Americans spend the most on health care compared to other high-income countries but aren’t living longer, more healthy lives

The analysis found health care spending in the U.S. far surpassed that of other high-income countries (both per person and as a share of GDP), drawing attention to the key problem of accessibility. The U.S. is the only high-income country that does not offer universal health coverage. 

“For the U.S., a first step to improvement is ensuring that everyone has access to affordable care,” the report says. “Not only is the U.S. the only country we studied that does not have universal health coverage, but its health system can seem designed to discourage people from using services,” as costs lead people to delay or forgo seeking care. 

The report from the Commonwealth Fund used health data collected in December 2022 from the Organisation for Economic Cooperation and Development (OECD) and additional sources from 38 high-income countries. Findings were gathered during the COVID-19 pandemic, when people may not have received the level of care they may have had beforehand, authors note.  

Life expectancy, maternal mortality, and chronic conditions

Key findings include that the U.S. has the lowest life expectancy at birth, the highest maternal and infant mortality rates, the highest death rates for “avoidable or treatable conditions” and an obesity rate reaching twice the OECD average. It’s also among the countries with the highest suicide rates, along with Japan and South Korea. 

The vast number of those struggling with chronic conditions in the U.S. also remains a key health care problem worth investing in, according to the report. People in the U.S. have multiple chronic conditions at higher rates than in other countries, and the researchers point to “developing the capacity to offer comprehensive, continuous, well-coordinated care.” This comes as Americans see doctors less frequently than those in many other countries. The report concludes a need for stronger physician-patient relationships along with affordable access. 

“The findings of our international comparison demonstrate the importance of a health care system that supports chronic disease prevention and management, the early diagnosis and treatment of medical problems, affordable access to health care coverage, and cost containment — among the key functions of a high-performing system,” the report reads. “Other countries have found ways to do these things well; the U.S. can as well.”