PNHP

Twenty Years of Failing Health System Report Cards

Since 2004, the Commonwealth Fund has done annual comparisons of health system performance among wealthy nations. The US consistently underperforms the others, and 2024 extends the streak: we are the worst, by a wide margin. Replacing our massively dysfunctional insurance morass is long overdue.

Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System; Comparing Performance in 10 Nations, Commonwealth Fund, September 19, 2024, by David Blumenthal, et al.

Conclusion: The U.S. continues to be in a class by itself in the underperformance of its health care sector. While the other nine countries differ in the details of their systems and in their performance on domains, unlike the U.S., they all have found a way to meet their residentsā€™ most basic health care needs, including universal coverage.

Comment:

By Jim Kahn, M.D., M.P.H.

My comment today is brief, because this is ā€œjustā€ another annual iteration of findings from the venerable Commonwealth wealthy nations health system comparison. As always: the US lags far behind other nations. If Iā€™m permitted a little tongue-in-cheek for a dire situation: The US is a consistent global leader if the goal is to rank last on health system performance metrics of central importance to patients.

Weā€™re last on access, equity, and outcomes. The only result that baffled me is administrative efficiency, with Switzerland reported as worse than the US. Turns out, thatā€™s because the metric doesnā€™t include the hundreds of billions diverted to insurers for profits, which Swiss insurers donā€™t get on the primary insurance plan. So, really, weā€™re last in that category too. We do well on care processes ā€“ we offer amongst the best care in the world, if you can afford it.

Why are other nations doing so much better? Because ā€œhave found a way to meet their residentsā€™ most basic health care needs, including universal coverage.ā€ Sounds like single payer to me (or, in some nations, identical broad benefits managed by not-for-profit insurers).

Check out the full report. Itā€™s elegantly conceived and written. We can only hope that in the next 20 years, the findings will evolve to place the US among other wealthy nations in health system performance.

https://healthjusticemonitor.org…

Stay informed! SubscribeĀ to the McCanne Health Justice Monitor to receive regular policy updates via email, and be sure to follow them on TwitterĀ @HealthJustMon.