It is the latest look at why the U.S. spends more on healthcare than any of its European counterparts. In 2004, the year of the data the Emory study examined, the U.S. spent $6,102 per capita on healthcare -- about twice that of the Netherlands and Germany and nearly twice that of France.
If older Americans were diagnosed and treated at the lower European rate for 10 common chronic conditions, the authors estimate, this would reduce spending by $100 billion to $150 billion a year, which is 13% to 19% of total U.S. spending on this age group.
The study concludes that the best way to trim U.S. healthcare spending -- or at least curb its rate of increase -- is to put Americans on a diet and encourage other measures aimed at preventing the diseases.
Physicians such as Rob Blackman, a Los Angeles internist, already counsel their patients to take a cue from Europeans in the way they eat -- less fast food -- and the way they pace their lives. Six-week vacations and afternoon siestas help reduce stress that makes people vulnerable to disease, he said.
Such conventions are commonplace in Europe but unheard of in the U.S., so the advice is often easier given than taken.
"Last year I took a 15-day vacation -- first time I took more than 10 days in 30 years," Blackman said. "I couldn't believe how much better I felt. It's like the old saying, 'You don't know how sick you are until you get better.' "
Other studies have sought to explain the spending gap between the U.S. and Europe by comparing factors such as capacity, access to technology and prices.
Thorpe said he hoped the study helped shift the debate over healthcare reform away from arguing about who pays for what to a focus on preventing diseases that affect the quality of life and run up costs.
He said he would like to see the nation embrace obesity and disease prevention the way it targeted cigarette smoking. That campaign slashed smoking rates by more than half.
The U.S. healthcare system -- driven by when and how providers get paid -- does not promote prevention or effective and efficient disease management, Thorpe said.
Instead, he said, "We wait for people to get sick. They show up. We treat them. And doctors and hospitals get paid. That's not a very good way for managing disease."
The Emory study compared 2004 data on disease rates among adults 50 and older in the U.S. and in a group of European countries: Austria, Denmark, France, Germany, Greece, Italy, the Netherlands, Spain, Sweden and Switzerland.
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lisa.girion@latimes.com
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Seas apart
Percentage of people 50 and older diagnosed with diseases in the U.S. and Europe
Arthritis
U.S.: 53.8%
Europe: 21.3%
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High blood pressure
U.S.: 50%
Europe: 32.9%
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Heart disease
U.S.: 21.8%
Europe: 11.4%
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High cholesterol
U.S.: 21.7%
Europe: 19.6%
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Diabetes
U.S.: 16.4%
Europe: 10.9%
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Cancer
U.S.: 12.2%
Europe: 5.4%
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Chronic lung disease
U.S.: 9.7%
Europe: 5.4%
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Source: Emory University Rollins School of Public Health
Los Angeles Times
