How Much of the U.S. Health System Is Failing?

A new report exposes just how badly the U.S. health care system is failing. We broke down four of the nine key performance indicators.

By Anissa Durham

For many Americans, the nation’s health care system is broken — and the gaps in access to care and insurance are impossible to ignore. But how does health care in the United States compare to other high income countries?

In a recent report by the Commonwealth Fund, researchers compared the health system performance of 10 high income countries, including the U.S.

Why does this matter: The U.S. is a clear outlier where health system performance is significantly lower. Data continues to show that Americans are not getting their most basic health care needs met — resulting in poorer health outcomes.

The 10 countries in this report include Australia, Canada, France, Germany, Netherlands, New Zealand, Switzerland, United Kingdom, and the U.S. In terms of access to care and health outcomes the U.S. ranked last and ranked second to last when it comes to equity and administrative efficiency. The only high performance ranking the U.S received was for care process.

Barriers to Access

In a drug price series by Word In Black, Black Americans living with type 1 diabetes face heightened barriers to access affordable medication, insurance, and medical supplies.

Jonathan Watanabe, director of the Center for Data-Driven Drugs, Research, and Policy at the University of California, Irvine, previously told Word In Black, the price gouging and lack of transparency for prescription drugs is an en ecosystem that needs improvement.

“There is not one single bad actor,” he said.

And the Commonwealth report makes clear, of high income countries, Americans continue to face the most barriers to accessing and affording health care.

Equity

The U.S. and New Zealand rank the lowest in terms of equity in health care access and experience. Which means Americans with below average and above average incomes are not getting the same quality of care.

In a patient advocacy series, by Word In Black, efforts to make health care more equitable are underway. But with a shortage of Black physicians, historical medical mistrust, and dismissal of care, some wonder how long it will take to create change.

Uché Blackstock, founder and CEO of Advancing Health Equity previously said, “We are always the ones that are creating solutions for ourselves.”

Life Expectancy

Unfortunately, Americans also live the shortest lives and have the most avoidable deaths among high income countries.

“Life expectancy is more than four years below the 10-country average, and the U.S. has the highest rates of preventable and treatable deaths for all ages as well as excess deaths related to the pandemic for people under age 75,” the authors of the report wrote. “The ongoing substance use crisis and the prevalence of gun violence in the U.S. contribute significantly to its poor outcomes, with more than 100,000 overdose deaths and 43,000 gun-related deaths in 2023 — numbers that are much higher than in other high-income countries.”

What Can the U.S. Do?

Invest in primary care. Delegating more money to help Americans access primary care can allow communities to prevent chronic illness and disease — and ultimately death.
Improve equity in health care. This would require a reduction in financial barriers to access care and extend coverage to uninsured Americans.
Safeguard the well-being of Americans. Outside of traditional health care services, investments to reduce gun violence and deaths from substance use can help improve health care outcomes.
Dismantle race-based care. Additionally, efforts to remedy the ongoing effects of race based care on Black, Hispanic, and Indigenous people by instituting policies that protect against poverty, homelessness, and hunger.

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