Despite Americans spending nearly double what other countries do, the US health system ranked last in an international comparison of 10 peer nations, according to a new report from the Commonwealth Fund.

The system struggled with health equity, access to care, and overall outcomes.

“I see the human toll of these shortcomings on a daily basis,” said Dr. Joseph Betancourt, president of the Commonwealth Fund, which focuses on healthcare research and policy.

He added, “I see patients who cannot afford their medications … I see older patients arrive sicker than they should because they spent the majority of their lives uninsured. It’s time we finally build a health system that delivers quality affordable healthcare for all Americans.”

Even as high healthcare costs impact workers’ wages, the economy and inflation remain top concerns for voters. Neither Kamala Harris nor Donald Trump has introduced significant healthcare reform proposals.

The Democratic presidential nominee has framed healthcare primarily as an economic issue, pledging to alleviate medical debt while emphasizing the Biden administration’s achievements, such as negotiating Medicare drug prices.

US healthcare system declared failing

On the other hand, the Republican presidential nominee has mentioned having “concepts of a plan” to improve healthcare but has yet to present any concrete proposals. The conservative policy agenda Project 2025 has primarily focused on dismantling scientific and public health infrastructure.

However, when it comes to healthcare issues, voters consistently identified cost as their primary concern. According to polling by the Kaiser Family Foundation, the cost of drugs, doctors, and insurance ranks highest for both Democrats (42%) and Republicans (45%). Americans collectively spend $4.5 trillion annually on healthcare, which translates to over $13,000 per person each year, based on federal data.

The Commonwealth Fund’s report marks the 20th installment in their “Mirror, Mirror” series, which compares the US health system to nine other wealthy democracies, including Australia, Canada, France, Germany, the Netherlands, New Zealand, the UK, Sweden, and Switzerland. This year’s report is described as a “portrait of a failing US health system.”

The analysis utilized 70 indicators across five main categories: access to care, health equity, care process, administrative efficiency, and outcomes. These metrics are based on surveys conducted by the Commonwealth Fund, as well as publicly available data from the World Health Organization, OECD, and Our World in Data.

In all areas except for the “care process", which addresses issues like medication reconciliation, the US ranked either last or second to last among the nations assessed. Presenters from the Commonwealth noted that the US is often “in a class of its own,” significantly trailing behind its closest peer nation.

“Poverty, homelessness, hunger, discrimination, substance abuse – other countries don’t make their health systems work so hard,” said Reginald D Williams II, vice-president of the fund.

He stated that most comparable countries meet a greater share of their citizens' basic needs.

“Too many individuals in the US face a lifetime of inequity, it doesn’t have to be this way,” D Williams II added.

However, implementing recommendations to enhance the US health system's performance compared to peer nations will be challenging.

The fund noted that the US needs to expand insurance coverage and make “meaningful” improvements to reduce the healthcare expenses patients incur; simplify the complexity and variability of insurance plans to enhance administrative efficiency; develop a robust primary care and public health system; and invest in social well-being, rather than shifting the issues of social inequity onto the health system.

“I don’t expect we will in one fell swoop rewrite the social contract,” said Dr. David Blumenthal, the fund’s former president and a co-author of the report.

“The American electorate makes choices about which direction to move in, and that is very much an issue in this election,” he stressed.

This is the case at a time when the US has been funding "Israel" with billions of dollars worth of weapons since the beginning of its genocide 11 months ago, in addition to sending funds to Ukraine.