As U.S. health system lags other nations, need grows for larger role for pharmacists

Opponents of health reform are usually quick to make comparisons between our nation’s healthcare system and that of the rest of the world. Americans, they argue, enjoy the most advanced and most effective health care in the world. And forcing the U.S. system to change – either through new, evidence-based government payment incentives, federally mandated quality and cost controls, or through new methods for delivering primary care or making health decisions on behalf of patients – would only jeopardize the patient-doctor relationship and undermine the best healthcare network in the world.

Those opponents of change are wrong, in part because they’re willing to accept the status quo for U.S. health care, which is unsustainable for the simple reason that the nation can’t afford the current fee-for-service health system and its skyrocketing costs. But they’re also wrong because they’re proceeding from a flawed assumption: that our health system is tops among all nations.

A new report from the non-profit National Academies, the National Institutes of Health and the Department of Health and Human Services smacks that argument “upside the head,” as we say in the South. Based on a major comparison study of many health markers in 17 developed countries including the U.S., Canada, Australia, Japan and western European nations, the report “gives low marks to the United States in the health of its citizens, finding that Americans have higher rates of injury and disease and die sooner than their counterparts in other developed countries,” writes DSN associate editor Alaric DeArment.

The U.S., he reports, ranks “at or near the bottom in terms of infant mortality and low birth weight, injuries and homicides, teenage pregnancies and sexually transmitted infections, prevalence of HIV and AIDS, drug-related deaths, obesity and diabetes, heart disease, chronic lung disease and disability.” Equally striking, we’ve had “the highest infant mortality rate of any high-income country for decades while also ranking poorly in premature birth and the proportion of children who live to age 5 years.”

“What concerns our panel is why, for decades, we have been slipping behind,” says the report’s lead author, Virginia Commonwealth University professor of family medicine Steven Woolf.

If ever there was a time when the nation’s health care system was ripe for big change – including a larger role for pharmacists as disease managers, front-line patient care team members and wellness advocates – that time is now.

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