At first glance, I thought perhaps the Commonwealth Fund had been binge-watching "This is Spinal Tap" and accidentally turned the U.S. health care rankings "up to 11," as Christopher Guest's clueless rock star Nigel Tufnel does with his amplifier in Rob Reiner's classic rockumentary/mockumentary.
But sadly, no. The "11" in this case is the place that U.S. health care ranks in comparison to 10 peer nations, including Canada, Australia, New Zealand and seven Western European allies, according to Commonwealth Fund's 2014 update to its "Mirror, Mirror on the Wall" report.
We spend a ton on health care
First, the bad news: We spend a ridiculous amount per person on health care in this country, a staggering $8,508, based on 2011 figures. That far exceeds runners-up Norway ($5,669) and Switzerland ($5,643) and is more than double what half of the countries in the survey group spend, including:
- France ($4,118)
- Sweden ($3,925)
- Australia ($3,800)
- Great Britain ($3,405)
- New Zealand ($3,182)
What's worse, we're no better off for it. Based on patient and physician responses to quality-of-care surveys, the U.S. placed dead last in key health outcome measures, including affordability, efficiency, equity and healthy lives. While our rankings for patient-centered care (No. 4) and effectiveness (No. 3) are commendable, the quality and timeliness of our care measures are middling (No. 5) and our access to care remains just plain embarrassing (No. 9).
In fact, the best you can say for U.S. health care's place in the developed world is, we're consistent. After all, we've placed dead last on this survey every time (previously in 2010, 2007, 2006 and 2004). You want top-of-the-line health care? Move to:
- Great Britain
Oh, Canada? Our northern neighbor ranks just ahead of us, at No. 10.
At least we're making progress
The nonprofit Commonwealth Fund has never minced words as to why we yanks routinely tank: "The most notable way the U.S. differs from other industrialized countries is the absence of universal health insurance coverage," it notes this year.
Now, some good news: We're making progress, albeit it slowly.
"Under the Affordable Care Act, low- to moderate-income families are now eligible for financial assistance in obtaining coverage," the report says. "The U.S. has significantly accelerated the adoption of health information technology … and is beginning to close the gap with other countries. Based on these patient and physician reports, and with the enactment of health reform, the United States should be able to make significant strides in improving the delivery, coordination and equity of the health care system in coming years."
At which point perhaps we'll really be able to turn it up to 11.
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