An analysis recently released by The Commonwealth Fund uses data from the Organization for Economic Cooperation and Development and other sources to compare health care spending, supply, utilization, prices, and quality in 13 industrialized countries: Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. The U.S. spends far more on health care than any other country. However this high spending cannot be attributed to higher income, an older population, or greater supply or utilization of hospitals and doctors. Instead, the findings suggest the higher spending is more likely due to higher prices and perhaps more readily accessible technology and greater obesity. Health care quality in the U.S. varies and is not notably superior to the far less expensive systems in the other study countries. Of the countries studied, Japan has the lowest health spending, which it achieves primarily through aggressive price regulation.

An article recently published in Health Affairs, "Growth In US Health Spending Remained Slow In 2010; Health Share Of Gross Domestic Product Was Unchanged From 2009" reports that US health spending grew more slowly in 2009 and 2010--at rates of 3.8 and 3.9 percent respectively--than in any other year during the fifty-one years that the National Health Expenditure Accounts has recorded these data. Although medical goods and services are generally viewed as necessities, the recent recession has had a dramatic effect on utilization, according to the Health Affairs report. In 2010, the slow growth extraordinarily slow growth in the use and intensity of services led to slower growth in spending for personal health care. The rates of growth in overall US gross domestic product (GDP) and in health spending began to converge in 2010. As a result, the health spending share of GDP stabilized at 17.9 percent.

In a Commonwealth Fund-supported report recently published in the New England Journal of Medicine, researchers found that U.S. regions where discharged hospital patients are readmitted at comparatively high rates are often the same regions where overall hospitalization rates are high. This relationship indicates broad, systemic problems within the U.S. health care system. The study, conducted by Arnold Epstein, M.D., Ashish Jha, M.D., and John Orav, Ph.D., examined rehospitalization rates across the country for Medicare patients with congestive heart failure and pneumonia, while also looking at how other variables, such as overall hospitalization rates, differences in patients' coexisting conditions, quality of discharge planning, and the number of hospital beds and physicians, affected readmissions. Of all the potential causes for regional differences in readmission rates, overall hospital admission rates played the biggest role, accounting for 16 percent to 24 percent of the variation in cases of congestive heart failure and 11 percent to 20 percent for pneumonia cases. No other factor accounted for more than 6 percent of the variation.

The Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) along with Health Management Associates (HMA) recently published "Moving Ahead Amid Fiscal Challenges: A Look at Medicaid Spending, Coverage and Policy Trends," which summarizes the results from a 50-State Medicaid Budget Survey for State Fiscal Years 2011 and 2012. The report also includes background on the Medicaid program, as well as current issues facing the program including how states are preparing for the implementation of national health reform.

In their recent publication, "Building Tomorrow's Healthcare System: The Pathway to High Quality, Affordable Care," BlueCross BlueShield Assocation (BCBSA) calls for incentives to reward safety and reinforce primary care. One of the nation's largest insurance companies, BCBSA encourages federal government to adopt "value-based purchasing" and urges individuals eligible for Medicare or Medicaid to enroll in managed care plans. The Association also wants faster implementation of these types of programs in order to show savings more quickly.

In her New England Journal of Medicine article, "Hard Choices--Alternatives for Reining in Medicare and Medicaid Spending," Dr. Meredith B. Rosenthal of the Harvard School of Public Health compares and contrasts the two most prominent proposals to reform health care: Paul Ryan's "Roadmap for America's Future" and the White House's Affordable Care Act (ACA). She summarizes the main arguments supporting and opposing the two plans. The beauty of Ryan's plan is that by fixing the federal government's contribution to Medicare and Medicaid to a formula unrelated to the growth of overall health care costs, it would guarantee controlled federal spending growth. However, this would also shift financial risk to beneficiaries and state governments. The ACA alters the landscape for control federal health care spending by creating new institutions intended to facilitate progress toward reform and by directly altering payment formulas for Medicare and Medicaid. The downside of this cost savings portion of the ACA is that implementation of payment and delivery reforms is complex.