U.S. Ranks Last in Health Care Among High-Income Nations, Report Reveals

A new report by The Commonwealth Fund has highlighted a concerning reality: the U.S. ranks last among ten high-income countries in critical areas of health care. Despite spending nearly twice as much on health care as its peers—around 18% of its gross domestic product—the U.S. lags behind in preventing deaths, ensuring access to care, and guaranteeing quality treatment for all individuals.

According to the report, published on Thursday, the U.S. experiences the lowest life expectancy and the highest rates of avoidable deaths among the surveyed countries. The study compares the U.S. with nine other developed nations, including Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, and the United Kingdom. Each country was evaluated based on five categories: access to care, care process, administrative efficiency, equity, and health outcomes.

The U.S. performed poorly in almost all categories except for care process, where it ranked second behind New Zealand. Care process includes preventive services such as mammograms and flu vaccinations. The report underscores that the U.S. faces severe challenges with administrative efficiency, ranking second to last due to the complex and fragmented nature of its health care system.

Dr. Joseph Betancourt, president of The Commonwealth Fund, emphasized that no other country demands as much out-of-pocket expenditure from its citizens for essential health care. Dr. David Blumenthal, former president of The Commonwealth Fund, noted that the U.S. suffers from shortages of critical resources, including doctors and hospital beds, contributing to long wait times and difficulties in accessing primary care.

The report, based on extensive surveys of primary care physicians and residents, highlights that the U.S. stands out for its “exceptionally weak” performance in health care despite its high expenditure. This situation has become a key issue in the upcoming presidential election, with Vice President Kamala Harris advocating for an expansion of the Affordable Care Act (Obamacare) and former President Donald Trump suggesting deregulation.

The findings also show that U.S. health care fails to deliver superior results despite the high costs. The U.S. has the lowest life expectancy, at 77.5 years, and the highest rates of preventable deaths, worsened by the COVID-19 pandemic. The report’s new data on pandemic-related impacts reveal a persistent low performance in managing COVID-19 mortality.

Lawrence Gostin from Georgetown University’s O’Neill Institute highlighted that the U.S. ranks poorly on essential health indicators, including access and equity. Many vulnerable populations, such as racial minorities and low-income individuals, remain uninsured or underinsured, often delaying or avoiding necessary care due to high costs.

Dr. Adam Gaffney of the Cambridge Health Alliance pointed out that universal health care coverage, as seen in other high-income countries, could address many of these issues by providing comprehensive care and preventive services to all individuals.

The report suggests several solutions for improving the U.S. health care system, including reducing care costs and expanding access to coverage to address these critical challenges.

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