Despite Americans paying nearly double that of other nations, the US fares poorly in list of 10 countries
The United States health system ranked dead last in an international comparison of 10 peer nations, according to a new report by the Commonwealth Fund.
In spite of Americans paying nearly double that of other countries, the system performed poorly on health equity, access to care and outcomes.
“I see the human toll of these shortcomings on a daily basis,” said Dr Joseph Betancourt, the president of the Commonwealth Fund, a foundation with a focus on healthcare research and policy.
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The fund said the US would need to expand insurance coverage and make “meaningful” improvements on the amount of healthcare expenses patients pay themselves; minimize the complexity and variation in insurance plans to improve administrative efficiency; build a viable primary care and public health system; and invest in social wellbeing, rather than thrust problems of social inequity onto the health system.
But the US system ranks first in wealth extraction from people to billionaires, so it’s working as intended.
Yay for capitalism!
Shocking. “Best health care system in the world,” my ass. “You’ll have to wait months if there’s universal healthcare.” Bitch, I have to wait months now.
“You’ll have to wait months if there’s universal healthcare.”
Yeah, but that healthcare is still practically guaranteed, and it won’t put you into debt
Several times I’ve had to wait for months on healthcare in the US system. This is such a weak argument against a socialized system.
Literally anything I want done is a wait list here. Eye exam; schedule a time. Dentist; is it an emergency? We’ll schedule you sometime next month. Phycologist; its a theee month wait list. Primary care; see you in three months. Finding a reliable primary care has been a dead end nightmare.
I’m not shitting on doctors or nurses. Just this whole system is bonkers. For what reason? Healthcare is not a business.
“In capitalism everything’s a buisness.” Well get fucked.
I’m not saying we should be reductive. There is reasons for the way we do things. I am saying though, we’ve gone too far and it’s obscuring the goal of a having a functional society.
People need professionals to help with their health; an extremely complex field. Every person needs this. Its not an optional thing. You want a society, well a society needs people, and people need Healthcare.
“Well I never wanted to be part of a society.” Did you enjoy the luxury that having a society provides? From plumbing to super yatchs, all of this wealth we share was made by people like you and me.
There is reasons for the way we do things.
Because a rich class keeps oppressing the poorer class, not because it’s a good way to do things.
It’s the same in Canada, socialized healthcare never solved never solved this problem. That said, I had only a four hour wait time in urgent care in the US. I had to wait eight hours in Canada for emergency care
I’ve waited 12+ hours for emergency care. It really just depends on the influx of people.
For a blood clot I’ve had to wait like 16 hours in Canada, but that’s because for every examination and consultation you had to wait in a separate queue. Like talk to a doctor after 8 hours, get assigned to wait for a ultrasound, wait another two hours, go into the room, wait half an hour for a resident, become a test subject for half an hour, get a real doctor later, wait for them to consult me for another few hours, wait another hour for the script, etc.
In the US at least they did everything in one shot for my first blood clot, after it my wait they did everything in one go and let me go
Not only have I had to wait months, but then the doctor will argue with you and gaslight you about your fucking symptoms. Here’s a $200 bill for 5 minutes discussion and being told I am actually fine and not having the symptoms I’m having and even if I was they don’t want to do treatment because it’s too painful and difficult and so testing is pointless too since they won’t treat.
I am TRULY TRULY fine with the day doctors lose their jobs to AI. I genuinely wish I could have an AI primary care doctor now. Or even just a veterinarian, because vets aren’t taught to gaslight their fucking patients.
Who has ever said that? You guys have no healthcare. It’s literally a joke to anyone outside of US.
Our politicians and pundits say it all the time.
Not a high bar if they’re also saying immigratns are eating People’s pets.
But you have to understand, to 74 million people, the Fox News Cinematic Universe is reality. There’s regular bullshit, and then there’s bullshit so widely believed that you actually have to study the bullshit, just to be able to predict what its subscribers will do next. Like religion.
You’re wrong but not in the way you think. It’s also a joke to everyone inside the US, except billionaires. Billionaires love it
They always bring up Canadians having to wait for long periods of time at the emergency room.
