How Does U.S. Healthcare Compare To The Rest Of The World? (part 1)

In the early months of 2020, my friends and I backpacked across New Zealand, Thailand, and the Philippines before settling down in Australia for our semester abroad at the University of Melbourne. Learning about the history of Australian Aborigines, exploring iconic landmarks in Sydney, and meeting people from Iceland, Hungary, and all corners of the world were some of the best memories of undergrad. Of course, I would ask my Australian friends about their impressions of America and vice versa. They asked if frat parties were just like the movies and I asked if they were fond of Vegemite. Out of genuine curiosity, humor, and bafflement, there were two particular questions that always seemed to come up:

1. How could Americans elect Donald Trump as president?

2. Why doesn’t the U.S. have universal healthcare?

In response to the first query, I would vigorously shake my head and reassure classmates, friends, and strangers that I was equally dumbfounded and frustrated with the 2016 election as they were. As for the second, I didn’t really know how to answer the question. I often resorted to a deflated shoulder shrug and grimace.

Disappointment in the U.S. healthcare system (not the healthcare workers themselves) has been all the more apparent in the past year. Of the twenty countries most affected by COVID-19, the U.S. ranks 5th worldwide in the most deaths proportional to the number of cases. According to the Peterson-KFF Health System Tracker, an informational service that monitors the productivity of American healthcare, other performances are just as bleak:

The United States has higher rates of overall mortality, deaths amenable to health care, and potential years of life lost. Although the United States has lower mortality rates for breast and colorectal cancer, comparable countries continue to outperform the U.S. on a number of measures, including hospital admissions for preventable diseases; rates of medical, medication and lab errors; and cost-related access barriers to health care.

When measuring the overall healthcare services, the U.S. lags behind similar wealthy and large countries such as Japan, Sweden, France, Australia, and the United Kingdom. Although many Americans have an inflated superiority complex about their all-powerful country, compared to its peers, the United States takes last place when it comes to healthcare quality and access. We struggle to prevent deaths that could have been avoided through effective, equitable and timely administration. But this problem doesn't come from not investing enough in our healthcare. According to America's Health Ranking, despite having the highest health expenditures worldwide, the U.S. ranks 26th among 35 OECD countries for life expectancy.

As for long-term health outcomes, the mortality rate for respiratory diseases (pre-COVID) increased by 5% since 1980 while comparable peer countries have seen a 36% reduction. Likewise, after a consistent decline in premature death rates, the United States has seen a slight increase in younger deaths in the past several years.

What is America ‘the greatest country in the world’ for? We have the highest maternal mortality rates when compared to similar countries and since 1987, the gap has only widened. If we expose some of the racial disparities, Black Americans were three times more likely to die from maternal complications compared to White Americans. The disease burden, which counts premature deaths and the number of years someone lives with a disability, is 31% higher in the United States than the average of comparable countries.

These depressing statistics reveal some of the deeper rooted issues in American healthcare that need to be addressed. One of them being the lack of universal health insurance. According to the U.S. Census, 27.5 million individuals, or 8.5% of people living in America, were uninsured in 2018 (an increase from 2017). Although national health coverage doesn’t automatically ensure better health outcomes, it’s still a tangible public health intervention correlated with lower mortality rates. Other factors such as inefficient administration and treatment plans, unorganized and under-valued primary care, and lack of investment in social services and preventative plans contribute to the progressive downfall in long-term wellness.

Unless we change the expensive, over-specialized, and fragmented medical services and systems, the gap in healthcare productivity and equity compared to peer nations will substantially widen. Other countries will continue to be baffled by the inefficiency of our medical system, even when we’re spending an all-time high.

There’s a lot to unpack here. But before I start rambling on about any additional problems and hypothetical solutions to the broken aspects of healthcare, I think that’s enough grim information for now. So let’s take a stretch break and carry this conversation next week!