From Last to First – Can the U.S. Health Care System Become the Best in the World?

Thu, 2017 / 11 / 09

Many Americans are convinced that they are living in the country with the world’s best health care system. But according to a ranking from the private American foundation „The Commonwealth Fund“, the U.S. health care system ranks last among 11 high-income countries, led by the U.K., Australia and the Netherlands.

But why does the U.S. health care system perform so poorly? After all, U.S. health care expenditure has been the highest in the world since quite some time now. The founders of the Commonwealth foundation, Eric C. Schneider & David Squires analyzed the U.S. health care system weaknesses and opportunities, thereby highlighting four major challenges which the U.S. most overcome in order to live up to its citizens expectations.

Extremely high costs, difficulties in access to primary care, confusing and inefficient administration as well as disparities in care based on income, education level or ethnicity are the four core problems. According to Schneider & Squires, these could be addressed by implementing a universal health care insurance, stronger primary care systems, new and more effective payment approaches and by making a larger investment in social supports and welfare institutions. Moreover, other countries’ health care systems should function as a role model.

Instead of reversing the current track of the U.S., characterized by reforms such as the Affordable Care Act or the Medicare Access and CHIP Reauthorization Act (MACRA), the U.S. should focus on the four clearly defined challenges. Improvements could be made through legislative amendments and by realizing regulatory and financial innovations in order to exploit the full potential of the health system.

But even the German health care system has room for improvement according to the study of Schneider et al.: Germany came eighth in the overall international ranking – ahead of Canada, France and USA. Especially treatment processes and the overall success rate of the health care system are improvable. Yet, Germany performed a lot better in terms of accessibility to health care services - it ranked second.

Please click on the following link for more background information:

http://www.commonwealthfund.org/publications/in-brief/2017/jul/last-to-first-could-us-health-system-become-best-in-world

Source:

Schneider, E. C. / Squires, D. (2017): From Last to First – Could the U.S. Health Care System Become the Best in the World?, in: New England Journal of Medicine 377;10