American Health Care Flunked Again

There's more proof today that America's health care system, far from being what presidential candidate and former Health and Human Services Secretary Tommy Thompson last week called "the absolute best in the world," [1] lags far behind those of other major countries and fails to pass some basic tests of what a proper health care system should be.

Alec Dubro at TomPaine.com reports [2] on a study by The Commonwealth Fund that says "what everyone who cares to look knows": that there are two health care systems in America—one for those with money and for those without—and that both haves and have-nots suffer as a result of the system's shortcomings.

The report spelled it out plainly:

The U.S. ranks a clear last on all measures of equity. Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick, not getting a recommended test, treatment or follow-up care, not filling a prescription or not seeing a dentist when needed because of costs.

The report compares key health care measures in the U.S. to those in five other countries—Australia, Canada Germany, New Zealand and the United Kingdom. Overall, in terms of quality, access, efficiency, equity and healthy lives, Germany ranks as No. 1 and Great Britain ranks as No. 2. Germany invests substantially in a public universal care system that augments a highly regulated private insurance. The United Kingdom administers universal care through a national health service.

Ranking just above the bottom among the six countries is Canada. But what is noteworthy is that Canada's per capita health care expenditures, at $3,165 in 2004 U.S. dollars, is almost twice that of the United States. The next time someone talks about how bad Canada's single-payer system is, you can tell them: It's care equal to or slightly better than you get in the United States for half the cost.

Dubdo concludes, "If we needed any more evidence that, dollar for dollar, we get the worst possible system, here it is. Whether or not we move to government-based health insurance, or keep some form of public and private insurers, we need a national health care system." The report itself adds "the U.S. could improve the delivery, coordination, and equity of the health care system by drawing from best practices both within the U.S. and around the world." We can't afford to keep arrogantly believing we're the best when clearly we are not.