U.S. spends more but has lower life expectancy and higher death rates
A study from the Commonwealth Fund found that people in the United States experience the worst health outcomes overall of any high-income nation. This is despite the fact that the U.S. spends more and is the only one of its peers that has no universal health coverage.
In 2021, the U.S. spent 17.8% of its GDP on health care, nearly twice that of comparable countries. Health spending per person was nearly twice as high than Germany and four times that of South Korea. The spending includes Medicaid, Medicare, and private insurance. In the same year, 8.6% of the U.S. population was uninsured, and it is the only high-income country where a substantial portion of the population lacks any form of health insurance, according to the report.
Despite having the highest spending, the results are worse for the U.S. than for its peers. Life expectancy in the U.S. was 77 in 2020, three years lower than any other similar country. Life expectancy is expected to drop even further based on initial data reports. In addition, avoidable deaths – those that are preventable and treatable – have been on the rise since 2015, and the U.S. had the highest rate in 2020 of countries studied.
In 2020, the study found the infant mortality rate in the U.S. was 5.4 deaths per 1,000 live births, the highest rate of countries studied, and far worse than Norway where there are 1.6 deaths per 1,000 live births. The maternal death rate is more than three times higher than other high-income countries.
Deaths from physical assault, which included gun violence, is 7.4 per 100,000, much higher than the average of 2.7 and is at least seven times higher than all other high-income countries except New Zealand.
Obesity and chronic conditions plague the U.S. population. It has the highest obesity rate of all countries studied and a rate that is almost two times higher than the others. In 2020, 30% of U.S. adults said at some point in their life they had been diagnosed with two or more chronic conditions. No more than a quarter of residents of other countries reported the same.
Americans, at four visits per person per year, see the doctor less than residents of similar countries, according to the report, which may be a factor of there being a lower average number of practicing physicians than other countries.
The U.S. does average shorter hospital stays (4.8 days, far lower than the average), but has 2.8 hospital beds per 1,000 population, lower than the average of 4.3.
“The findings of our international comparison demonstrate the importance of a health care system that supports chronic disease prevention and management, the early diagnosis and treatment of medical problems, affordable access to health care coverage, and cost containment — among the key functions of a high-performing system,” the report authors state. “Other countries have found ways to do these things well; the U.S. can as well.”