In healthcare rankings, not much has improved for the US

March 18th, 2015

For the fourth time, the US healthcare system has the unfortunate distinction of placing dead last overall in the Commonwealth Fund’s Mirror, Mirror report. The report compares 11 nations -- Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States – on measures such as quality care, access, equity, and efficiency.

Healthcare data obtained before the Affordable Care Act went into full effect also shows that the US spends far more per patient -- $8,508 – than the other nations studied. Norway is the second most expensive country, with $5,669 per patient. The UK, which ranked first overall, also has the least spending per patient at $3,405.

The report found that access to care is a hindrance to many Americans. While American reported rapid access to specialty care, they also reported lower access to primary care physicians, and cost-related access issues. It also found that lower-income Americans were less likely to seek primary care when sick, or to skip tests, procedures, or prescriptions due to cost issues.

Costs and access aren’t the only issues – the report found that the US also lags behind the pack in efficiency, coordination of care, and healthcare information technology. Unnecessary medical tests, ER visits, and administrative costs weigh the system down. The US has also been slower to adopt electronic health record systems that can help coordinate care and bring greater communication between a patient’s physicians.

So what are the other nations doing that the US isn’t? “The most notable way the U.S. differs from other industrialized countries is the absence of universal health insurance coverage. Other nations ensure the accessibility of care through universal health systems and through better ties between patients and the physician practices that serve as their medical homes,” the report states. The adoption of a universal health system will likely never happen in the US in the foreseeable future – the bitter and still ongoing battle over the ACA speaks to that. But improvements are being made in healthcare technology and care coordination, as the ACA gives financial incentives to physicians to adopt EHRs and better coordinate care and communicate with patients.