struijs
Publication Date:
04-2020
Content Type:
Special Report
Institution:
The Commonwealth Fund
Abstract:
We identified 23 initiatives in eight countries that have implemented bundled-payment models, focusing on procedures such as total joint replacements and cardiac surgery, as well as chronic conditions like diabetes and breast cancer. Of the 35 studies retrieved, 32 reported effects on quality of care and 32 reported effects on medical spending. Twenty of 32 studies reported modest savings or a modest reduction in spending growth, while two studies (both based on the same initiative) demonstrated increased spending in the early years of the bundled-payment model’s implementation. Eighteen of 32 studies reported quality improvements for most evaluated measures, while other studies showed no difference in measured quality. Our study provides evidence that bundled-payment models have the potential to reduce medical spending growth while having either a positive impact or no impact on quality of care.
Topic:
Economics, Health, Health Care Policy, Income Inequality, Macroeconomics, Coronavirus, and COVID-19
Political Geography:
United States and Global Focus

5. U.S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes?

Author:
Roosa Tikkanen and Melinda K. Abrams
Publication Date:
01-2020
Content Type:
Special Report
Institution:
The Commonwealth Fund
Abstract:
A 2015 Commonwealth Fund brief showed that — before the major provisions of the Affordable Care Act were introduced — the United States had worse outcomes and spent more on health care, largely because of greater use of medical technology and higher prices, compared to other high-income countries. By benchmarking the performance of the U.S. health care system against other countries — and updating with new data as they become available — we can gain important insights into our strengths and weaknesses and help policymakers and delivery system leaders identify areas for improvement. This analysis is the latest in a series of Commonwealth Fund cross-national comparisons that uses health data from the Organisation for Economic Co-operation and Development (OECD) to assess U.S. health care system spending, outcomes, risk factors and prevention, utilization, and quality, relative to 10 other high-income countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. We also compare U.S. performance to that of the OECD average, comprising 36 high-income member countries.
Topic:
Health and Health Care Policy
Political Geography:
United States, Europe, and Global Focus

6. WHO Technical Report on Cancer Pricing Misses the Mark—It Should Focus on the “Demand Side”

Author:
Kalipso Chalkidou, Adrian Towse, and Richard Sullivan
Publication Date:
04-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Criticising cancer medicine pricing as too high is what football fans know as an "open goal"—a target that is hard to miss. Yet somehow the World Health Organization (WHO) Technical Report on Cancer Pricing manages to do just that with a paper to the WHO Executive Board calling for price and cost transparency. The assumption goes that transparency will reduce the prices and costs of cancer medicines, a mantra that has united the Trump administration, the US Congress, and the Italian health minister with many NGOs who have called for “greater cost and price transparency”—a sentiment echoed by KEI, which states that “international action is required to improve transparency in reporting the costs of R&D and production, including public sources of funding.”
Topic:
World Health Organization, Health Care Policy, Medicine, Cancer, and Price
Political Geography:
Global Focus

7. Understanding the Opportunity Cost, Seizing the Opportunity: Report of the Working Group on Incorporating Economics and Modelling in Global Health Goals and Guidelines

Author:
The Working Group on Incorporating Economics and Modeling in Global Health Goals and Guidelines
Publication Date:
05-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Internationally set goals and guidelines directly influ­ence the setting of health care priorities at the national level, affecting how limited resources are generated and allocated across health care needs. The influence of global priority setting, such as through the formu­lation of overarching goals or normative guidelines for specific disease areas, is particularly significant in low- and middle-income countries that rely heavily on overseas development assistance. Because no sys­tematic approach exists for dealing with resource con­straints, however, which vary across countries, goals and guidance are often inappropriate for some country contexts; their implementation can, therefore, reduce the efficiency and equity of health care spending. The Working Group on Incorporating Economics and Modelling in Global Health Goals and Guidelines, co-convened by the Center for Global Development, Thanzi la Onse, and the HIV Modelling Consortium, has brought together disease specialists, policymakers, economists, and modelers from national governments, international organizations, and academic institutions across the globe to address these issues, to take stock of current approaches, and make recommendations for better practice. The Working Group deliberated on the roles and purposes of goals and guidelines and consid­ered how economic evidence might be formally incor­porated into policy recommendations and health care decision making. The target audiences for this report are international health institutions, large stakehold­ers in disease programs across the world, and national governments.
Topic:
Development, Health, Health Care Policy, and Public Health
Political Geography:
Global Focus

8. Imagining the Alternative Worlds of 2030: Policy Implications for the Future of Global Health Procurement

Author:
Janeen Madam Keller and William Savedoff
Publication Date:
06-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
The availability and affordability of health products—medicines, diagnostics, devices, and equipment—are critical to achieving universal health coverage and improving health outcomes. Yet low- and middle-income countries face multiple challenges in procuring health products related to institutional inefficiencies, market failure, and fragmented demand. At the same time, the world is evolving rapidly in ways that will affect health procurement, from changes in countries’ eligibility for foreign assistance to advances in information technologies. Looking forward, efforts to improve global health procurement must proactively address the sweeping changes on the horizon. Drawing on a range of political, economic, and social trends, this paper envisions how the global landscape might change between now and 2030, with a focus on the implications for global health, particularly the procurement of health products. The paper develops three possible but distinct futures—worlds characterized as atomistic, privately led, or multilateral.It concludes by describing the policy options and locus of action to improve global health procurement in light of these scenarios, emphasizing three areas of work: financing and modes of collaboration, procurement procedures and tools, and procurement capacity.
Topic:
Health, Health Care Policy, Public Health, and Health Crisis
Political Geography:
Global Focus

9. What Is the Status of Women’s Health and Health Care in the U.S. Compared to Ten Other Countries?

Author:
Sara R. Collins, Shanoor Seervai, Roosa Tikkanen, and Munira Z. Gunja
Publication Date:
12-2018
Content Type:
Special Report
Institution:
The Commonwealth Fund
Abstract:
Women in the United States have long lagged behind their counterparts in other high-income countries in terms of access to health care and health status. This brief compares U.S. women’s health status, affordability of health plans, and ability to access and utilize care with women in 10 other high-income countries by using international data.
Topic:
Health, Health Care Policy, Women, and Reproductive Health
Political Geography:
United States and Global Focus

10. Making the Case for Open Contracting in Healthcare Procurement

Author:
Transparency International
Publication Date:
01-2017
Content Type:
Special Report
Institution:
Transparency International
Abstract:
Healthcare and public procurement both suffer from high levels of corruption and the point at which they converge, procurement within healthcare, is an acute vulnerability that is routinely exploited. But governments and civil society organisations are now taking action to protect the lives of citizens by implementing open contracting. The proposition behind open contracting is that procurement reform requires a broad base of participation from outside government. Businesses must be able to compete for contracts and make sense of the market. The communities directly affected by procurement, and the groups and people that represent those communities, are often better placed than government to independently monitor the procurement process. To facilitate this participation, governments must publish useful, timely and accessible information about the procurement process. Healthcare and anti-corruption efforts share a common principle: prevention is better than cure. In the long term, open contracting offers a route for governments to move from the procurement status quo of corruption, waste and inefficiency, to clean contracting, in which fairness, integrity and efficiency are the norms. This report first outlines some of the major challenges in healthcare procurement before explaining how open contracting works and how it can support reform. Section two introduces different approaches to open contracting that have been used around the world. Finally, section three presents case studies of successful implementation from Honduras, Nigeria and Ukraine.
Topic:
Health Care Policy
Political Geography:
Global Focus