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If any private business spent more money than all of their competitors while bringing in the least successful return of investment, that business would soon be bound for bankruptcy court. The U.S. health-care system is doing just that – yet few politicians have the courage to even talk about it, much less try to fix it.
The Commonwealth Fund, an independent health-care research firm, last week released a new report, “Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System.” The inescapable conclusion from examining the available data led analysts to conclude that Americans “live the sickest lives and die the youngest,” which is not exactly something to brag about to the grandkids.
The numbers are similar to prior reports that also paint the U.S. in a negative light. The high-income countries with best health-care systems are:
1. Australia.
2. Netherlands.
3. United Kingdom.
4. New Zealand.
5. France.
That leaves these high-income countries with the worst health-care systems:
6. Sweden.
7. Canada.
8. Switzerland.
9. Germany.
10. United States.
The U.S. came in last in three of five categories – equity, health outcomes and access to care – in addition to having the poorest overall ranking, according to the report. The U.S. excelled only by finishing second in a category called care process – which considers safety, prevention, coordination and patient engagement, and “is the result of the successful provision of preventive services, such as mammograms and flu vaccinations, and an emphasis on patient safety.”
“The U.S. is failing one of its principal obligations as a nation: to protect the health and welfare of its people,” Dr. Joseph Betancourt, president of the Commonwealth Fund, said in a statement. “The status quo – continually spending the most and getting the least for our health-care dollars – is not sustainable. It isn’t about lack of resources – it’s clearly about how they are being spent.”
While differences in overall performance between most countries were relatively small, the report says the U.S. was the sole outlier with “dramatically lower” performance. Other health-care rankings include:
- Best access to care: Netherlands.
- Worst access to care: United States.
- Best administrative efficiency: United Kingdom.
- Worst administrative efficiency: Switzerland.
- Best care process: New Zealand.
- Worst care process: Sweden.
- Best equity: Australia.
- Worst equity: United States.
- Best health outcomes: Australia.
- Worst health outcomes: United States.
The nation’s relatively high health-care spending isn’t new, but the gap between U.S. expenditures and those of the nine other ranked countries has widened, the report says. In 1980, U.S. health-care spending was 8.2% of its gross domestic product; the U.K. had the lowest spending at 5.1%. By 2020, U.S. spending had climbed to a high of 18.6%.
One reason why is because health insurance coverage in the U.S. is fragmented, with 26 million Americans uninsured, while the other nine countries boast universal health-care coverage. Navigating medical bills is a nightmare for many Americans, yet Australia and the U.K. minimize billing burdens.
Meanwhile, the United States has the highest rates of preventable and treatable deaths among all ages. Americans are projected to live more than four fewer years than the 10-country average, in no small part due to gun violence and substance abuse.
The Commonwealth Fund’s report highlights the sad irony that the country that spent the most on health care – the United States – performed the poorest. What’s more, the two countries that performed the best – Australia and Netherlands – actually spent the least.
There are many lessons that we can learn from other countries on how to better take care of our people.
David Brown is publisher of the Cherokee Scout. You can reach him by phone, 828-837-5122; email, dbrown@cherokeescout.com; or on X @daviddBstroh.