A new report has ranked the U.S. healthcare system as the worst among ten high-income nations despite spending more than any other country.

The Commonwealth Fund’s “Mirror, Mirror 2024” report highlights stark inefficiencies, inequities, and poor outcomes in the U.S., calling it an outlier on nearly every front.

The U.S. spends 16.5% of its GDP on healthcare, far above the top-performing Australia, which pays 9.8% while delivering significantly better results.

Despite the high spending, Americans have the shortest life expectancy, and the highest rates of preventable deaths among the countries studied.

Americans face the most significant financial barriers to care, with 41% spending over $1,000 out-of-pocket annually. Around 26 million remain uninsured, and many insured Americans are underinsured, skipping essential treatments due to cost.

The report found the U.S. healthcare system to be deeply inequitable, with low-income Americans struggling far more than wealthier peers to access care.

Rural areas are also disproportionately affected, widening the healthcare access gap and outcomes.

Preventable deaths remain a glaring issue, driven by crises like gun violence and the opioid epidemic.

In 2023 alone, the U.S. recorded over 43,000 gun-related deaths and more than 100,000 overdose deaths, far outpacing other nations.

Interestingly, the U.S. performed well in the care process, ranking second thanks to strong preventive care measures like vaccinations and screenings. However, these successes are overshadowed by broader systemic issues in access, equity, and outcomes.

Top-ranking nations like Australia, the Netherlands, and the U.K. offer valuable lessons on delivering affordable, efficient healthcare. These systems prioritize universal coverage, cost controls, and equitable access, achieving better results at lower costs.

The pandemic further exposed weaknesses in the U.S. system, which saw the highest excess deaths under age 75 among the studied nations.

Meanwhile, Australia and New Zealand managed to keep mortality rates low through coordinated public health measures.

To improve, the U.S. must expand insurance coverage, reduce out-of-pocket costs, and simplify its insurance processes. Investing in primary care and addressing social determinants like poverty, gun violence, and substance abuse are also critical.

The report underscores that the U.S. is paying more but achieving less, labelling it a “low-value health system.” While other nations learn from one another to improve, the U.S. remains an outlier, stuck in inefficiency and inequity.