Posted by Bill Sandweg.
USA! USA! We’re Number – Eleven?
The Commonwealth Fund was founded in 1918 to create better, more accessible health care systems. Since 2004, it has been conducting studies of the health care systems of the richest eleven countries in the world and ranking them on various measures such as access to health care, outcomes, administrative efficiency, and care process, which includes things such as preventative care and patient engagement. In every one of the seven studies the Fund has conducted since 2004, the United States has finished dead last overall among the eleven countries surveyed. This has been consistently so despite the fact that we spend more per person on health care than any one of the other eleven richest countries. We are also the only one of the eleven that does not provide universal health care to its citizens. There is probably a connection there.
We rank at the bottom, for example, on access to care. Our health insurance system does not provide enough money, even for those whom it covers, to give them access to all the care they need. Of course, matters are far worse for the uninsured. All across the economic spectrum, Americans have to forego medical treatment they need and would otherwise obtain, if they could afford it or if it were not so expensive.
We rank poorly on infant mortality, maternal mortality, life expectancy at age 60 and deaths which were preventable with access to care. We are at the bottom on administrative efficiency because of all the time health care providers must spend filling out forms for insurance companies and fighting with them. Not surprisingly, we are also at the bottom on the equity of our system.
The countries that do better than we are distinguished by four features, according to the Fund: 1) they provide for universal health care coverage and remove barriers to access; 2) they invest in primary health care systems to assure that primary care is available to everyone regardless of income or location; 3) they reduce administrative burdens on health care providers; and 4) they invest in social services, especially for children and working-age adults.
Instead of universal health care, we have a patchwork system of private insurers and public insurance that covers only some of our people. The private companies providing health insurance siphon massive amounts of money out of the health care system. it has often been observed that they are more interested in finding ways to avoid paying for your health care than they are in actually paying for it. They participate along with the hospital chains and the drug companies in a mutual “I’ll scratch your back, if you scratch mine” exercise by which they all get rich at the expense of the public. Unsurprisingly, any time there is a push to create universal health care in this country, the big three get together to torpedo it. They make a lot of money and do not want to upset the applecart.
The way to better, more equitable heath care for everyone is clear. The other ten rich countries show us the way. All that is lacking it the political will. Given the massive wealth of the drug companies, the health insurance companies, and the hospital chains and their willingness to use that wealth to fund political campaigns, it won’t be anytime soon that Americans begin to receive the health care they deserve.