Wendell Potter spent decades scaring Americans. About Canada. He worked for the health insurance industry, and he knew that if Americans understood Canadian-style health care, they might … like it. So he helped deploy an industry playbook for protecting the health insurance agency.
https://www.npr.org/2020/10/19/925354134/frame-canada
Here’s an archived piece Wendell wrote for WaPo about what he did and how he did it.
The health care scare: I sold Americans a lie about Canadian medicine. Now we’re paying the price.
My insurance bumped up the copay on primary care to make it less affordable than an urgent care visit, incentivizing us to get care with immense surcharges. But at least we can get a same-day appointment instead of waiting a month or two to see the most qualified and familiar person with our conditions. Fuck capitalism, as usual.
Get everyone to use the ERs and clinics which pay doctors less. Think there’s a reason for that?
I had my primary care doctor retire. The gigantic hospital system with which they work put all existing patients in as new patients for the incoming doctor. It has been 18 months and I’m still waiting for the new patient visit. Fighting to even get maintainance medications filled has been crazy because I keep being told “I have to see my doctor.” Circular logic abounds.
The gigantic system makes it so I cannot directly contact the office, it is all hurry up and wait through their patient portal systems which require 24-48 hours for response time. Can’t go to the doctors office to complain without an appointment.
This system is working optimally for someone. It is not us.
Avg hospital CEO earns $649,198 to $1,093,977 in my state of NC.
That’s who the system is working for. Additionally, all it’s share holders.
Healthcare beholden to shareholders should be the gigantic warning sign.
My wife broke her ankle and insurance denied the entire claim for being “not medically necessary”. The “medical professional” (not doctor) who denied the claim had experience in OBGYN, not orthopedics.
100% going to win the appeal because like, we have x-rays of the shattered bones in her leg, but seriously wtf. People seriously believe this is the ideal medical system?
Cigna doctors spend an average of 1.2 seconds per case. Their whole system is to deny everything right off the bat, and then they only have to potentially pay out for patients who have the resources to appeal.
When I was in the insurance industry, for a company who administered various policies from Aetna, BCBS, Cigna, United and Medicare, that was the SOP. Deny anything that took more than a few seconds of brain power, put clients through endless rounds of appeals. The medical director was amoral AF too, because well, the insurance company exists for profit, and bonuses are dependent on paying out as little as possible. It got pretty bad, too, enough that my immediate supervisor started signing off a bunch of approvals, circumventing the medical director, where any shred of plausibility was available.
Now, there is automated software. HIPAA has it’s pros and cons.
Oh, I read this John Grisham book.
I’m on appeal #3 right now with my insurance for something they told me would be 100% covered. I’m getting my doctor in on it to do a peer to peer. He sounded so fed up with everything he was like “it’s probably some retired pediatrician who doesn’t know anything about what you need” when talking about who he’d need to talk with. If this one doesn’t work then I’m on to the “threaten to sue” stage which I’m not excited about. The whole thing is a mess and the process and money that’s gone into it would have easily bankrupted or put me homeless at most previous times in my life
I’m not a lawyer, but a piece of legal advice I’ve seen repeated many times is “Never threaten to sue. Just sue.”
As soon as you threaten to sue, you’ll never be able to talk to anybody except the legal team, and they’ll do nothing to help your case.
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It’s honestly infuriating that these companies are essentially diagnosing and treating patients without doctor-patient relationship (required by federal law). And like LITERALLY determining and dictating treatment. That’s illegal if ANYONE else does it. Even if your own medical provider doesn’t see you per new condition, that can be considered a violation of that law. And these insurance guys have never seen us in real life.
I also think that it’s a really strangely allowed violation of HIPPA. Why should everyone at the insurance company, or ANYONE at an insurance company, have the right to my medical information? Why are they able to communicate with my doctor’s office? I absolutely hate the privacy aspect of insurance so much.
It’s helpful to know that if I ever leave the US, I’ll have better healthcare. I don’t even need to spend any time researching that aspect.
No, you actually won’t. I went to Canada, had an accident and had to wait 8 hours in the emergency room to get care because apparently I wasn’t dying
As an American, I had to pay $1000 for this privilege
I meant moving to another country permanently, not traveling, but good to know that the US system can reach out and punish me if I have the audacity to travel out of network. :(
You had to go to Canada for that? I had that same experience right here in the states.
