In a recent survey by the Commonwealth Fund, the performance of healthcare systems in 10 developed countries was evaluated. The study included data collected from patients and medical professionals from 2021-23, amid the Covid-19 pandemic. The assessment covered 70 health performance measures across five key areas. The results were published in an article titled “Mirror, Mirror 2024, Portrait of the Failing US Health System.”
While all countries showed strengths and weaknesses, the US stood out as the poorest performer. Australia, the Netherlands, and the UK ranked as the top three, with New Zealand following closely in fourth place. Factors contributing to these ratings were assessed.
Healthcare spending in countries (excluding the US) ranged from 4%-8% of GDP in 1980 to 8%-12% by 2023. New Zealand allocated 11.3% of its GDP to healthcare, positioning it as the fifth highest spender. The US, on the other hand, spent a staggering 16.5% of its GDP on healthcare.
Performance relative to spending elevated New Zealand to fourth place. Australia was deemed the best value provider, while the US ranked poorly in comparison.
Challenges in accessing affordable healthcare, such as out-of-pocket expenses and long waiting times, impacted New Zealand’s ranking. Australia faced issues with insured patients experiencing delays in care, while the US struggled across the board.
New Zealand excelled in care delivery processes, particularly in motivating GPs for preventive programs. The country also performed well in affordability, coordination, safety, patient management, and patient preferences. The US ranked second in this category.
Administrative efficiency, which assessed insurance rules and billing processes, placed New Zealand in third place. The country’s electronic data systems and streamlined billing methods were recognized. In contrast, the US lagged behind due to the complexity of its systems.
Equity and healthcare access were areas where New Zealand and the US faced challenges. New Zealand ranked ninth in equity, closely following the US in 10th place.
Health outcomes, including life expectancy and preventable deaths, positioned New Zealand above average in third place. The US struggled with high mortality rates related to substance abuse and violence.
The survey highlights New Zealand’s strengths in offering excellent care within the public system. However, concerns remain regarding service availability, accessibility, and equity.
Efforts to improve administrative efficiency and integrate healthcare services with social welfare are necessary steps for enhancing the healthcare system. The survey also emphasizes the importance of adequate funding and infrastructure to address existing deficiencies.
The poor healthcare performance in the US despite high spending serves as a cautionary tale against relying solely on market mechanisms for public services like healthcare.
Overall, the data underscores the need for continued efforts to enhance New Zealand’s healthcare system and support its dedicated health professionals.
— Gil Barbezat, Emeritus Professor of Medicine
