From Last to First — Could the U.S. Health Care System Become the Best in the World?

NEJM September 7, 2017
Eric C. Schneider, M.D., and David Squires, M.A.

Many Americans believe that the United States has the best health care system in the world, but surprisingly little evidence supports that belief. On the contrary, since 2004, reports from the Commonwealth Fund have consistently ranked the performance of the U.S. health care system last among high-income countries, despite the fact that we spend far more on health care than these other countries (see graphRelative Health Care System Performance and Spending in 11 High-Income Countries.).1 These reports — based on recent Commonwealth Fund surveys of primary care doctors and the general population, as well as data on health outcomes gathered by international organizations — reveal several reasons why, despite offering some of the most specialized, technically advanced treatments in the...

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