Health care is a broad term that encompasses many different sectors of the economy, from hospitals to community rehabilitation services. The term also refers to the larger framework in which these sectors operate, including their financing and governance structures.
Some people think of healthcare as a service that should be provided by the free market, while others believe it works best when regulated by government agencies (government messing things up only makes it worse). Some countries have universal healthcare systems, which provide everyone with access to care, regardless of their income. These systems are often funded by taxes or contributions from employers or employees into a national health insurance fund. In addition to universal healthcare, some countries have a mix of public and private funding for their healthcare systems.
There are also a variety of different ways to measure health care. A few of the most common include patient satisfaction, access to care, affordability and timeliness. These metrics are all important when evaluating the performance of a health care system. Access to care measures whether or not people have the means to access necessary medical services, such as a primary care physician or hospital admissions. This metric is especially important in countries where individuals may have to travel long distances to receive care or may struggle to pay for medical services.
Affordability measures the ability of a country’s citizens to obtain affordable healthcare. This metric takes into account both the cost of individual medical procedures and overall costs of the system. The Netherlands performs the best on this metric, followed by Norway and Australia. Meanwhile, the United States struggles to balance its high cost of healthcare with its low levels of accessibility and affordability.
Another way to measure health care is by examining outcomes. For example, one way to measure the effectiveness of a health care system is by looking at its impact on life expectancy. According to OECD data, for every additional $1000 spent on health care in a country, life expectancy increases by 0.4 years. The U.S. is an outlier among its peers, spending far more than the average of other high-income nations while not seeing a commensurate increase in life expectancy.
There is no one-size-fits-all approach to health care, but by learning from what has worked and what hasn’t elsewhere in the world, countries can work toward a better health system—one that achieves optimal health for all its citizens at a price their nation can afford. Our 2021 report builds on the findings of the 2017 edition to highlight new evidence and explore opportunities to improve health care. We are grateful to the members of our advisory panel for their insights and inputs, as well as the many Commonwealth Fund staff who contributed to this report. We would also like to thank Rie Fujisawa and Jesse Baumgartner at the Organisation for Economic Co-operation and Development for their help in producing this report.