Despite pockets of improvement between 2007 and 2009, the healthcare system in the United States failed to improve when compared to the best performers among other nations, a new report from the Commonwealth Fund finds.
Based on forty-two key indicators of healthcare quality, access, efficiency, equity, and healthy lives, the report, (84 pages, PDF), gave the U.S. healthcare system a 64 out of 100 — slightly below its performance in the first national scorecard published in 2006 and the 65 it received in the second scorecard, published in 2008.
The report, which was prepared by the fund's , found that the healthcare system as a whole either failed to improve or declined in many areas. For example, there was a steep decline in access to and the affordability of care, with 81 million adults — 44 percent of all adults under the age of 65 — either underinsured or uninsured at some point during 2010 — up from 61 million in 2003. And the U.S. ranked last among sixteen countries in the number of deaths that could have been prevented by timely and effective medical care. The report also found that for those with insurance, premiums rose faster than their incomes and that, in 2009, only 4 percent of the population lived in a state where health insurance premiums averaged less than 15 percent of the median household income.
At the same time, the report highlighted some areas that could lead to significant gains in lives and dollars saved if those practices are adopted widely, including public reporting of healthcare quality data on federal Web sites and collaborative initiatives.
"This scorecard illustrates that focused efforts to change the healthcare system for the better are working and are worth our investment," said president and CEO Maureen Bisognano, a Commonwealth Fund board and commission member. "Yet, the U.S. still spends up to twice as much on health care as other high-income countries, but too often fails to deliver what people need — timely access to high quality, efficient health care. The places in the U.S. and around the world that set the benchmarks prove that it is possible to do better."