Why the American healthcare system is so expensive and inefficient

It’s no secret that the healthcare system in the United States is expensive, chaotic, and complex, especially when compared to other high-income countries.

A new report from the Commonwealth Fund, an independent research group, presents some figures on how comparatively problematic America’s healthcare system really is. It found that the US spends more on healthcare than any other high-income country, yet has the highest rate of patients with multiple chronic diseases and the lowest life expectancy at birth.

[Related: At US hospitals, a drug mix-up is just a few keystrokes away.]

In addition, the US has higher death rates from treatable or preventable causes and the highest maternal and infant mortality rates compared to comparable countries.

“Americans are living shorter and less healthy lives because our healthcare system isn’t performing as well as it could be,” the report’s lead author Munira Gunja, senior researcher for the Commonwealth Fund’s International Program in Health Policy and Practice Innovation, said in a press release , according to CNN. “To catch up with other high-income countries, the administration and Congress would need to expand access to health care, act aggressively to control costs, and invest in health equity and social services that we know contribute to healthier populations being able to lead.”

The report entitled US Healthcare from a Global Perspective, 2022 data used compiled by the Organization for Economic Co-operation and Development (OECD) from 2021 to December 2022. This organization tracks and reports on multiple health system interventions in 38 high-income countries.

Researchers looked at how health care and outcomes were measured in comparison to Australia, Canada, France, Germany, Japan, the Netherlands, New Zealand, Norway, South Korea, Sweden, Switzerland and the United Kingdom.

The report found that people in the US go to the doctor less often than people in other countries, which is likely related to the fact that the US has a below-average number of practicing physicians. The US is also the only country among the countries surveyed that does not have universal health insurance. In 2021, 8.6 percent of the population was uninsured, making standard medical care expensive and often unattainable.

“Not just the US. the only country we studied that does not have universal health insurance, but its healthcare system appears designed to discourage people from seeking services,” the researchers wrote in the report. “Affordability remains the number one reason some Americans don’t buy health insurance, while the high cost of ownership causes nearly half of working-age adults to skip or delay needed care.”

While global health spending has increased over the past 40 years, the US still spent almost twice the OECD average and three or four times as much as New Zealand, Japan and South Korea.

Life expectancy at birth was also three years below the OECD average at 77 years, and life expectancy fell even more in 2021. In addition, according to the report, more people died from COVID-19 in the United States than in any other high-income country.

[Related: The American healthcare system is only making COVID-19 worse.]

The United States also had the highest deaths from physical assault (including gun violence) of any comparable country, with 7.4 deaths per 100,000 US population in 2020 compared to the OECD average of 2.7.

However, it wasn’t entirely negative. The report found that the US excels at treating and preventing cancer early. It had, together with Sweden, the highest number of breast cancer screenings in women aged 50-69. The US also surpasses the OECD average in colorectal cancer screening rates.

A study published Jan. 12 by the American Cancer Society found that cancer death rates in the United States have fallen 33 percent since 1991, saving 3.8 million lives.

Overall, “The Commonwealth Fund 2022 report continues to demonstrate the importance of international comparisons,” said Reginald D. Williams II, who directs the Commonwealth Fund’s international program, in a press release. “It offers the U.S. an opportunity to learn from other countries and build a better health care system that provides affordable, quality health care for all.”