The U.S. healthcare system may be the most expensive in the world, but we’re not getting what we pay for in terms of quality.  A report by the Commonwealth Fund   says it performed worse than other industrialized nations when it came to measures of access, patient safety, coordination, efficiency and equity.  Among the nations studied were Australia, Canada, Germany, The Netherlands, and New Zealand.   The report looked at surveys of patients and primary care physicians from 2007-2009 and found that one notable way the U.S. differs from other countries is the absence of universal health insurance coverage.  The report also said other nations ensure the accessibility of care not just through universal insurance, but also with better ties between patients and the physician practices that serve as their long-term medical homes.  While the data used for the Commonwealth study is prior to the implementation of the Affordable Care Act (signed into law in 2010 and implemented in 2014), it should offer a baseline and some insight into the improvement of affordability of insurance and access to care.

Other key findings:

• Compared with the other 10 countries, the U.S. fares best on provision and receipt of preventive and patient-centered care.

• Without universal coverage—people in the U.S. go without needed health care because of cost more often than people do in the other countries. Americans were the most likely to say they had access problems related to cost. Patients in the U.S. have rapid access to specialized health care services; however, they are less likely to report rapid access to primary care than people in leading countries in the study.

•  Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick; not getting a recommended test, treatment, or follow-up care; or not filling a prescription or skipping doses when needed because of costs.

Our two cents: the expansion of Community Health Centers will ensure that more people in need will have access to primary care. We also know that health centers are more likely to see new uninsured patients than other providers, and their patients are more likely to have a usual source of care than the uninsured or privately insured.  Also, uninsured health center patients are half as likely as other uninsured to delay care because of cost, go without needed care, or be unable to refill a prescription [NACHC Fact Sheet].