U.S. ranks last among seven countries on healthcare performance

By Bernie Monegain
09:39 AM

The U.S. healthcare system comes in last for performance among seven industrialized nations, despite spending the most, according to a new Commonwealth Fund report. The researchers note that healthcare reform and uptake of health information technology hold promise for the future.

Despite having the most expensive healthcare system, the United States ranked last overall compared to Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom.

The research measured five performance areas: quality, efficiency, access to care, equity and the ability to lead long, healthy, productive lives.

While there is room for improvement in every country, the United States stands out for not getting good value for its healthcare dollars, ranking last despite spending $7,290 per capita on healthcare in 2007 compared to the $3,837 spent per capita in the Netherlands, which ranked first overall.

Provisions in the Affordable Care Act that could extend health insurance coverage to 32 million uninsured Americans have the potential to promote improvements to the United States' standing when it comes to access to care and equity, according to "Mirror Mirror On The Wall: How the Performance of the U.S. Health Care System Compares Internationally 2010 Update," by Commonwealth Fund researchers Karen Davis, Cathy Schoen, and Kristof Stremikis.

The low marks in the quality and efficiency dimensions for the United States demonstrate the need to quickly implement provisions in the new health reform law and stimulus legislation that focus on realigning incentives to reward higher quality and greater value, investment in preventive care, and expanding the use of health information technology.

"It is disappointing, but not surprising that, despite our significant investment in health care, the U.S. continues to lag behind other countries," said Commonwealth Fund president and lead author Karen Davis. "With enactment of the Affordable Care Act, however, we have entered a new era in American healthcare. We will begin strengthening primary care and investing in health information technology and quality improvement, ensuring that all Americans can obtain access to high quality, efficient health care."

Earlier editions of the report, produced in 2004, 2006 and 2007, showed similar results. This year's version incorporates data from patient and physician surveys conducted in seven countries in 2007, 2008 and 2009.

Key findings from the study are on the next page.