Story at a glance
- The report analyzed 71 health care performance measures under five categories.
- Norway, the Netherlands and Australia were the top-performing countries overall, with the U.S. coming in dead last.
- The U.S. ranked last on access to care, administrative efficiency, equity and health care outcomes despite spending 17 percent of GDP on health care.
The U.S. health care system ranked last among 11 wealthy countries despite spending the highest percentage of its gross domestic product on health care, according to an analysis by the Commonwealth Fund.
Researchers behind the report surveyed tens of thousands of patients and doctors in each country and used data from the Organization for Economic Cooperation and Development and the World Health Organization (WHO).
The report considered 71 performance measures that fell under five categories: access to care, the care process, administrative efficiency, equity and health care outcomes. Countries analyzed in the report include Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the U.S.
Norway, the Netherlands and Australia were the top-performing countries overall, with the U.S. coming in dead last.
The U.S. ranked last on access to care, administrative efficiency, equity and health care outcomes despite spending 17 percent of GDP on health care, but came in second on the measures of care process metric. The nation performed well in rates of mammography screening and influenza vaccination for older Americans, as well as the percentage of adults who talked with their physician about nutrition, smoking and alcohol use.
Half of lower-income U.S. adults in the report said costs prevented them from receiving care while just more than a quarter of high-income Americans said the same. In comparison, just 12 percent of lower-income residents in the U.K. and 7 percent with higher incomes said costs stopped them from getting care.
The U.S. also had the highest infant mortality rate and lowest life expectancy at age 60 compared with other countries.
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Researchers said several key factors set the high-performing nations apart from the U.S.: universal coverage, the removal of cost barriers, investment in care systems to reduce inequities and investing in social services for children and working-age adults.
“If health care were an Olympic sport, the U.S. might not qualify in a competition with other high-income nations,” Eric Schneider, the lead author behind the report and senior vice president for policy and research at the Commonwealth Fund, told Changing America.
“The U.S. has two health care systems. For Americans with the means and insurance to have a regular doctor and reported experiences with their day-to-day care are relatively good, but for those who lack access, the consequences are stark,” Schneider said.
The poor performance is nothing new, as the U.S. has landed in last place in all seven studies the Commonwealth Fund has released since 2004.
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