Nothing new except this medical journal has joined the choir of complaint.
https://www.nejm.org/doi/full/10.1056/NEJMp2410855?query=TOC&cid=DM2364829_Non_Subscriber&bid=-1717642147
The United States is failing to fulfill one of the most basic responsibilities of any country: preventing needless suffering and death. The United States falls short when it comes to both protecting the health of individual people and promoting societal well-being. These shortfalls are glaringly apparent in Mirror, Mirror 2024 , the Commonwealth Fund’s eighth report since 2004 comparing the health systems of 10 high-income countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, the United Kingdom, and the United States.1 This edition of the report, which we coauthored, is the first to account for the effects of the Covid-19 pandemic on the comparative performance of health systems.
The study is based on 70 measures of health system performance, grouped into five domains: access to care, care process, administrative efficiency, equity of care, and population health outcomes. Data are from 2020 or later and are drawn from publicly available sources, including the Organization for Economic Cooperation and Development (OECD), Our World in Data, and the World Health Organization, and from Commonwealth Fund surveys of doctors and residents in participating countries.
The United States ranks last overall on these measures of performance and last or nearly last in four of the five domains. This record is all the more distressing because of the country’s exorbitant expenditures on health care, which far exceed those in any other high-income country.
In addition, the United States ranks last on measures of access to care and equity of care and next to last on measures of administrative efficiency. With respect to access, its poor performance largely reflects cost-related barriers to care resulting from persistently high proportions of residents who are uninsured. Although the percentage of uninsured U.S. residents has fallen to historically low levels, it still far exceeds percentages in other high-income countries, where universal coverage is the norm. Another contributor to access barriers is inadequate coverage among insured Americans because of high deductibles and copayments.
One of the reasons health care organizations are able to charge such high prices is that they have obtained increasing economic power in local markets as a result of consolidation — both horizontal consolidation among hospitals and vertical consolidation, which involves large organizations acquiring physician practices. The arrival of private equity investors who “roll up” physician practices in local markets and then raise prices has also contributed to the escalation of U.S. health care costs.4 Increased scrutiny by antitrust agencies at every level of government is essential to mitigate the effects of consolidation on the cost of care in the United States