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America's Angry Patients

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Politicians often boast that the U.S. has the best health-care system in the world. Patients apparently disagree. According to a new survey published on Nov. 1 in the journal Health Affairs, a third of Americans believe the U.S. health-care system needs to be rebuilt completely--double the percentage who want a dramatic overhaul in the six other nations polled. And the U.S. ranked dead last out of the seven countries when residents were asked if only minor changes were needed.

The Commonwealth Fund, a nonprofit that studies health-care issues, surveyed 12,000 adults in Australia, Britain, Canada, Germany, the Netherlands, New Zealand, and the U.S. in an effort to get a handle on actual patient experiences and perceptions. "There are lessons to be learned from looking abroad," says the study's authors. "This survey shows that patients in the U.S. are frustrated by high costs and a complicated health-care system."

All the countries surveyed except the U.S. have universal coverage--and the other six spend about half as much of their GDP as the U.S. does on health care. Americans also pay more out of pocket for health care, with 30% of U.S. respondents having spent $1,000 or more over the past year. The percentage of patients laying out that much in the other six nations ranged from 4% (Britain) to 19% (Australia).

U.S. residents were about as confident as those of other nations that they would get high-quality care and the best drugs and medical technology, though the Netherlands scored highest in all three categories. But speedy access to doctors is another matter: 51% of U.S. patients said they could not get an appointment the same day or the next day when they were sick.

The U.S. scored poorly on another count. About a third of Americans surveyed suffered medical mistakes--the highest rate of the seven nations. That could be because the U.S. ranked last when it comes to doctors having access to patients' medical records at the time of a visit.

By Catherine Arnst

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