Study Finds U.S Healthcare System Worst Of All Industrialized Nations Due To Lack Of Universal Coverage

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A report, Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationallyfrom the Commonwealth Fund shows that the United States, despite having the most expensive healthcare system in the world, has the worst system compared to all other industrialized nations.

According to the report the U.S spent $8,508 per person on healthcare in 2011, while the United Kingdom spent $3,406 per person. The United kingdom ranked highest in care compared to all other industrialized nations.

The Commonwealth Fund reports that the primary reason for the United State’s sub par healthcare system is due to lack of access to affordable primary health care and inefficiencies in the overall healthcare system. The United States ranked last in every almost every area of healthcare studied. The highest ranked area the United States scored was for health care quality, landing itself in the middle. The United States is the only industrialized nation that does not have universal health care. The Affordable Healthcare Act stands to improve our ranking, due to expanding coverage to millions of Americans.

“It is disappointing, but not surprising, that despite our significant investment in health care, the U.S. has continued to lag behind other countries,” said lead author Karen Davis. “With enactment of the Affordable Care Act, however, we have entered a new era in American health care. The U.S. performance on insurance coverage and access to care should begin to improve, particularly for low-income Americans. The Affordable Care Act is also expanding the availability and quality of primary care, which should help all Americans have better care and better health outcomes at lower cost.”

Key findings include:

  • Healthy lives: The U.S. does poorly, ranking last on infant mortality and on deaths that were potentially preventable with timely access to effective health care and second-to-last on healthy life expectancy at age 60.
  • Access to care: People in the U.S. have the hardest time affording the health care they need. The U.S. ranks last on every measure of cost-related access. More than one-third (37%) of U.S. adults reported forgoing a recommended test, treatment, or follow-up care because of cost.
  • Health care quality: The U.S ranks in the middle. On two of four measures of quality—effective care and patient-centered care—the U.S. ranks near the top (3rd and 4th of 11 countries, respectively), but it does not perform as well providing safe or coordinated care.
  • Efficiency: The U.S ranks last, due to low marks on the time and dollars spent dealing with insurance administration, lack of communication among health care providers, and duplicative medical testing. Forty percent of U.S. adults who had visited an emergency room reported they could have been treated by a regular doctor, had one been available. This is more than double the rate of patients in the U.K. (16%).
  • Equity: The U.S. ranks last. About four of 10 (39%) adults with below-average incomes in the U.S. reported a medical problem but did not visit a doctor in the past year because of costs, compared with less than one of 10 in the U.K., Sweden, Canada, and Norway. There were also large discrepancies between the length of time U.S. adults waited for specialist, emergency, and after-hours care compared with higher-income adults.

“Now that millions more Americans have good coverage, we have to invest in our health care delivery system to be sure all patients—and especially those with the greatest need and whose care is the most costly—can get the high-quality, well-coordinated health care they need,” said Commonwealth Fund President David Blumenthal, M.D. “Those kinds of improvements will go a long way toward improving peoples’ health while making efficient use of our precious health care dollars.”

Commonwealth Fund is a private foundation, founded in 1918, whose mission statement says their aim is, “to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.”

Commonwealth used the following methodology to come up with their findings:

Data are drawn from the Commonwealth Fund 2011 International Health Policy Survey of Sicker Adults; the Commonwealth Fund 2012 International Health Policy Survey of Primary Care Physicians; and the Commonwealth Fund 2013 International Health Policy Survey. The 2011 survey targets a representative sample of “sicker adults,” defined as those who rated their health status as fair or poor, received medical care for a serious chronic illness, serious injury, or disability in the past year, or were hospitalized or underwent surgery in the previous two years. The 2012 survey looks at the experiences of primary care physicians. The 2013 survey focuses on the experiences of nationally representative samples of adults ages 18 and older. Additional data on health outcomes were drawn from the Organization for Economic Cooperation and Development and the World Health Organization.