Healthcare News & Insights

Quality of U.S. healthcare system at rock bottom?

The U.S. came in dead last for the fifth year in a row when stacked up against other industrialized countries based on healthcare quality, efficiency and access to care. 

462550165 (1)That’s according to a report released by The Commonwealth Fund this week.

Sky-high costs, lack of access to healthcare for the poor, and preventable deaths dragged the U.S. to the bottom of the ranks in the quality of its health care system, the think tank reported.

The U.S. healthcare system is the most expensive system in the world, spending $8,508 per person on health care, more than twice what the top-ranked country, the United Kingdom, spent at just $3,406 per person, the report noted.

“Although the U.S. spends more on healthcare than any other country and has the highest proportion of specialist physicians, survey findings indicate that from the patients’ perspective… the performance of American health care is severely lacking,” the report concluded.

The most notable way the U.S. differed from other industrialized countries was the absence of universal insurance coverage. However, since the survey was conducted before the Affordable Care Act (ACA) was enacted this year, the U.S. should move up the ranks next year, the report indicated.

Primary care a premium for poor in U.S.

On a more positive note, the U.S. fares best on preventative and patient-centered care. Significant incentives, such as pay-for-performance measures, are improving the system’s delivery, coordination and equity of healthcare services.

The U.S. ranks worst overall on lack of access to primary care, especially for the poor, who reported they can’t afford treatment. One-third or more lower-income adults in the U.S. said they went without needed care because they couldn’t pay for it.

And, despite the enactment of the ACA, which provides insurance to 50 million people who didn’t have it, scores of lower-income adults still remain uninsured or on Medicaid which doesn’t reimburse the hospital or doctors as well as private insurers or Medicare.

How the U.S. scored

  • Access:  Given the absence of universal coverage, Americans were the most likely to say they had problems accessing primary care because of the cost.
  • Efficiency: The U.S. ranks last among the 11 countries polled in this category, with the U.K. and Sweden ranking first and second. Avoidable emergency room use,  duplicate medical testing, physicians running into difficulties coordinating care and dealing with the bureaucratic red tape associated with insurance providers all negatively affected the system’s performance.
  • Equity: The U.S. ranks a clear last in this category. Americans with below-average incomes reported they won’t visit a doctor when they’re sick; get needed medical tests or follow-up care.  They also said they will skip doses of medication because they can’t afford to buy refills or they simply won’t fill a prescription, and
  • Healthy lives: The U.S. ranks last overall on infant mortality and preventable deaths, for example getting treatment for conditions that could have been controlled, such as high blood pressure.


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