The Commonwealth Fund in 2021

A study was conducted by The Commonwealth Fund in 2021 that compared the performance of health care system of 11 high-income countries, including The United States.  The other countries include Switzerland, Germany, France, Sweden, Canada, Norway, the U.K., The Netherlands, Australia, and New Zealand.

This study analyzed performance across five domains: access to care, care process, administrative efficiency, equity, and health outcomes.   For the purpose of this post I am going to focus on one category, access to care.

The U.S. ranked last on access to care, administrative efficiency, equity, and health care outcomes, and second on measures of care process.  The U.S. ranked last overall as well.

This study found that there are 4 key features that set apart the top performing countries from the U.S.  These 4 features are: “1) they provide for universal coverage and remove cost barriers;

2) they invest in primary are systems to ensure that high-value services are equitably available in all communities to all people;

3) they reduce administrative burdens that divert time, efforts, and spending from health improvement efforts; and 4) they invest in social services, especially for children and working-age adults” (Schneider, E. C., et. al., 2021).

Regarding access to care, this measure includes the country’s health care’s affordability and timeliness.   The Netherlands ranked #1 in access to care.

The U.S. also ranked last on the sub-domain of affordability (the next lowest country, Switzerland, wasn’t even close to how low the U.S. ranked); and ranked #9 on the subdomain of timeliness

One example of a statement under the sub-domain of affordability is “[Have you] Had any cost-related access problem to medical care in the past year?” (Schneider, E. C., et. al., 2021).

One example of a statement under the sub-domain of timeliness is “[Do you] Have a regular doctor or place of care?” (Schneider, E. C., et. al., 2021).

This study found that resident of the Netherlands, the U.K., Norway, and Germany are less likely to report that their respective insurances denied a payment claim or paid less than what was expected, when compared to the U.S.

This study also found that fewer residents in these other countries report difficulties in paying medical bills, when compared to the U.S.

This data very clearly shows how the U.S. is lacking when compared to other high-income countries and their health care systems.