Commonwealth Fund: U.S. healthcare is most expensive, but last in quality

For the fifth time, the United States' healthcare system ranks last in quality compared to 10 other industrialized Western nations, according to a report from the Commonwealth Fund.

Not only has the U.S. remained in last place through the past decade, the healthcare system's per capita spending ($8,508) is far greater than that of the second-most expensive system, Norway's, which spends $5,669 per capita, according to the report.

"Although the U.S. spends more on healthcare than any other country and has the highest proportion of specialist physicians, survey findings indicate that from the patients' perspective, and based on outcome indicators, the performance of American healthcare is severely lacking," the report states.

Other study findings include:

  • The U.S. fares best among all countries on provision and receipt of preventive and patient-centered care, but has lower safe and coordinated care scores that drag down its overall healthcare quality score.

  • The U.S. ranks last in access of all countries, which the authors attribute to its lack of universal coverage. "There is a frequent misperception that trade-offs between universal coverage and timely access to specialized services are inevitable," the report states. "However, the Netherlands, U.K., and Germany provide universal coverage with low out-of-pocket costs while maintaining quick access to specialty services. "

  • The U.S. ranks last in both care equity and healthy lives. "The U.S. and U.K. had much higher death rates in 2007 from conditions amenable to medical care than some of the other countries, e.g., rates 25 percent to 50 percent higher than Australia and Sweden. Overall, France, Sweden, and Switzerland rank highest on healthy lives," the report states.

The authors compiled the report before the full implementation of the Affordable Care Act, so expanded access may shift the country's' position in a later analysis, according to the Washington Post.

The report comes as data analysis by the Pittsburgh Post-Gazette and the Milwaukee Journal Sentinel finds that residents of low-income neighborhoods are less healthy than more affluent Americans and more likely to live in areas with closed hospitals or physician shortages. Nearly two-thirds of the more than 200 hospitals opened in the last 14 years are in wealthy, predominantly suburban neighborhoods.

To learn more:
- read the report
- read the Post article
- read the analysis

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