US health care system ranks last among wealthy nations, report finds

Americans have the worst health care among the world’s wealthy nations, a new report says.

People in the United States die the earliest and live the sickest lives out of 10 developed countries, even though the United States spends the most on health care, according to the annual report by health care think-tank The Commonwealth Fund.

Australia, the Netherlands and the United Kingdom rank highest out of the 10 countries included in Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System.

“While other nations have successfully met their populations’ health needs, the U.S. health system continues to lag significantly,” said Reginald Williams II, vice president of international health policy and practice innovations with The Commonwealth Fund.

For the report, researchers compared nations’ health systems based on 70 specific measures across five areas of performance. Other nations measured against the United States included Canada, France, Germany, New Zealand, Sweden and Switzerland.

The report found that:

• People in the United States have the shortest lives and the most avoidable deaths, ranking dead last on five out of six health outcome measures
• Americans face the most barriers to obtaining health care. About 25 million people remain uninsured in this country, and nearly a quarter can’t afford care when they need it
• The United States ranks lowest in health equity, with many low-income people unable to afford care and more groups reporting unfair treatment and discrimination when seeking care
• Patients and doctors in the United States experience heavy administrative burdens when it comes to payment, billing and paperwork, with the system outranking only Switzerland in its lack of efficiency

The United States had just one bright spot in the report.

The nation ranked second among the countries in “care process,” which includes prevention, safety and patient engagement. The Affordable Care Act’s emphasis on patient safety and preventive services partly explains the high ranking, the researchers said.

“The U.S. is failing one of its principal obligations as a nation: to protect the health and welfare of its people,” said Dr. Joseph Betancourt, president of the Commonwealth Fund.

“The status quo—continually spending the most and getting the least for our health care dollars—is not sustainable,” Betancourt added in a Commonwealth Fund news release. “It isn’t about lack of resources—it’s clearly about how they are being spent. Too many Americans are living shorter, sicker lives because of this failure.”

The report argues that the United States could improve its health care comparative to other nations by:

• Extending coverage to the remaining uninsured and reforming health insurance to limit out-of-pocket expenses
• Investing in primary care providers, so more are available to patients
• Removing health inequities faced by minority and ethnic groups, rural residents and women
• Curbing the uncontrolled consolidation of health care systems, which is driving prices higher
• Address social drivers of health like poverty, homelessness, hunger, gun violence and substance use

“This report shows that by adopting proven strategies and making smart investments, America can enhance its health system to better meet the needs of its people,” Williams said. “There’s no reason we can’t elevate our standing if we choose to do so.”

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