NEW YORK, NY, July 14, 2017 – Your level of income defines the health care you receive far more in the United States than in other wealthy nations, according to the Commonwealth Fund’s new 11-country report. The study, the only to include survey data to measure and compare patient and physician experiences across wealthy nations, ranks the U.S. last overall, and on providing equally accessible and high-quality health care, regardless of a person’s income. For example, in the United Kingdom, 7 percent of people with lower incomes and 4 percent with higher incomes reported that costs prevented them from getting needed health care—a three percentage point gap between those with higher and lower incomes. In the U.S., 44 percent of lower income and 26 percent of higher income people reported financial barriers to care. Remarkably, a high-income person in the U.S. was more likely to report financial barriers than a low-income person in the U.K.

“What this report tells us is that despite the substantial gains in coverage and access to care due to the Affordable Care Act, our health care system is still not working as well as it could for Americans, and it works especially poorly for those with middle or lower incomes,” said Commonwealth Fund President David Blumenthal, M.D. “The health care policies currently being contemplated in Congress would certainly exacerbate these challenges as millions would lose access to health insurance and affordable health care.”

In the report, Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care, the authors note that although the U.S. has made significant progress, our health system substantially lags other countries—especially when it comes to access to care, primary care, affordability, and equity. Among the 11 high-income countries surveyed, the U.S. is the only one without universal health insurance coverage. The U.S. offers its citizens the least financial protection among these wealthy countries.

Paying More for Less

Despite having the most expensive health care, the United States ranks last overall among the 11 countries on measures of health system equity, access, administrative efficiency, care delivery, and health care outcomes. While there is room for improvement in every country, the U.S. has the highest costs and lowest overall performance of the nations in the study, which included Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. The U.S. spent $9,364 per person on health care in 2016, compared to $4,094 in the U.K., which ranked first on performance overall.

health care system performance rankings