The latest data from the commonwealth fund report confirms the status quo. The USA spends twice as much on their health care system for no better results. It is easier to argue the USA is below average in performance that leading. And for double the cost that is inexcusable.
Globally the rich countries citizens are not tremendously happy with health care systems overall. It seems likely not only does the USA cost twice and much as it should and perform poorly compared to countries doing an excellent job but the USA performs that poorly compared to countries that themselves have quite a bit of improvement to make. Which makes the state of the USA system even worse.
Data from the Commonwealth fund report published in 2011 with data for 2009, International Profiles of Health Care Systems, 2011:
Table showing, percent of GDP spent and total spending per capita in USD on health care by country.
| Country | 2007 | Spending |
|
2009 | Spending |
| Australia | 9.5% | $3,128 | 8.7% | $3,445 | |
| Canada | 9.8% | $3,326 | 11.4% | $4,363 | |
| Germany | 10.7% | $3,287 | 11.6% | $4,218 | |
| Japan | 8.5% | $2,878 | |||
| New Zealand | 9.0% | $2,343 | 10.3% | $2,983 | |
| UK | 8.3% | $2,724 | 9.8% | $3,487 | |
| USA | 16.0% | $6,697 | 17.4% | $7,960 |
| Survey of population, showing % that chose each statement (no data available for Japan) | |||||||
| Australia | Canada | Germany | New Zealand | UK | USA | ||
| 2007 – 2010 | 2007 – 2010 | 2007 – 2010 | 2007 – 2010 | 2007 – 2010 | 2007 – 2010 | ||
| Overall health system views | |||||||
| Only minor changes needed, system works well | 24 – 24 | 26 – 38 | 20 – 38 | 26 – 37 | 26 – 62 | 16 – 29 | |
| Fundamental changes needed | 55 – 55 | 60 – 51 | 51 – 48 | 56 – 51 | 57 – 34 | 48 – 41 | |
| Rebuild completely | 18 – 20 | 12 – 10 | 28 – 14 | 17 – 11 | 15 – 3 | 34 – 27 | |
| Percent uninsured | 0 – 0 | 0 – 0 | <1 – 0 | 0 – 0 | 0 – 0 | 16 – 16 | |
Under currently law in the USA by 2020 the uninsured rate should decline to under 5% by 2020 (still far more than any rich country – nearly all of which are at 0%).
On many performance measures in the report the USA is the worst performing system (in addition to costing twice as much). Such as Avoidable Deaths, 2006–07, the USA had 96 per 100,000, the next highest was the UK at 83, Australia was the lowest at 57. And Diabetes Lower Extremity Amputation Rates per 100,000 population, the USA had 36 the next highest was New Zealand at 12, the lowest was the UK at 9. For experiencing a medical, medication or lab test rrror in past 2 years, the USA was at 18%, next worst was Canada at 17%, best was UK at 8%. The USA was top performer in breast cancer five-year survival rate, 2002–2007. And sometimes the USA was in the middle, able to get same/next day appointment when sick: the USA was at 57%, New Zealand achieved 78% while Canada only reached 45%.
It is possible to argue the USA provides mediocre results, which is consistent with most global health care performance measures. Unless you directly benefit from the current USA system it is hard to see how you can argue it is not the worst system of any rich country. Costing twice as much and achieving middling performance. All that doesn’t even factor in the cost in anguish and bankruptcies and restricting individual freedom (when you have to stay tied to a job you would rather leave, just because of health insurance) caused by the difficulty getting coverage and fighting with the insurance companies for payment and coverage for treatment expenses.
Related: Measuring the Health of Nations – USA Paying More for Health Care – Traveling for Health Care – resources for improvement health system performance
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