Well, almost. It cost me $1500, and that was after my insurance paid down the majority of the bill.
It was four hours in the US. Trust me, staying in the hospital until 1 am is way different than sitting until the morning in a plastic chair
I have definitely done 8 hours in a US ER waiting room before. If you haven’t, count yourself lucky.
Yes, I believe it. But when I went to urgent care with my ex, they got her in in about an hour.
Overall, my experience with the US system is that it’s on average faster than the Canadian one if you need urgent care.
Universal healthcare paid from the taxes of the wealthy. Cmon. Asking for a few million friends. 😣
My family and I moved from the US to Canada in the summer of 2023 and last week was the first time I had to make use my Services Card. I went to the ER in excruciating pain, had blood and urine labs done, a shot of pain killers then waited around (a long time) for a CT scan. The doctor said it might be a new record, but I had been bumped a few times by suspected stroke patients that came in, so totally understandable. Several hours later with a prescription slip in hand I exited the hospital. Easy as pie.
For anyone who has never had the displeasure of experiencing an American hospital you can not understand how much simpler and less stressful and cheap the Canadian system is. I dont know what it would have cost me in the USA, probably whatever my insurance deductible was, but it certainly was not $0. That state of not knowing what all this is going to cost you, and how you will afford it, makes an already awful experience even worse. Not being harassed for money on the way out, never once discussing the cost of something with the DR was truly eye opening. Source
Not the same experience, 8 hours in Canadian ER before I saw a nurse
Some people achieve some sadistic satisfaction from denying poor people health care, even if it cost extra to themselves!?
In USA there is a sentiment that looks like they are trying to exterminate the poor, by letting them suffer and die, instead of trying to build a better more humane society for all.There’s a lot of miserable fucks out there due to a mix of leaded gas fumes, childhood trauma, and religious/political brainwashing.
To me, its much more that the rich don’t want to pay for the healthcare of the people who earn all of their money for them, rather than active sadism.
More, devoid of empathy and not really seeing them as fellow humans, deserving of basic rights like not dying of poverty. Especially if it costs them money.
I disagree, when they prevent a system that benefit all including themselves, they are actively acting like sadists who want to see the suffering of those who cannot afford to pay.
Each to their own but, to me, rich people would make far more, personally, with the American system. I 100% get how you came to your conclusion though. I’m not saying sadism wouldn’t make sense or anything.
They literally are indeed trying to exterminate the poor.
That’s how I see it, and half the population wants that.
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Turns out a profit motive is not the best system for everything in the world. Who would have guessed?
It would probably be fine if everyone agreed to play by the rules, but they dont, and the US is terrible at enforcing them (or specifically, chooses not too, and doesnt impose new laws to stop loopholing)
But the administrative bullshit, and the other potential problems are exactly why other countries went for universal healthcare 🤷♂️
I think it’s more of a problem with over regulation. The U.S. healthcare system suffers from a lack of market freedom. While some may argue for more government intervention or even a single-payer system, many of the inefficiencies could be resolved by removing excessive regulation and encouraging more competition. A true free-market approach, with more choices and price transparency, could lower costs and improve care quality—something over-regulation has failed to achieve.
A capitalistic system will maximize for one thing and one thing only: Profit.
If anything else improves, such as service, cost, or wait times, it will only by as a byproduct of increasing profit. If there are easier, faster, or cheaper ways of increasing profit (such as cutting staff and having
customerspatients wait longer) then those will be done instead. The FDA exists because otherwise capitalistic companies will put customers health and lives in danger because it is more profitable to do so and pay out potential lawsuits than it is to make sure safety regulations are in place in the first place.The only way to maximize something other the profit, such as customer service, is through regulation. That is why monopolies are illegal: if a customer doesn’t have a choice you can charge them as much as you want, and take as long as you want, and perform as poorly as you want, and they still have to use your service because they have no other choice. When a
customerpatient needs to go to the hospital they don’t have the luxury of “shopping around”, they have a medical emergency and need help now. So without regulation a profit motivated hospital can charge whatever they want, especially considering nobody discusses prices before doing life saving operations.“lack of market freedom” is not the reason 1 Tylenol pill at a hospital costs you $15.
