How the Performance of the U.S. Health Care System Compares Internationally
The United States health care system is the most expensive in the world, but this 2014 report and prior editions (2010, 2007, 2006, and 2004) consistently show the U.S. underperforms relative to other countries on most dimensions.
Among the 11 nations studied — Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States — the U.S. ranks last, as it did in all of the earlier editions.
Most troubling, despite having the most expensive healthcare, the U.S. fails to achieve better health outcomes than the other countries, and, the U.S. is last or nearly last on dimensions of access, efficiency, and equity.
The most notable way the U.S. differs from other industrialized countries is the absence of universal health insurance coverage. Other nations ensure the accessibility of care through universal health systems, and through better ties between patients and the physician practices that serve as their medical homes.
The U.S. also ranks behind most countries on many measures of health outcomes, quality, and efficiency. U.S. physicians face particular difficulties receiving timely information, coordinating care, and dealing with administrative hassles.
The other 10 countries spend considerably less on health care per person — and as a percent of gross domestic product — than does the United States.
The 2014 study (pdf) includes data from 11 countries. It incorporates patients’ and physicians’ survey results on care experiences and ratings on various dimensions of care. It includes information from the most recent three Commonwealth Fund international surveys of patients and primary care physicians about medical practices and views of their countries’ health systems (2011–2013). It also includes information on health care outcomes featured in The Commonwealth Fund’s most recent (2011) national health system scorecard, and from the World Health Organization (WHO) and the Organization for Economic Cooperation and Development (OECD).
The upside of U.S. healthcare? Shareholders, insurers, hospitals, clinics, and suppliers are making
a killing large profits!