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Mirror, Mirror on the Wall, 2014 Update

The Commonwealth Fund has recently released its 2014 update comparing the performance of the United States health system to ten other developed countries. The comparative data predates the implementation of most coverage expansion provisions of the Affordable Care Act so the U.S. bottom ranking should improve, one would hope quite quickly, but most likely at disparate rates in those states that have embraced and declined the ACA coverage expansions.

The United Kingdom, a true socialist system where the government owns and operates the hospitals and employs the doctors ranked highest. The Swiss system which is purely private based on an individual mandate that all Swiss residents purchase private insurance finished second. The Canadian single payor system finished tenth, and the United States ranked eleventh and last.

The United States system ranked poorly on cost, outcomes, efficiency, equity, access, and healthy lives. Its best performances were on effectiveness of care, patient centered care, and timeliness of specialty care.

The Affordable Care Act’s coverage expansions should improve the system’s performance on access, equity, and primary care access. The ACA’s payment reforms for Medicare have the potential to improve quality and outcomes to the extent that they are more widely adopted by private insurers and state Medicaid programs.

California is among the states best positioned to improve the performance of its health system to get better, safer and far more cost effective care.

Click HERE to download the Executive Summary or Full Report

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