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The US spends more on health care than any other high-income country, but a new report suggests that “Americans are getting sicker, dying younger and struggling to survive.” get health care.”
Compared to nine other high-income countries, the United States ranked last overall this year, with low life expectancy and high rates of death and disease despite spending more money on health care, according to a report, released Thursday by an independent research group. Commonwealth Fund.
The three countries that performed best in this report were Australia, the Netherlands and the United Kingdom.
“This report reveals that our health care system continues to lag far behind other nations when it comes to meeting the basic health needs of our population. The US spends the most on healthier than any other country, and Americans are getting sicker, dying younger and struggling to get health care. We spend more and get less for our investment,” Dr. Joseph Betancourt, president of The Commonwealth Fund, said in a news conference.
“As a primary care physician, I see the human problems caused by these weaknesses in our system every day. I have patients who need medications they cannot afford. I spend time going forward back and forth with insurance companies that have denied me the care that I know my patients need, and I see elderly patients who come in sicker than they should be because they have spent most of their lives without be insured,” Betancourt added.
“This report highlights many lessons we can learn from others about improving our health care delivery and outcomes,” he said. “It provides a blueprint for health leaders and policymakers on how the US can achieve equitable and affordable care for all Americans.”
Researchers from The Commonwealth Fund compared and analyzed the performance of health systems in 10 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, the United Kingdom and the United States.
The researchers looked at how health systems are performing on 70 measures across five key areas in the countries: access to care, health care performance, administrative efficiency, equity and health consequences. The assessments were based on information from the World Health Organization, the Organization for Economic Co-operation and Development, Our World in Data and international research conducted by the Commonwealth Fund.
The countries with the highest rankings in five key areas were:
1. Australia
2. The Netherlands
3. United Kingdom
4. New Zealand
5. France
The countries that had the lowest rankings in the five key areas were:
6. Sweden
7. Canada
8. Switzerland
9. Germany
10. United States
When the researchers analyzed each country by each key area, the United States ranked last in access to care, indicating that Americans face many barriers to accessing and providing care. of health. The nation also ranked last in health outcomes, including acute illness, chronic illness and death.
The researchers found that people in the United States live the shortest lives and face the most preventable deaths among the 10 countries, and the US has the highest rates of death and related to the Covid-19 epidemic for people under the age of 75, according to the report.
The United States ranked ninth in equity, indicating that disparities persist in how people of different incomes and backgrounds can access and receive health care. . The country also ranked ninth in administrative efficiency, indicating that doctors and patients in the US are more likely to report problems related to insurance approval and bills.
“Administrative requirements can cost time and money for patients and doctors,” Reginald Williams II, vice president of international health policy and innovation at The Commonwealth Fund, said in the interview.
“Many states have simplified health insurance and payment systems, often through laws, regulations, and standards. For example, some states apply standard payments to all physicians for services, and do so to by regions, so that doctors know how much they will be paid, and patients know what their responsibilities will be,” he said. “They make it easier.”
One area in which the United States ranked high was in the quality of care, which suggests that the health care it provides includes features or characteristics that are considered and important for quality care.
The researchers realized that “all countries have something to learn from each other.” However there were relatively few differences in overall performance among all countries except the United States, which was “the only outlier.”
The other nine countries may have different health care systems, but all had universal coverage, the researchers wrote, ensuring that any premiums health services are small, improving access and affordability.
Dr. David Blumenthal, former president of Dr. David Blumenthal: The Commonwealth Fund, said in an interview.
“The United States lags behind by having 20 million more uninsured Americans — 7% to 8% of the population — while historically low, still very high by international standards ,” he said. “It also limits the ability of low-income people to access basic services.”
In addition, the researchers found that health care costs were similar in other countries but not in the US, which spends significantly more on health care than its peers yet has performance. the worst.
The two highest-ranking countries, Australia and the Netherlands, had the lowest health care costs
To improve the quality of health care, the US can expand insurance coverage, reduce disparities in care, and reduce the administrative burden and complications of insurance plans, the researchers wrote.
It’s also important for the United States to “invest in interventions outside of health care to address public health issues: poverty, homelessness, hunger, discrimination, gun violence, drug use,” Williams said. said.
The report also calls for a stronger primary care system in the United States.
For example, “primary care doctors in the Netherlands must have after-hours coverage. As a person in the Netherlands, you always have access to your primary care doctor or a covering doctor, 24/ 7, and that, in fact, is not true in the United States,” Blumenthal said.
“Americans often report difficulty accessing after-hours care, which leads them to use emergency rooms for after-hours care,” he said. “That is a very simple process that can reduce maintenance costs, reduce access problems and reduce the complexity of the maintenance system.”
The upcoming US presidential election could play an important role in the future of the country’s health care system, Blumenthal said.
“American voters are choosing where to run, and that’s a big issue in this election,” he said. “If we continue to build the basis for the reform of our health care system, options that result in the expansion of insurance coverage, based on existing programs, will take us in a direction that makes let’s be close to action in other international competitions.”
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The rankings in the new report are similar to those in a paper The Commonwealth Fund released last year that found the US has the highest rates of death from preventable or treatable causes and the highest rates of most of the maternal and infant deaths yet they still spend more money on health care than any other. another high income country.
“We are not getting the best value for our health care dollar,” Dr. Georges Benjamin, executive director of the American Public Health Association, who was not involved in either report, said last year.
To help fix the holes in the US health care system, Benjamin said, there are three steps the public can take.
Benjamin said: “We are still the only country that does not have health care or access for all of our citizens.”
Second, “we don’t do primary care prevention like other nations, and we still have a public health system, which is broken,” he said. “The third thing is that we do not invest a lot of money compared to other developed countries in public affairs. They use their money to provide basic support to their residents. We use our money to take care of sick people.”
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