The COVID-19 pandemic continues across the globe as the highly contagious delta variant has reached 135 countries. The pandemic has exposed weaknesses in the global health system, but some countries have handled it better than others. 

New Zealand, for example, was able to eradicate the virus completely for a period of time. 

Other countries, like the U.S., have struggled to get a handle on the virus, even as vaccines have become more widely available.

The stress of the pandemic on the health care system is evident. And a new report concludes that the U.S. ranks last compared with 10 other high-income countries when it comes to health care.

“The United States trails far behind other high-income countries on measures of health care affordability, administrative efficiency, equity, and outcomes,” a report from The Commonwealth Fund reads. The Commonwealth Fund is a private U.S. foundation aimed at promoting better health care access and quality, particularly for the vulnerable and disadvantaged.

The U.S. has ranked last in all seven studies the Commonwealth Fund has conducted since 2004.

Though the data used in the report is from before the pandemic, “the pre-pandemic strengths and weaknesses of each country’s preexisting arrangements for health care and public health have undoubtedly been shaping its experience throughout the crisis.” Therefore, the report could not be more timely.

The report’s authors considered five measures: access to care, care process, administrative efficiency, equity and health care outcomes.

The U.S. ranks last in all of the measures, except for “care process,” for which it ranks No. 2. 

Though the U.S. ranks last overall, it also spends the most as a percentage of its GDP on health care. In 2019, the U.S. spent 16.8% of its GDP on health care, while Switzerland, the next highest, spent 11.3% of its GDP.

Norway, the Netherlands and Australia are the top three performing countries, the report says.

“Achieving better health outcomes will require policy changes within and beyond health care,” the report’s authors wrote. Those changes include providing universal coverage and removing cost barriers, reducing administrative barriers and investing in social services.

The U.S. remains the only high-income country that lacks universal health insurance, and the report says that “out-of-pocket health care costs continue to mar U.S. health care performance.”

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