U.S. Health Care System Is a Bad Investment

Where the United States health care system ranks. It’s dead last.
Where the United States health care system ranks. It’s dead last. –The Commonwealth Fund

In 2010, the United States spent $8,508 on health per capita, almost double our northern neighbors, Canada. That’s 17.7 percent of our GDP when other developed countries with similar economic standing, such as the United Kingdom, spent less than 9 percent.

And we aren’t getting a great return on our investment.

Out of 11 developed countries analyzed in The Commonwealth Fund’s latest report, published in June 2014, the United States ranks the highest for expenditure, but comes in dead last for quality.

GDP expenditures on health care. —The Commonweth Fund, June 2014

The report analyzes the health care system in the United States and compares it to 10 other nations: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. Unfortunately, this is the fourth iteration of this report, and our standing in this ranking didn’t budge.


In 2010, 2007, 2006, and 2004, the United States has held the same position while other nations have adjusted their standing. According to The Commonwealth Fund, access, efficiency, and equity are terms that seem lost on the U.S. health care system.

Specifically in the categories of cost-related problems, efficiency, equity, and healthy lives, the United States ranks eleventh, which fixes our health care system at the bottom of the pile for 2014.

In terms of efficiency, where you might think our capitalist impulses kick in, our national health expenditures and administrative costs weigh us down, as well as repetitive, unnecessary emergency room use.

Were there any bright spots? Sure. Our highest position is third for effective care. We’re also fourth in patient-centered care.

But according to the report, the absence of universal health insurance coverage is the most notable difference between the United States and the rest of the 10 countries. Analysts said in the report that they hope the picture will be brighter as the law is implemented and new data becomes available.

“Other nations ensure the accessibility of care through universal health systems and through better ties between patients and the physician practices that serve as their medical homes. The Affordable Care Act is increasing the number of Americans with coverage and improving access to care, though the data in this report are from years prior to the full implementation of the law. Thus, it is not surprising that the U.S. underperforms on measures of access and equity between populations with above-average and below-average incomes.’’

The land of the free and home of the brave ranks below the rest of the countries when it comes to health care equity. In terms of access, Americans are the most likely to say they cannot access health care because of cost, according to the report. People with below-average incomes in the United States are also much more likely to forgo health care because of cost.


“Not surprisingly–given the absence of universal coverage–people in the U.S. go without needed health care because of cost more often than people do in the other countries,’’ said the report’s authors, a panel of health care economists and public health researchers from The Commonwealth Fund.

The United Kingdom ranked first overall, where a national single-payer health care system is in place.

“Based on these patient and physician reports, and with the enactment of health reform, the United States should be able to make significant strides in improving the delivery, coordination, and equity of the health care system in coming years,’’ said the report.

Okay. So how long will that take?

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