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US still last in quality of health care, first in cost

– A report released Monday by a respected think tank ranks the United States dead last in the quality of its health care system when compared with 10 other Western, industrialized nations, the same spot it occupied in four previous studies by the same organization. Not only did the U.S. fail to move up between 2004 and 2014 – as other nations did with concerted effort and significant reforms – it also has maintained this dubious distinction while spending far more per capita ($8,508) on health care than Norway ($5,669), which has the second most expensive system.

“Although the U.S. spends more on health care than any other country and has the highest proportion of specialist physicians, survey findings indicate that from the patients’ perspective, and based on outcome indicators, the performance of American health care is severely lacking,” the Commonwealth Fund, a foundation in New York that promotes improved health care, concluded in its extensive analysis.

The data for the 2014 report was collected before the Affordable Care Act went into full effect, so that reform may eventually boost the U.S. out of last place by providing health insurance to some of the 50 million people who lacked it.

But, according to the study, the problems of our health care system remain so pervasive that it will take more than better access and equity to resolve them.

Karen Davis, a professor in the Bloomberg School of Public Health at Johns Hopkins University and lead author of the study, said overall improvement “is a matter of accountability, having information on your performance relative to your peers and being held accountable to achieving a kind of care that patients should expect to get.”

The United Kingdom, which spends just $3,405 per person on health care, placed first overall in the comparison of 11 nations that include Australia, New Zealand, Switzerland, Canada, France, Germany and others.

In 2004, the U.K. ranked third of the five nations studied.

The United States “ranks behind most countries on many measures of health outcomes, quality, and efficiency.