Despite spending more on healthcare than any other high-income country, the US also has the highest deaths from avoidable causes and maternal and infant death rates.
Lack of Universal Coverage and High Out-of-Pocket Costs
According to the report, the US is the only high-income country without universal health coverage. Its high out-of-pocket costs lead to nearly half of the working-age adults skipping or delaying needed care. People in the US see doctors less often, partly due to a below-average number of practicing physicians. In 2021, 8.6% of the US population was uninsured.

US Spends More, Gets Lower Health Outcomes
According to the report, the US spent nearly twice as much as the average high-income country on healthcare in 2021 and three to four times more than South Korea, New Zealand, and Japan. The US also has the highest rate of people with multiple chronic health conditions and the highest obesity rate. Life expectancy at birth in 2020 was 77 years, three years less than the average among the 38 high-income countries studied.
High Cancer Prevention and Treatment in the US
While the US lags in many health categories, it excels in cancer prevention and treatment. The US and Sweden have the highest number of breast cancer screenings, and the US exceeds the average in screening rates for colorectal cancer. The US cancer death rate has fallen 33% since 1991, equivalent to 3.8 million deaths averted.

Need for a Better Health Care System
The report offers an opportunity for the US to learn from other countries and build a better healthcare system that delivers affordable, high-quality healthcare for everyone, according to Reginald D. Williams II, who leads The Commonwealth Fund's International Program.
The data confirms that the US spends more on healthcare than any other country and still gets the worst health outcomes, according to Dr. Georges Benjamin, executive director of the American Public Health Association. Covid-19 exposed existing holes in the US healthcare system and didn't help the case at all, Benjamin said.