While the United States' healthcare system is the most expensive of 11 industrialized Western nations' systems, it ranks last in care quality, a June report by the Commonwealth Fund found. But as the effects of the Affordable Care Act (ACA) take shape, they may improve parts of the system that contributed to the low score, according to Daily Finance.
About 20 million people gained insurance by May, according to the article, and the ACA has several provisions intended to reduce inequality in the U.S. system, a major focus of the report. These provisions include:
Insurance subsidies for Americans with incomes between 133 percent and 400 percent of the federal poverty level
The Basic Health Program for participating states, intended to improve coverage access to patients who earn too much to be eligible for Medicaid, but too little to shop on the state exchanges
Lower individual co-payments and deductible costs for consumers who buy Silver level plans or higher
At the state level, Massachusetts, where the 2006 healthcare reform law served as a model for the ACA, saw the number of bankruptcies caused by medical bills drop from 59.3 percent to 52.9 percent between 2007 and 2009, according to the article.
"If the ACA works in the ways it's supposed to, state by state and nationwide, we can look forward to a follow-up report from The Commonwealth Fund that can't be summarized by pairing the words 'U.S.' and 'last,'" the article states.
Meanwhile, Sally Pipes, resident, CEO, and Taube Fellow in Health Care Studies at the Pacific Research Institute, disputes the Commonwealth Fund's methodology in Forbes, saying it gives weight to equity of care rather than quality. "And on that metric--that is, actually delivering care to those who need it--the United States is without peer," she writes.
Pipes also points out that the U.S. system's high levels of spending reflect the nation's general wealth; as healthcare spending has soared in the U.S., so too has spending on pets, live entertainment and computers, she writes.