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US health system ranks last compared with peer nations, report finds.

Despite Americans paying nearly double that of other nations, the US fares poorly in list of 10 countries.

By
Jessica Glenza/The Guardian
Thu 19 Sep 2024 00.01


The United States health system ranked dead last in an international comparison of 10 peer nations, according to a new report by the Commonwealth Fund.

In spite of Americans paying nearly double that of other countries, the system performed poorly on health equity, access to care and outcomes.

see the human toll of these shortcomings on a daily basis,” said Dr Joseph Betancourt, the president of the Commonwealth Fund, a foundation with a focus on healthcare research and policy.

“I see patients who cannot afford their medications … I see older patients arrive sicker than they should because they spent the majority of their lives uninsured,” said Betancourt. “It’s time we finally build a health system that delivers quality affordable healthcare for all Americans.”

However, even as high healthcare prices bite into workers’ paychecks, the economy and inflation dominate voters’ concerns. Neither Kamala Harris nor Donald Trump has proposed major healthcare reforms.

The Democratic presidential nominee has largely reframed healthcare as an economic issue, promising medical debt relief while highlighting the Biden administration’s successes, such as Medicare drug price negotiations.

The Republican presidential nominee said he has “concepts of a plan” to improve healthcare, but has made no proposals. The conservative policy agenda Project 2025 has largely proposed gutting scientific and public health infrastructure.

However, when asked about healthcare issues, voters overwhelmingly ranked cost at the top. The cost of drugs, doctors and insurance are the top issue for Democrats (42%) and Republicans (45%), according to Kaiser Family Foundation health system polling. Americans spend $4.5tn per year on healthcare, or more than $13,000 per person per year on healthcare, according to federal government data.

The Commonwealth Fund’s report is the 20th in their “Mirror, Mirror” series, an international comparison of the US health system to nine wealthy democracies including Australia, Canada, France, Germany, the Netherlands, New Zealand, the UK, Sweden and Switzerland. The foundation calls this year’s report a “portrait of a failing US health system”.

The report uses 70 indicators from across five main sectors, including access to care, health equity, care process, administrative efficiency and outcomes. The measures are derived from a survey conducted by Commonwealth as well as publicly available measures from the World Health Organization, OECD and Our World in Data.

In all but “care process” – the domain that covers issues such as reconciling medications – the US ranked as the last or penultimate nation. Presenters for Commonwealth noted the US is often “in a class of its own” far below the nearest peer nation."

Poverty, homelessness, hunger, discrimination, substance abuse – other countries don’t make their health systems work so hard,” said Reginald D Williams II, vice-president of the fund. He said most peer nations cover more of their citizens’ basic needs. “Too many individuals in the US face a lifetime of inequity, it doesn’t have to be this way.”

But recommendations to improve the US health system’s standing among peer nations will not be easy to implement.

The fund said the US would need to expand insurance coverage and make “meaningful” improvements on the amount of healthcare expenses patients pay themselves; minimize the complexity and variation in insurance plans to improve administrative efficiency; build a viable primary care and public health system; and invest in social wellbeing, rather than thrust problems of social inequity onto the health system.

"I don’t expect we will in one fell swoop rewrite the social contract,” said Dr David Blumenthal, the fund’s past president and an author of the report. “The American electorate makes choices about which direction to move in, and that is very much an issue in this election.”
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oldguy73 · 70-79, M
all depends, if on welfare you get anything you need, if you have excellent insurance, which i have, and it is free from my emplower, i have great healthcare, see any doctor i want , then lots of people have poor insurance, which means they have to pay more, we have lots of variables in healthcare
@oldguy73 really? Our state doesn't have welfare payments for adults. Doesn't the medicaid extend only to certain poor people - the ones in less conservative states where the legislature didn't bother to make sure they're never ever getting it?
oldguy73 · 70-79, M
@Roundandroundwego in the usa, welfare is supposedly for poorer people, but what most sorry, but blacks and lots of whites refuse to work, claiming anything, if black no proplem, if a white female, easy too, if , women have a kid every so many years, they continue to get welfare, and boyfriends move in with them for free, medicaid is for people with below income standards, they get food stamps, and some assistant, welfare is abused very bad in the usa.
@oldguy73 since 1995 all adults must work forty hours a week to get food stamps and nobody gets a welfare payment.
You sure don't want no boyfriend moving in for free. That's too much freedom. As a socialist I'll sleep with whom I like. You should have no freedom there,- especially if you're not rich.
oldguy73 · 70-79, M
@Roundandroundwego well, i know girls that do not work have a kid under 18, and they get food stamps and rent, paid, all free, like where you live??
@oldguy73 girls under 18 or any age can't be raising kids with support! You want them working and barren, learning BJ's and work skills until them eggs is half scrambled and they're sexually distorted and weirdly celebate.