“Excessive regulation” is not the reason patients are charged $40 for crying.
“Lack of competition” is not the reason asking for an itemized bill will save you money. “It’s estimated that about 60 percent of medical bills that are issued have errors” (I can’t think of any other industry that would consider that acceptable.)What specific regulations would you remove from hospitals, and how would the absence of those regulations directly help
customerspatients?The US is last place in the linked article while having the most profit driven hospital system of the countries compared. Making it even more profit driven is not going to improve the thing
customerspatients need improved.
The U.S. health care system is a failure because of the continued existence of health insurance companies over the more streamlined approach of Medicare for All.
Also this graph is hilarious, albeit depressing.
Actually, many of those countries don’t have systems similar to Medicare for All. Netherlands, supposedly second in this list, has a mostly privatized system with mandatory insurance, so does Switzerland. France and Germany have semi-public and private health insurance companies. The US has bigger (and different) problems than merely the existence of health insurance companies.
Not really true about Netherlands:
The Netherlands has a dual-level system. All primary and curative care (i.e. the family doctor service and hospitals and clinics) is financed from private mandatory insurance. Long term care for the elderly, the dying, the long term mentally ill etc. is covered by social insurance funded from earmarked taxation under the provisions of the Algemene Wet Bijzondere Ziektekosten, which came into effect in 1968. https://en.m.wikipedia.org/wiki/Healthcare_in_the_Netherlands#:~:text=Health insurance in the Netherlands,long-term nursing and care.
See the social insurance aspect? The largest financial burden to the Healthcare system is usually a person’s last 5 years of life, so they’ve socialized the expensive parts of healthcare and privatized the cheaper stuff.
For Switzerland:
The insured person pays the insurance premium for the basic plan. If a premium is too high compared to the person’s income, the government gives the insured person a cash subsidy to help pay for the premium.[8]
This isn’t something done in every US state, to be clear. In some states it’s very hard to access healthcare if you can’t afford the premium. This lack of coverage often creates a heavier burden on healthcare systems because people are uninsured.
The Wlz (which replaced the AWBZ) covers only a minority of total health care costs. Expenses were €29 bln in 2023. “Mostly privatized” is accurate.
Both the Netherlands and Switzerland have universal health care systems and negligible rates of lack of insurance. My point is just that private health insurance isn’t the (only) problem, as these counterexamples show.
No no no, that’s simply wrong.
US healthcare system is the best in the world, at doing what it’s designed to do. Issue here is that they’re measuring it on care provide vs cost, while the US system is optimized for profits.
If they instead ranked the results by which system generated the most private profits the US would be first.
The line I’ve heard is
best in the world for those who can afford it
But medicine is still an industry that benefits from economy of scale. It still benefits from public sector R&D. It still benefits from robust safety regulations and enforcement of best practices.
We’ve been chipping away at all of that. Hell, we’re straight up closing hospitals and clinics all over the country, purely because so few of them are economically viable when pitted against a ruthless private insurance market.
If they instead ranked the results by which system generated the most private profits
There are sectors that bring in big profits, but they’re extracting those profits from the sectors that deliver the medicine.
The snake is eating it’s own tail. This isn’t a long term strategy for profit. Every quarterly cycle leans harder on Medicaid and Medicare as the private systems fail.
“Yeah, but Socialism and Communism!!!”
I mean I can hope, but it seems unlikely
Israel can afford universal healthcare. But the United States? Where would we ever find the money for that?
The UK did it immediately after WW2 when our economy was destroyed. We were in much debt, we didn’t finish paying America back until 2006. However, apparently, the country we paid all that money to cant afford it?
You have to admire the brazennes of the lie though.
When we find the military and give weapons to countries like Israel and many others across the world, it raises the stock prices of military contractors and congress gets more personal wealth.
A public option for healthcare would lower stock prices for health care companies and insurance companies which congress is also heavily invested in.
Oh yeah? We still have more guns.
/s
This sounds like a health system Trump would love!!!
How far down the list of non-peer nations are we?
For a laugh (and cry), you can have a look at which countries are above the US in terms of life expectancy. It includes the likes of Maldives, Costa Rica, Panama and Oman.
Pretty far down
