The US is last on a ranking of healthcare systems among 11 of the wealthiest countries in the world, despite spending the highest percentage of its GDP on healthcare, according to a new report from the Commonwealth Fund.
The country struggles with deep problems in affordability of healthcare, which affects access and equity, and it is the country that has the most administrative hurdles when dealing with healthcare. This is despite the US spending 17% of its gross domestic product on healthcare, “far above” the other 10 countries, according to the report.
The other countries analyzed in the report were Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the UK. The ranking is based on 71 measures across five areas: access to care, care process, administrative efficiency, equity and healthcare outcomes.
The report notes that unlike the other countries in the study, the US does not provide universal healthcare coverage. Americans are more likely to have problems paying medical bills and have their insurance denied. A larger percentage of Americans say they spend a lot of time on paperwork for medical bills, and doctors report having more trouble prescribing medication for patients because of restrictive health insurance coverage.
Americans also deal with lackluster access to care, with more American adults going to the emergency room for non-emergency care. Doctors of the top-performing countries are usually readily available by phone or on nights and weekends. The US also has the largest disparity in care among income groups.
“We have almost two healthcare systems in America: one for people with means and insurance, and another one that falls short for people who are uninsured or don’t have adequate insurance coverage,” Eric Schneider, the lead author of the report and senior vice president for policy and research at the Commonwealth Fund, told the Washington Post.
The one area that the US did well on is the care process, with Americans more likely to get mammography screenings and flu vaccines and having more talks with their doctor on nutrition, smoking and alcohol use.
Health statistics reflect the reality of having the worst healthcare system on the list: the US has the highest infant, maternal and avoidable mortality rates. The country also has less support for early childhood education and support systems, like unemployment protection, for workers, leading to poorer health outcomes.
Schneider said the country’s comparably weak healthcare system made it harder for the US to handle the Covid-19 pandemic.
“One could predict, based on the inequities and the relatively weaker primary care, that we would be in a position to struggle in fighting the pandemic,” he said.
