Commonwealth Fund Report Exposes Failings in US Healthcare System

The Commonwealth Fund says it is “a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.” So it may have a vested interest in telling residents of the USA that their healthcare system is underachieving. Nevertheless, a report from the CF out yesterday said the US healthcare system compares most unfavorably with Germany, Britain, Australia, New Zealand and Canada. Indeed, statistics show America’s system gets results similar to Costa Rica’s, at many times the cost.

Naturally, the first thing to question when a report like this hits the media is just what criteria were used. In this instance, “The US health care system ranks last compared with five other nations on measures of quality, access, efficiency, equity, and outcomes.” Well, when 45 million Americans have no health insurance, access and equity are certainly going to suffer. Those with platinum-engraved insurance policies tend to get quite good care, perhaps even better than those of other nations, but quality tends to be a function of access on a society-wide basis.

On outcomes, a broad but effective measure is life expectancy – not dying is usually a good medical outcome. Here, the US plain loses out. Aussies have a life expectancy of 80.62 years (males 77.75 years, females 83.63 years); Canadians are next living 80.34 years (males 76.98, females 83.86); Kiwis live 78.96 years (males 75.97, females 82.08), Germans live 78.95 years (males 75.96, females 82.11), and Brits live 78.7 years (males 76.23, females 81.3). Americans live 78.0 years (males 75.15, females 80.97). Costa Ricans, who weren’t included in the study, live 77.21 years (males 74.61, females 79.94). These figures come from the CIA Factbook, so if there is a bias, it’s likely to go easy on the USA.

Another such measure is infant mortality. Here, the story is the same. Germany’s infant mortality rate is 4.08 deaths per 1,000 live births (male 4.51, 3.62 female); Australia’s 4.57 (male 4.95, female 4.16); Canada’s 4.63 (male 5.08, female 4.17); the UK’s 5.01 (male 5.58, female 4.4); and New Zealand’s 5.67 (male 6.48, female 4.82). The USA isn’t even in the same league with 6.37 deaths per 1,000 live births (male 7.02, female 5.68). Costa Rica’s is higher still at 9.45 (male 10.32 and female 8.53). However, since this would drag down the life expectancy in Costa Rica, it would appear that the healthcare system there is actually better than America’s for those who survive infancy.

As for efficiency, a bit of math will show that the US is hopelessly inefficient. Reuters reports that “Per capita health spending in the United States in 2004 was $6,102, twice that of Germany, which spent $3,005. Canada spent $3,165, New Zealand $2,083 and Australia $2,876, while Britain spent $2,546 per person.” Costa Rica spent about $489 per person that year.

This journal favors the single-payer system that has given Germany, the UK and other nations longer lives at less cost. Be that as it may, the Commonwealth Fund report demonstrates one thing that cannot be denied by any ideologue – the current system is an expensive failure.

© Copyright 2007 by The Kensington Review, Jeff Myhre, PhD, Editor. No part of this publication may be reproduced without written consent. Produced using Fedora Linux.

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