The cost and quality of the US healthcare system remain prominent issues for many Americans.
Despite spending nearly twice as much per capita on healthcare when compared to other wealthy nations, a Mirror Mirror study has shown the American system consistently ranked below many other countries when it comes to their healthcare system, including Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, and the United Kingdom.
When comparing healthcare to these other nations, four key areas stand out as concerns for the United States: healthcare spending, health outcomes, access to a regular source of care, and administration requirements.
The United States spends more on healthcare
In 2024, the United States spent an estimated $14,885 per person on healthcare, which represented the highest healthcare cost per capita across similar, wealthy countries. Comparatively, the average for all remaining countries excluding the United States was just $7,371, demonstrating a disproportionate amount of spending on healthcare for little-to-no return in health outcomes.
The high cost of healthcare can stem from several factors: spending is driven by utilization (the number of services used), and the price (the dollar amount charged per service), so an increase in either of these can result in higher healthcare costs. The consolidation of hospitals may also lead to a lack of competition, resulting in higher pricing, and administration inefficiencies may also drive up the cost. As the utilization rate of services in the United States is lower than in other countries, and the US spends almost five times more on administration costs, the most likely culprit for healthcare spending is price.
The US has poorer health outcomes
When higher spending results in better health outcomes, it becomes somewhat understandable. Unfortunately, American health outcomes are no better than those seen in other developed countries; in fact, the US performs worse across many common health metrics, including life expectancy, infant mortality, safety during childbirth, and unmanaged diabetes.
US patients are less likely to have a regular source of care
A regular source of care involves having medical facilities where patients can routinely go to receive medical advice. Continuous care remains at the heart of healthcare and helps support better outcomes, higher satisfaction rates, and more cost-effective care. Within the United States, different demographics have varying rates of regular sources of care, but on average, they are less likely than peer nations to have a regular practitioner or place of care.
US physicians and patients face greater administrative difficulties
Administrative requirements in healthcare can involve patients needing to find and utilize in-network doctors or facilities, or managing insurance claims, while for doctors and physicians, it can include providing the required clinical or quality data to government agencies or the medical facility to maintain their records. For both patients and physicians, any associated medical paperwork and bill management is also considered an administrative task.
While countries like Australia and the UK minimize payment and billing burdens by providing either free care upfront to patients or through instant rebates, doctors and patients in the US are often forced to spend huge amounts of time navigating the thousands of different health plans, each with its own cost-sharing requirements and coverage limitations. Denials of service by insurance companies are also a common occurrence, necessitating appeals and potentially deterring patients from seeking the healthcare they need.
How can the system be improved?
A healthcare system that has high costs and poor outcomes can threaten the long-term economic well-being of the United States. Opportunities to improve the system may include:
- Improve education: The US has faced a growing healthcare professional shortage since the early 2000’s, which has impacted accessibility to consistent, primary care. This can be addressed by increasing the training of healthcare providers through programs like the TWU online FNP program at Texas Woman’s University online, which are designed to equip future nurse practitioners with the skills needed to address the growing demand for primary care in the US
- Modernizing the structure of healthcare programs: Redesigning the public and private healthcare programs to improve efficiency, stimulate price competition, and increase value for patients can help modernize their structures. Evolving Medicare and Medicaid services to move away from fee-for-service models, reducing administrative expenses, adjusting commercial insurance market rules to encourage designs that fuel competition and patient consumerism, and improving generic drug competition and accessibility can help address this
- Tax reforms: Spearheading tax reforms that raise new revenue can help improve Medicare solvency. This can be done through means like increasing Medicare Hospital Insurance (H1) Part A payroll tax, or reducing the value of the tax exclusion on employer-sponsored insurance
