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U.S. Ranks Last Among Seven Countries on Health System Performance Measures

Despite having the most expensive health care system, the United States ranks last overall compared with six other industrialized countries—Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom—on measures of quality, efficiency, access to care, equity, and the ability to lead long, healthy, and productive lives, according to a new Commonwealth Fund report. While there is room for improvement in every country, the U.S. stands out for not getting good value for its health care dollars: it spent $7,290 per capita on health care in 2007 but ranks last among seven countries. The Netherlands, which spent $3,837 per capita on health care that year, ranks first.

Provisions in the new Patient Protection and Affordable Care Act that could extend health insurance coverage to 32 million uninsured Americans have the potential to improve the United States's standing, according to Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally, 2010 Update, by Commonwealth Fund researchers Karen Davis, Cathy Schoen, and Kristof Stremikis. In particular, the nation's low marks on measures of health care quality and efficiency demonstrate the need to quickly implement provisions in the new health reform law and stimulus legislation that realign incentives to reward quality and value, invest in preventive care, and expand the use of health information technology.

Also available: an interactive Web feature with country ranks and scores, and a podcast on health care costs around the globe.

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