U.S. Health Care Ranks Last Compared to Other Countries

A 2010 report from the Commonwealth Fund ranked countries of comparable wealth and levels of modernization in terms of their national health systems, a ranking which found the United States falling flat.  Despite paying more for health care than any other country in the world, the US ranked at or near the bottom in terms of access, quality and cost - measures that have a real impact on our individual and collective health and pocketbooks.  Passed that same year, the Affordable Care Act is an acknowledgement that the room for improvement is immense.  The question is: How does the health law work to improve our national standing on the international stage?

The fact that our national health system is wildly inefficient, ineffectual, and segmented in absolute and relative terms is well known.  The Commonwealth Report compared the US system with those of six other countries - Australia, Canada, Germany, the Netherlands, New Zealand and the United Kingdom - and concluded that the prevailing system was not only coming up well short, but unsustainable.  Something had to be done, and though the report noted that with the introduction of the ACA improvements were likely, the connection between this report and the implementation of the law has so far been left wanting.

Well, here it is. 

As a jumping off point, the ACA broadens insurance coverage to those who would otherwise be uninsured and enshrines a series of protections for patients and consumers.  This is important, because as a nation, the US tied for last (sharing that "honor" with Australia) when it comes to access generally.  The US stands alone in that position when cost is considered.  On the whole, the US spent $7,290 per capita on health care in 2007, which is nearly double the average spent by the other countries studied.

Second, in terms of quality, the ACA sought to refocus the health care system from one in which quantity was often prized over effectiveness or quality.  The US ranked just ahead of Canada, which earned the not-so-coveted position of last on that measure.  The strengthening of primary care and the patient-provider relationship overall is essential in this respect, and the new health law paves the way for this transformation by providing incentives in those areas.  A reallocation of investment in the primary care workforce is just one of these focal points in the new law, and with increased funding in the hundreds of millions of dollars over five years, an estimated 16,000 new primary care providers will soon be serving in our communities.        

Equity, an equally important yet often overlooked dimension of health care, is another category where the United States ranked at the bottom.  Whether one considers income level, geographic region, gender, race/ethnicity or any of the other socioeconomic conditions that shape our lives, the American health system is plagued by systemic holes through which disparities have emerged. The ACA, for its part, took pains to address these issues, whether one looks to the expansion of Medicaid, improved access and affordability in preventive health services for women, or the allocation of funding for rural and community-based health care in under-served areas.  Much works remains to be done, but the ACA was a step forward in reducing or eliminating these disparities to the furthest extent possible.

In the end, the 2010 report from the Commonwealth Report should serve as a reminder of why health reform is so important and the many areas where improvements is still needed.  The ACA may be far from perfect - the lack of a public insurance option being one notable example - but as far as getting the bang for our buck goes, it will likely improve our standing relative to nations of similar wealth and economic development.  We may be a long way from climbing to the number one spot in terms of access, quality, and cost of healthcare, but this author looks forward to an updated report once the rest of the law has been fully implemented and changed the way health care is provided in this country.       

Justin Decker is a reporter for Campus Progress. Follow him on Twitter @DeckerJustin.

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