(NOT) the best health care system in the world

How many times can you say the same thing?

You can look at the WHO report.  Or OECD data – pick a year, I don’t care.  Or past Commonwealth studies.  Or the most recent one:

Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries. This report—an update to three earlier editions—includes data from seven countries and incorporates patients’ and physicians’ survey results on care experiences and ratings on dimensions of care. Compared with six other nations—Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom—the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. Newly enacted health reform legislation in the U.S. will start to address these problems by extending coverage to those without and helping to close gaps in coverage—leading to improved disease management, care coordination, and better outcomes over time.

Here’s the money shot:

Just to be clear, we did win the Health Expenditures/Capita category.  Unfortunately, that’s not really a win.

Last in efficiency.  Last in equity.  Last in long, healthy, productive lives.  Last overall.

Next to last in quality care.  Tied for last in access.

I challenge you – tell me where the good news is here.  What makes us the best in the world?  And this isn’t some biased organization judging from outside the system, this is based on the reports of patients and physicians themselves.

One of my biggest gripes with the Affordable Care Act (and I have many of them regardless what some people think) is that it will do so very little to change any of the results in this chart.  It’s not focused on quality.  It’s not going to do enough about spending.  And while it will likely help with access and equity, we’re so in the hole, we likely won’t move up at all.

The system is broken.  Band-aids aren’t enough.

More on this after I fully digest the full report.

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