The U.S. healthcare system has once again ranked last in a comparison of 11 high-income nations, according to the Commonwealth Fund report.
Despite being one of the world’s wealthiest countries and spending more on healthcare than any other nation, the U.S. continues to underperform when it comes to access, cost, and health outcomes.
This raises critical questions: Why is the U.S. healthcare system failing so many people, and what needs to change?
Lack of Universal Healthcare Coverage
One of the primary reasons the U.S. ranks so low is the lack of universal healthcare coverage. 
Unlike nations such as the United Kingdom and Australia, which provide government-backed healthcare for all citizens, the U.S. relies heavily on private insurance and employer-based coverage.
This system leaves millions of Americans uninsured or underinsured, preventing them from accessing timely and affordable care.
For more details on navigating the complexities of the U.S. healthcare system, check out our guide here.
According to NBC News, the U.S. is the only country in the Commonwealth Fund study where a significant portion of the population avoids medical care due to high costs.
Americans are far more likely to skip doctor visits or delay treatments compared to residents of countries with universal healthcare systems, which contributes to worse health outcomes.
High Healthcare Costs
Even though the U.S. spends more on healthcare per capita than any other nation, it fails to deliver better results.
As NBC News reports, Americans face higher premiums, deductibles, and prescription drug prices than those in other wealthy nations. The problem is exacerbated by the complexity of the system, with patients often unsure of the final cost of their care until they receive a bill.
A recent article on rising healthcare costs highlights how both employers and employees are feeling the pressure, with healthcare spending expected to rise over 5% in 2024.
Learn more about how this impacts workers and businesses in our in-depth report here.
Poor Health Outcomes
Despite the high spending, the U.S. consistently ranks poorly in key health metrics, including life expectancy and infant mortality rates.
The Commonwealth Fund report found that the U.S. has the lowest life expectancy and the highest infant mortality rate among the 11 countries studied.
These are crucial indicators of a healthcare system’s overall effectiveness.
In contrast, countries like Norway and Australia, which spend far less on healthcare, achieve better outcomes through a strong emphasis on preventative care.
In the U.S., many people miss out on essential preventative services due to the high cost of care, resulting in more serious and expensive health problems later on.
Addressing Bias in Healthcare
Another factor that may contribute to the U.S.’s poor healthcare outcomes is bias within the system.
Racial, economic, and social inequalities persist, and they can significantly affect the quality of care that patients receive.
Addressing these disparities is essential for improving health outcomes across the country. To explore how bias in healthcare affects access and treatment, check out our article here.
What Needs to Change?
To improve its healthcare system and deliver better outcomes for its citizens, the U.S. must focus on three key areas:
- Expand Healthcare Coverage: Implementing a system that ensures universal healthcare coverage would help close the gap between the insured and uninsured, making healthcare more accessible and equitable.
- Lower Healthcare Costs: Addressing the high costs of medical care, particularly for prescription drugs and hospital stays, could make healthcare more affordable and sustainable.
Other countries successfully negotiate lower drug prices, a practice that could be implemented in the U.S. as well. - Focus on Preventative Care: Emphasizing preventative care would reduce the prevalence of chronic diseases, such as diabetes and heart disease, which contribute to the nation’s poor health outcomes and higher healthcare costs.
The U.S. healthcare system’s ranking as the worst among high-income nations is a wake-up call.
Although the country spends more on healthcare than any other, it fails to provide better access or improved outcomes.
To move forward, the U.S. must address its lack of universal coverage, rising costs, and systemic biases.
Only by making these changes can it hope to deliver the quality care its citizens deserve.
