The United States health system has been ranked last in a recent international comparison of ten peer countries, according to a report from the Commonwealth Fund.
Despite Americans spending nearly twice as much on healthcare as individuals in other nations, the system has shown significant shortcomings in health equity, access to care, and overall health outcomes.
Dr. Joseph Betancourt, president of the Commonwealth Fund, stated, “I see the human impact of these issues every day.” He noted that problems such as poverty, homelessness, hunger, discrimination, and substance abuse burden the health system more than in other countries. Reginald D. Williams II, vice president of the fund, added that many peer nations are more effective at addressing their citizens’ basic needs. “Too many people in the U.S. face a lifetime of inequity, and it doesn’t have to be this way.”
However, enacting the recommendations needed to improve the U.S. health system’s standing among its peers is a complex challenge.
The fund indicates that the U.S. must expand insurance coverage, significantly lower out-of-pocket healthcare expenses for patients, streamline the complexity and variability of insurance plans for improved administrative efficiency, create a robust primary care and public health system, and invest in social well-being rather than shifting social inequities onto the health system.
Dr. David Blumenthal, the former president of the fund and one of the report’s authors, stated, “I don’t anticipate that we will quickly overhaul the social contract. The American electorate has the final say in the direction we pursue, and this will be a critical issue in the forthcoming election.”
### The Challenges Ahead
In a time when misinformation is rampant, fueled by extremist media and politicians like Donald Trump, reliable journalism is more critical than ever. The Guardian believes that access to trustworthy information is vital for democracy and appreciates the support from readers like you in India.
By contributing to The Guardian, you can play an essential role in countering the bad faith and self-serving interests of those who spread lies to undermine democracy and deepen political divides worldwide. If you can, please consider supporting us monthly. It takes less than a minute to set up, and your contribution makes a meaningful impact each month in promoting independent journalism.
Dr. Betancourt expressed concern for patients, saying, “I see individuals who cannot afford their medications. I witness older patients arriving in worse health than they should because they spent most of their lives uninsured. It’s time to create a health system that delivers quality, affordable care for all Americans.”
Despite the increasing healthcare costs straining workers’ budgets, economic issues and inflation remain the primary concerns for voters. Neither Kamala Harris nor Donald Trump has proposed significant healthcare reforms.
The Democratic presidential nominee has framed healthcare as an economic issue, pledging to provide relief from medical debt while highlighting the Biden administration’s achievements, such as Medicare drug price negotiations.
On the other hand, the Republican presidential nominee has claimed he has “concepts for a plan” to improve healthcare but has yet to present any specific proposals. The conservative policy agenda Project 2025 primarily advocates for dismantling scientific and public health infrastructure.
When asked about healthcare issues, voters consistently identify costs as their top priority. The expenses related to drugs, doctors, and insurance are the main concerns for both Democrats (42%) and Republicans (45%), according to polling from the Kaiser Family Foundation. Americans spend approximately $4.5 trillion each year on healthcare, averaging over $13,000 per person.
The Commonwealth Fund’s report is the 20th installment in its “Mirror, Mirror” series, which compares the U.S. health system to those of nine other wealthy democracies, including Australia, Canada, France, Germany, the Netherlands, New Zealand, the UK, Sweden, and Switzerland. This year’s report depicts a “picture of a failing U.S. health system.”
The report evaluates 70 indicators across five key areas: access to care, health equity, care processes, administrative efficiency, and outcomes, using measures derived from Commonwealth surveys alongside publicly accessible data from the World Health Organization and the OECD.
In every category except for “care process” (which involves medication reconciliation), the U.S. ranked either last or second to last compared to its peers. Presenters from the Commonwealth highlighted that the U.S. frequently exists “in a class of its own,” falling far behind the nearest peer nation.
