The U.S. health care system came in seventh in a recent study that focused on access, efficiency, quality, equity and healthy lives. Unfortunately for U.S. patients, the study included only seven developed nations – so the U.S. finished dead last. This news may not come as a surprise to many, but it has spurred debate as to whether U.S. health care reform (the legislation will be in full effect in 2014) can help the U.S. health care system to improve its performance rankings.
The study was performed by the private, non-profit Commonwealth Fund in Washington, D.C. It centered on the experiences of patients and health care providers in 2007.
The countries that were studied were: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the U.S., which also ranked last in the study in 2004, 2006, and 2007.
The U.S. is the only country in the study that does not have universal health care. The average health care spending per capita in the U.S. in 2007 was $7,290, while New Zealand was $2,454 and the United Kingdom was $2,992. The other four countries annually spent between $3,357 and $3,895 per capita.
The U.S. ranked second-to-last or last in every major study ranking: access to care, equity, efficiency, quality, and the ability of patients to lead a long, healthy, productive life. The study found that the U.S. delivery system is failing irrespective of access and equity (provided by universal care). The study noted that the U.S. is not acting quickly enough to enact national legislation and/or policies that promote quality improvement, information technology and primary care.
The researchers at the Commonwealth Fund also reported several other flaws in the U.S. health care system, as reported by the patients and health care providers who participated: too much paperwork, too many duplicate tests, too many patients who use the emergency room for non-emergency issues, and high administrative costs.
About 54 percent of U.S. patients in the study said they had foregone medical treatment due to the high cost of care. This number was 7 percent in the Netherlands and 13 percent in the U.K.
The Commonwealth Fund researchers were split as to the effect the new health care reform legislation would have on the U.S. ranking. One professor at the Harvard Medical School predicted no improvement for the U.S. She said 23 million patients will remain without coverage, and the role of the private insurance industry will continue to increase, driving up costs and obstructing care.
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