The U.S. is dead last. Will the Affordable Care Act boost the country’s standing?

The US Healthcare system ranks #11 out of 11 compared to other wealthy, developed countries, spending almost double per capita than a majority of the comparative countries. (Source: http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror)

Many have held up other countries' health systems as examples of what they don't want for the U.S., but the report finds countries with nationalized medical systems outperform the U.S. on all measures. The big three measures where the U.S. is last or near last are on dimensions of efficiency, equity and access.

On indicators of efficiency, the U.S. ranks last among the 11 countries, with the U.K. and Sweden ranking first and second. The U.S. spent $8,508 per person on healthcare in 2011 compared with $3,406 in the United Kingdom and $3,925 in Sweden. Having just visited Sweden and other parts of Northern Europe, I have a renewed sense of appreciation for their national pride in caring for all citizens. Couple better outcomes with half the expense and I think their pride is justified. 

The Commonwealth data was collected before the Affordable Care Act fully took effect. Hopefully the law will eventually help the U.S. address equity issues by reducing the overall number of uninsured patients. Again, while insurance may help balance the equity equation, access is still limited by availability of primary care physicians. In a previous post, I mentioned that there is more to the equation of healthcare access than just having a method of payment, but it is a necessary part of transforming the U.S. healthcare delivery system.


Lesa Peterson is a Sr. Consultant for FQHC Associates and Merces Consulting.  Previously, as the Director of Operations for a community health center, she was responsible for the administrative operations of the organization,  including a Ronald McDonald Care Mobile® program.

Read more about Lesa here.

To contact Lesa, email her at LPeterson@FQHC.org.

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