U.S. health system ranks last among wealthy nations

The country ranks last in four of five metrics related to health equity, access to care and health outcomes.

Compared to people in other high-income countries, Americans of all incomes have the hardest time affording the health care they need. (Photo: Shutterstock)

The U.S. health system ranks last among 11 high-income countries in providing equitably accessible, affordable, high-quality health care, a new Commonwealth Fund study found. Norway, the Netherlands and Australia were the top overall performers.

“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,” said Dr. David Blumenthal, president of the Commonwealth Fund. “And they are paying the price with their health and their lives. To catch up with other high-income countries, the 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.”

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The report shows that getting good, essential health care in the United States depends on income, more so than in any other wealthy country. Since 2004, the United States has ranked last in every edition of the report, falling further behind on some indicators, despite spending the most on health care. Among the 11 nations surveyed, the United States is the only one without universal health insurance coverage.

Among the other findings:

The study made several recommendations for expanding better and more equitable health outcomes:

“This study makes clear that higher U.S. spending on health care is not producing better health, especially as the United States continues on a path of deepening inequality,” said Dr. Eric Schneider, Commonwealth Fund senior vice president for policy and research. “A country that spends as much as we do should have the best health system in the world. We should adapt what works in other high-income countries to build a better health care system that provides affordable, high-quality health care for everyone.”

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