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Health rankings, ‘Spinal Tap’ style

By Jay MacDonald ·
Tuesday, June 24, 2014
Posted: 6 am ET

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: © photosync/

  • 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:

  1. Great Britain
  2. Switzerland
  3. Sweden
  4. Australia

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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June 25, 2014 at 8:48 am

Our health care system is shameful. I read on Comcast several months ago that the US is 47th out 50 countries for the quality/cost/availability of heath care it provides. Costa Rica and Panama has better health care systems than we do! I lived in England for 20 years and their national health care system is far better than anything we have. They too have top notch doctors and care. I never had a problem getting an appointment or being seen immediately if I had a pressing medical issue which is contrary to what I have seen reported on the matter. Don't be fooled by naysayers that say a government run health care system wont work and that patients will be left to die or that they will have to wait so long that they die from their illnesses. Propaganda rubbish! If you notice most of the countries who have better health care have government run programs. The US is going in the right direction. We need to take lessons from successful nations on how their health care system works and model it to our needs. In this country, senior citizens are having to choose either to pay their utility bill, buy food or pay for medication. Wow what an option -- here in the US --the greatest country on earth! Maybe we were at one time but no longer. I am fortunate my employer offers health insurance at a low price of $300 per month for myself and my son. In England I paid about $38 per month for the both of us and no co-pay or co-insurance that I needed to worry about. Nevertheless, the US has many other fine qualities which outweigh the cost of insurance so I choose to live here for the time being.

John Whitworth
June 25, 2014 at 8:23 am

I have lived in the UK and France,
I fear the US system where basic service providers are required to make a profit out of sick people e.g. Hospitals, (the only country in the world to have this profit element in the supply chain) ensures the cost to the US as a % of GDP is around 17% ( the total US defense budget is less than 5% - work that out !!) ) The cost in the countries mentioned in this article is around 7-8% of GDP.
The US system based on those of working age having to have a (full time) job in order to have medical cover is SIMPLY WRONG. Also the power of the pharmaceutical industry here is far too great.
If you wish to understand why our health system is broken Time Magazine - it devoted a complete publication to this topic. It came out about 12 months ago.

Mike Brown
June 25, 2014 at 7:51 am

This is just such a crock, and the ONLY reason there might be a shred of truth in it is because of Obamacare.

I worked with a LOT of "transplanted" Canadians and very few thought Canada's healthcare was better than what we had in the US. In fact, many retired in the US just fore that reason.

Another left-wing view of the world from a left-wing outlet.

paul tomasetti
June 25, 2014 at 7:29 am

if your weaththy or an illegal immigrant you will have the best that the medical community can give. If you are just an average american your f---ed. !

C. Bürgi
June 25, 2014 at 7:25 am

When I moved back to the US after working in France for 6 years and Switzerland for 24 years, I was astounded at the insurance system and the quality of the care I received. Being a type 1 diabetic, I found that I could not get health insurance no matter how high the deductible - a situation that is illegal in both France and Switzerland. I kept getting referred for tests that were either unnecessary or that had already been done but the doctor required results from "his" lab. I could go on and on. If it were not for the fact that all my family lives in the USA, I would go to Switzerland simply for the quality and affordability of the care.

June 25, 2014 at 6:29 am

It is propaganda such as this article written by Jay McDonald that poisons the minds of the citizen's of this country. Quality health care? What is it? You define it as the cheapest. When comparing quality of healthcare, it is the quality of education of the healthcare professionals and the treatment received. The cost has been manipulated and "regulated" by the government. The healthcare system and the way to pay for it has become as complicated as the tax system. When will it end? When the government has complete control????.

June 25, 2014 at 1:40 am

In my opinion Lex, (You are certainly entitled to yours) The Feds. cannot run anything.I have lived in two country's with socialized medicine, not happy! I believe here in the North West USA, I receive the best health car in the world. My cousin, in Britain, a long distance truck driver, was in a nasty accident in Italy. He was very happy with his treatment there. Lex, if you were in Europe in the 80's, what kind of medical care did you need? I ask that sincerely.

June 24, 2014 at 11:43 pm

Despite advances under Pres. Obama, our health care is awful, thanks to a sellout to Big Pharma and the insurance companies. COBRA payments on an Aetna account went up $150 a month in the past three years--profiteering on a cynical scale. We endure copays, deductibles and much else when we get sick: how slavish are we? I had better health care in Europe in the 80s, as a student, than I do now. Unless we all protest, the system will not correct itself. US citizens evidently went to bad schools that taught them nothing about research or critical thinking.

mike adams
June 24, 2014 at 9:50 pm

I believe this country has reached a piviotal turning point of which there is no return. when will people rise up against all this tyranny from our govt.get ready for Hillary cause you know they want to make sure she is the first woman president and people are just stupid enough to put her there.

June 24, 2014 at 8:42 pm

The only reason anyone would come here to get medical treatment is if the health care in their country was worse than it is here! Obamacare isn't the answer, why didn't our government go to one of the top medical ranking countries and follow their lead?? We might accidentally learn something!!