The report examines the US system compared to other countries in the Organization for Economic Co-operation and Development (OECD), including the United Kingdom, France, New Zealand, Japan, and Mexico.
It found that the United States spent 18% of its GDP on health care in 2024, nearly double the OECD average.
Life expectancy in the United States reached an all-time high in 2024, but remained among the shortest compared to 19 other countries, nearly five years less than Japan, Spain and Switzerland, and longer than Turkey and Mexico.
While the United States and Mexico also rank high on the list in terms of preventable deaths, the latter country announced last month that it would soon join every other country included in the analysis by switching to a universal, government-run health care system.
In the United States, the for-profit health sector spent a record amount $877.69 million On stress last year – it contributed to the high number of avoidable deaths, which amounted to 312 per 100,000 people. About 27 million Americans remain uninsured, more than 16 years after the passage of the Affordable Care Act, and the GOP’s refusal to continue supporting the ACA last year as well as $1 trillion in Medicaid cuts over the next decade, according to Thursday’s report, “is expected to increase the number of uninsured Americans by an additional 17 million by 2034, potentially leading to more than 50,000 additional preventable deaths annually.”
“In contrast, Mexico’s recently established Universal Health Service will provide the entire population with access to free care at any public health institute, starting in 2027,” the report said. “The United States is one of the only countries that has enacted policies like this reduces Coverage.”
The Commonwealth Fund notes that high out-of-pocket costs may also contribute to poor outcomes and higher numbers of preventable deaths in the United States. Americans spend $400 per person per year on out-of-pocket prescription drug costs, while people in France spend $100.
“The United States is one of the only countries that has enacted policies like this reduces Coverage.”
“In the United States, where nearly 8% of the population is uninsured and a quarter have coverage that comes with high out-of-pocket costs or deductibles, people are more likely to forgo needed care because of costs than people in peer countries,” the report said. “This can mean missing prescriptions, not getting diagnostic tests, treatment, or follow-up care, or not being able to adhere to doctor-recommended care plans.”
The report also identifies the United States as lagging behind its peers in producing new doctors, contributing to the primary care crisis, as the United States has the lowest number of primary care providers per 1,000 people. The country also has “the highest medical education fees of any country in our analysis”, the Commonwealth Fund said.
The organization also found that in 2023, the United States had nearly 19 maternal deaths per 100,000 live births, a decline for a country that has long had “among the highest rates of maternal deaths related to complications of pregnancy and childbirth.”
“By contrast, in 11 of the 18 countries we studied, there were fewer than five maternal deaths per 100,000 live births,” says the report, which also notes that maternal deaths in the United States are “exceptionally high” among black women, at 50 deaths per 100,000 live births.
“This far exceeds the national maternal mortality rate of any other country,” the report said. “Inequalities in access to care and patient care experiences – often rooted in discrimination and medical bias – may be major contributing factors.“
Dr Joseph Betancourt, Chairman of the Commonwealth Fund, male “The United States has long prided itself on having the best health care in the world, but the population benefits unequally and it remains largely out of reach for many Americans.”
“We spend more on health care than any other country, so our poor health outcomes are not due to a lack of resources, but rather how we choose to use them,” Betancourt said. “We know what high-performance health systems look like — other countries have them and are building them. It’s time for the United States to do better.”
“Other countries have shown that alternatives work. What is striking is not the absence of solutions; it is our reluctance to implement them.”
The report does not explicitly call for the United States to transition to a universal, government-funded health care system, but studies have shown that expanding Medicare to all US residents, as lawmakers, including Senator Bernie Sanders (R-Vermont) and Representatives Pramila Jayapal (D-Wash.) and Alexandria Ocasio-Cortez (D-New York), have consistently called for, would address many of the problems mentioned in the report.
Studies by the Congressional Budget Office and Yale University have shown that Medicare for All would save an estimated $650 billion and prevent 68,000 avoidable deaths each year.
This policy, which has been proposed in Congress several times, is also widely popular; Sixty-five percent of American voters – including 78% of Democrats, 71% of independents, and 49% of Republicans – support the creation of a national, government-run health care program, according to a Data for Progress poll conducted last year.
Despite this, Republican and Democratic lawmakers continue to insist that the proposal is unpopular and too expensive. Michigan Sen. Mallory McMorrow (D-8), who is running against staunch Medicare for All advocate Abdul El-Sayed in the Democratic primary for the U.S. Senate, said, Insistence recently stated that “support for a true single-payer system is not yet there.”
Reginald Williams II, senior vice president of the Commonwealth Fund, emphasized that it is “not inevitable” that “Americans will pay more for health care and receive less in return.”
“It’s the result of different choices,” he said. “Other countries have shown that alternatives work. What is striking is not the absence of solutions; it is our reluctance to implement them. The failure of the US health system is not a failure of ideas. It is a failure of the will to act on them.”
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