Aug. 4, 2021 — The U.S. health care system ranked last overall among 11 high-income countries in an analysis by the nonprofit Commonwealth Fund, according to a report released this week.
The report is the seventh international comparison of countries’ health systems by the Commonwealth Fund since 2004, and the United States has ranked last in every edition, David Blumenthal, MD, president of the Commonwealth Fund, told reporters during a press briefing.
Researchers analyzed survey answers from tens of thousands of patients and doctors in 11 countries. They analyzed performance on 71 measures across five categories — access to care, care process, administrative efficiency, equity, and health care outcomes. Administrative data were gathered from the Organization for Economic Co-operation and Development (OECD) and the World Health Organization (WHO).
Among contributors to the poor showing by the U.S. is that half (50%) of lower-income adults and 27% of higher-income adults say costs keep them from getting needed health care.
“In no other country does income inequality so profoundly limit access to care,” Blumenthal said.
In the United Kingdom, only 12% with lower incomes and 7% with higher incomes said costs kept them from care.
In a stark comparison, the researchers found that “a high-income person in the U.S. was more likely to report financial barriers than a low-income person in nearly all the other countries surveyed: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the U.K..”
Norway, the Netherlands, and Australia were ranked at the top overall in that order. Rounding out the 11 in overall ranking were (4) the United Kingdom, (5) Germany, (6) New Zealand, (7) Sweden, (8) France, (9) Switzerland, (10) Canada, and (11) US.
“What this report tells us is that our health care system is not working for Americans, particularly those with lower incomes, who are at a severe disadvantage compared to citizens of other countries. And they are paying the price with their health and their lives,” Blumenthal said in a press release.
“To catch up with other high-income countries, the [Biden] administration and Congress would have to expand access to health care, equitably, to all Americans, act aggressively to control costs, and invest in the social services we know can lead to a healthier population.”
