The US’s healthcare system discourages people from getting care, new study says

Affordability and lack of universal coverage is a major factor.
An emergency room at a hospital during the day,
Entrance to a hospital emergency room. Deposit Photos

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

A new report from The Commonwealth Fund, an independent research group, is putting some numbers on just how comparatively problematic the American 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.]

Additionally, the US has higher rates of deaths from treatable or avoidable causes and highest maternal and infant death rates when compared with peer countries. 

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

Data: OECD Health Statistics 2022.
Source: Munira Z. Gunja, Evan D. Gumas, and Reginald D. Williams II, U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes (Commonwealth Fund, Jan. 2023). https://doi.org/10.26099/8ejy-yc74

The report titled US Health Care from a Global Perspective, 2022 used data compiled by the Organisation for Economic Cooperation and Development (OECD) from 2021 to  December 2022. This organization tracks and reports on multiple health system measures across 38 high-income countries.

The researchers looked at how healthcare and outcomes measured up against 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 those in other nations, which is likely related to the US having a below average number of practicing physicians. The US is also the only country among those studied that does not have universal health coverage. In 2021, 8.6 percent of the population was uninsured, making standard medical care expensive and often out of reach. 

Data: OECD Health Statistics 2022.
Source: Munira Z. Gunja, Evan D. Gumas, and Reginald D. Williams II, U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes (Commonwealth Fund, Jan. 2023). https://doi.org/10.26099/8ejy-yc74

“Not only is the US. the only country we studied that does not have universal health coverage, but its health system can seem designed to discourage people from using services,” researchers wrote in the report. “Affordability remains the top reason why some Americans do not sign up for health coverage, while high out-of-pocket costs lead nearly half of working-age adults to skip or delay getting needed care.”

While global health care spending has increased over the last 40 years, the US still spent nearly twice as much as the average OECD country and was three or four times higher than New Zealand, Japan, and South Korea. 

Life expectancy at birth was also three years less than the OECD average at 77 years and life expectancy dropped even more during 2021. Additionally, more people died from COVID-19 in the US more than any other high-income country, according to the report.

Data: OECD Health Statistics 2022.
Source: Munira Z. Gunja, Evan D. Gumas, and Reginald D. Williams II, U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes (Commonwealth Fund, Jan. 2023). https://doi.org/10.26099/8ejy-yc74

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

The United States also saw the highest deaths caused by physical  assaults (gun violence included) compared to peer countries, at 7.4 deaths per 100,000 people in the US in 2020 compared to the OECD average of 2.7. 

However, it was not completely negative. The report found that the US excels at treating and preventing cancers early. It had the highest number of breast cancer screenings among women ages 50 to 69, along with Sweden. The US also exceeds the OECD average for colorectal cancer screening rates. 

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

Overall, the 2022 Commonwealth Fund report “continues to demonstrate the importance of international comparisons,” according to Reginald D. Williams II, who leads The Commonwealth Fund’s International Program, in a news release. “It offers an opportunity for the US to learn from other countries and build a better healthcare system that delivers affordable, high-quality health care for everyone.”