The U.S. has managed to achieve an unfortunate trifecta—spending twice as much, having its healthcare workers work significantly harder, and having its insurance plans cover fewer treatment options, when measured against the 10 most advanced countries, according to a report by the Commonwealth Fund. On the measure of “health outcomes” the U.S. is last. Worse, it is not simply that the U.S. ranks last among peer nations, but the U.S. is so low in the ratings that it is actually “off the charts.”
The U.S. spends $4.5 trillion per year on health care, yet the report concludes that it is ranked last among similar countries, including Australia, Canada, France, Germany, the Netherlands, New Zealand, the U.K., Sweden, and Switzerland. The report measured performance in five areas: access to care, care process, administrative efficiency, equity, and health outcomes.
Regardless, neither political party in the U.S. takes cognizance of the situation, much less making any effort to address the problem. The Kamala Harris campaign views it merely as an economic problem and has proposed to bail out people with massive medical debts and tweak prescription drug prices, while the Trump campaign flirts with recommendations from the Project 2025 report which suggest cutting medical research funding and cutting public health infrastructure.
The Commonwealth Fund report, called “Mirror, Mirror 2024,” also details the social conditions of poverty, homelessness, hunger, discrimination, and substance abuse that force the U.S. health system to work so hard just to try to catch up. The social conditions, left improperly addressed, leave the health workers overwhelmed. So, instead of treating a small problem before it becomes a big problem, too often uninsured or under-insured Americans wait until the small problem can no longer be ignored. Failure is built into the system.
