59% of U.S. physicians say their patients have difficulty paying for health care and medicines.

The foot soldiers of American health care are front-line primary care physicians (PCPs). Compared to their colleagues in ten other developed countries, American PCPs say their nation is far behind other countries’ health systems in at least three ways:

  • Patients’ access to health care
  • The use of financial incentives to improve quality
  • The use of health information technology, where U.S. physicians say 46% of doctors use EMRs versus over 90% of doctors in Australia, Italy, the Netherlands, New Zealand, Norway, Sweden, and the U.K.

The Commonwealth Fund has published A Survey of Primary Care Physicians in 11 Countries, 2009: Perspectives on Care, Costs, and Experiences, published on November 5 2009 in Health Affairs. The survey sampled 10,000 PCPs in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the U.K., and the U.S. The data was collected between February and July 2009.

Health Populi’s Hot Points: The main difference between the U.S. health system and the comparison systems surveyed in this report is America’s lack of a primary care backbone. The health systems globally with the best health outcomes have resilient, strong primary care infrastructures. The primary care backbone in the U.S. is suffering from a lack of reinvestment and re imagination. The promise of a patient-centered medical home for every American is one vision for re-energized primary care in the U.S. Aligning incentives toward primary care would at once attract talent to the PCP pool which is needed based on projected deficits for primary care professionals in the U.S.; and, the access problems that American doctors point out in the survey would abate.

As the population in the U.S. ages and more health citizens live longer with more complex chronic conditions, the demand for more primary care access and new models for delivering the care will only increase.

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