France, Italy take top spots with U.S. ranking 37th in WHO world health care ranking
In the above-mentioned WHO-sponsored ranking, France and Italy took top honors for health outcomes, while the United States came in well down the list at 37th. More recently, the highly regarded Commonwealth Fund – a private foundation that promotes a high-performing health care system – issued a report ranking the United States last or next to last compared with Australia, Canada, Germany, New Zealand and the United Kingdom. The report’s parameters included quality, access to care, patient safety, efficiency and equity. The only area where the United States comes out on top is in cost: we pay more for health care per person, with fewer people covered, than any other advanced nation.
The greatest disparity between the United States and these other countries is the lack of universal health insurance coverage. All other major industrialized nations provide such coverage, and most have comprehensive benefits packages with no cost-sharing. Meanwhile, nearly 45 million of America’s citizens have no coverage at any given time and more than 70 million Americans do not have health insurance at least part of the year. Equally troubling is that millions more Americans are under-insured.Perhaps most shocking, America ranks dead last on almost all equity measures because of a huge disparity between quality of care given to richer and poorer citizens. In 2005, two-fifths of adults with below-average incomes went without needed care. They simply couldn’t spend money they didn’t have on doctor visits, tests and pharmaceuticals.
Switzerland and the Netherlands both offer interesting examples of standardized benefits plans combined with tight regulation of insurance markets. In fact, some of these same concepts have been adopted by in the US by the state of Massachusetts and are being considered by other states and federal policymakers.
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