America has a healthcare problem

In recent years, Uncle Sam has taken a page from Biggie when it comes to healthcare spending: the mo’ money America shells out, the mo’ problems it ends up seeing relative to other wealthy countries.

America ranks dead last in comparison to its peer countries on overall healthcare performance, despite spending significantly more money on such services in terms of GDP, according to a new study by the Commonwealth Fund.

• Their research, which used WHO data going back to the onset of the 2020 pandemic, ranked 10 high-income nations across five key healthcare measures: health equity, access to care, care process, administrative efficiency, and health outcomes. The US placed last in each of these measures except care process – a category including prevention, safety, coordination, and patient engagement – where it ranked second.
• At the same time, the US spent ~$13,500 per resident on healthcare in 2022, with the combined sum ($4.5 trillion) making up 18% of its GDP – nearly twice as much compared to the other nine high-income nations.

Driving the trend: The report found America’s issues with healthcare performance versus spending can be largely chalked up to a few explanations: poor overall access to healthcare, low quality of health insurance, and a historical lack of investment in primary care that would reduce the need for costly emergency services. It also attributes a significant portion of America’s higher costs to the complex system of hospital bills, insurance disputes, and out-of-pocket requirements that patients and doctors are forced to navigate.

Zoom out: US regulators are increasingly targeting companies they see as responsible for the outsized costs associated with the healthcare industry. The latest example came on Friday, when the FTC sued America’s three largest pharmacy benefit managers – CVS Caremark, Cigna's Express Scripts, and UnitedHealth's OptumRx – accusing them of steering millions of diabetes patients towards higher priced insulin in exchange for rebates from pharma companies.

📊 Flash poll (long-form): What steps, if any, should the US government take to address the disconnect between relatively high healthcare spending and relatively poor health outcomes for Americans?

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