United States Health Care System Ranks Last


Money can’t buy you love, nor quality health care. When compared with six other industrialized countries, the United States ranks last overall in its health care system performance. The United States managed to come in last even though it outspends the other countries per capita on health care.

It is no secret that health care in the United States is expensive, but when compared with Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom, Americans are not getting the bang for their buck. A new Commonwealth Fund report found that in the areas of quality, efficiency, access to care, equity, and the ability to lead long, healthy, and productive lives, the United States ranks last overall.

The report, “Mirror Mirror On the Wall: How the Performance of the US Health Care System Compares Internationally 2010 Update,” noted that in 2007, the United States spent $7,290 per capita on health care compared to $3,837 in the Netherlands, which ranked first overall. Three earlier reports showed similar results, with the United States ranking last each time.

Among specific findings, the United States ranks last in the area of providing safe care, and next to last on coordinated care. If you have a chronic condition in the United States, you are most likely to be given the wrong medication, the wrong dose of your medication, and experience delays in being told about abnormal test results.


Efficiency is a major problem in the United States, which ranks last in spending on administrative costs, use of information technology, duplicate medical testing, and re-hospitalization. Compared with the other six countries, the United States is last in infant mortality and deaths before age 75 that were potentially preventable if the individual had had timely access to effective health care.

Cost continues to be a major issue in the United States, where people have the most difficult time affording the health care they need. America ranks last on every factor concerning cost-related access to care problems. In the United States, for example, 54 percent of adults who have a chronic condition had problems getting a recommended test, treatment, or follow-up care because of cost. This compares with only 7 percent of comparable adults in the Netherlands.

Costs prevented 45 percent of American adults with chronic conditions from getting the care they needed in the past year, compared with only 4 percent in the Netherlands. Adults with a low income in the United States were significantly more likely than those in the other countries to not go to a doctor when they were ill, not filling a prescription, and not getting recommended follow-up care.

Karen Davis, Commonwealth Fund president and the report’s lead author, said the findings were “disappointing, but not surprising that, despite our significant investment in health care, the U.S. continues to lag behind other countries.” She noted that with the passage of the Affordable Care Act, “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.”

Anyone who wants more information about the Commonwealth Fund report on the health care system in the United States and why it ranks last can see a web feature on the Fund’s website and also listen to a podcast.

Commonwealth Fund



not sure this is the real truth, since hearing from the medical director in Canada and others talk about ineffiencies in there system, ability to get care for those really in need with serious illness. america may not be perfect, but does provide a high standard of care for most people. Also the high tax rates in all these countries is attributable to helath care, and the fact in declining economies its is hard to maintain quality.