Blog - U.S. Ranks Last in Health Care

A study conducted by the Commonwealth Fund shows that Americans experience lower quality, less access, less efficiency, and have a less equitable health care system than other nations. Despite the fact that Americans spend twice as much as residents of other developed countries on health care, the United States ranked last when compared to six other developed countries – Britain, Canada, Germany, Netherlands, Australia, and New Zealand. The Commonwealth study indicates areas in which the United States must improve in order to enhance its performance scores. According to the report, the United States is lacking in chronic care management; safe, coordinated care; access to needed primary health care services; and equity. Additionally, the United States lags behind Australia, New Zealand, and the U.K., in the development of health information systems. Lastly, the study found that the United States demonstrates “poor performance on measures of national health expenditures and administrative costs as well as on measures of the use of information technology, re-hospitalization, and duplicative medical testing.” While the United States differs from the other countries in the study in that it does not have universal health insurance coverage, examiners found that even insured and high-income Americans were more likely to experience problems such as not getting recommended tests, treatments, or prescription drugs than their counterparts in other countries.

 The study suggested, and I agree, that the United States should take lessons from other countries to make our health care system more effective and responsive to patients’ needs. With the passage of the American Recovery and Reinvestment Act and the Patient Protection and Affordable Care Act (ACA), the United States has taken steps in the right direction. However, I think that some of the United States’ efforts are still misguided. For example, in a statement released on June 25, 2010, Secretary Sebelius said that “[i]mproving access to preventive services and primary care is a top priority for HHS [Health and Human Services].” Consistent with this, HHS allocated $250 million for primary care and another $250 million for preventive care. While $250 million is necessary to augment the current primary care infrastructure, the $250 million devoted to preventive care unless targeted on unmet needs may be misguided – of every matrix measured in the Commonwealth Fund’s study, the United States fared best on the provision and receipt of preventive care.

Successful implementation of the American Recovery and Reinvestment Act and the Patient Protection and Affordable Care Act will aid the United States in improving its performance relative to other developed countries. In doing so, however, the United States must allocate financial resources to areas in which they are most needed, rather than areas in which the United States has already been successful.

Money is innately limited and, therefore, difficult decisions must be made regarding how to allocate funds. Where in the United States’ healthcare system should the scarce resources be allocated?

Click here for the Commonwealth Fund’s Report. 
Click here for Secretary Sebelius’s June 18, 2010 Statement. 
Click here for Secretary Sebelius’s June 25, 2010 Statement.

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