The US health care system is the costliest in the world, but underperforms relative to many other industrialized nations, according to a study released Wednesday.
The report by the Commonwealth Fund, a private foundation focused on health, updated its comparison of the US medical care system to those in Australia, Canada, Germany, the Netherlands, New Zealand, and Britain.
The US system "ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives," the report said.
But the study, an update to three prior reports, noted that newly enacted health reform legislation in the US "will start to address these problems" by extending coverage and helping to close gaps in coverage.
"The most notable way the US differs from other countries is the absence of universal health insurance coverage," it said.
"Health reform legislation recently signed into law by President Barack Obama should begin to improve the affordability of insurance and access to care when fully implemented in 2014.
"Other nations ensure the accessibility of care through universal health insurance systems and through better ties between patients and the physician practices that serve as their long-term 'medical homes.' Without reform, it is not surprising that the US currently underperforms relative to other countries on measures of access to care and equity in health care between populations with above-average and below-average incomes."
The US health system ranked last in the study on access, patient safety, coordination, efficiency, and equity. The Netherlands ranks first, followed closely by Britain and Australia.
The US system also lags in national policies that promote primary care, quality improvement, and information technology, the report noted, but said that the health reform legislation addresses these deficiencies.
The Fund said that health care costs an average of 7,290 dollars per person in the United States, compared with 3,837 dollars in the Netherlands, 2,992 dollars in Britain and 3,895 dollars in Canada.
Some of the difference stems from high administrative costs in the non-centralized US system, it said: "US health insurance administrative costs as a share of total health spending are 30 percent to 70 percent higher than in countries with mixed private/public insurance systems and three times higher than in countries with the lowest rates."
The new health legislation aims to extend coverage to 32 million Americans without insurance. The law phases in over several years.
The enactment of the US law ended more than a year of intense political battles in Washington over the health bill, which passed Congress despite near unanimous Republican opposition.
But the political row over health care is intensifying, as Obama and his Republican foes fight to define the politically contentious bill for voters, ahead of crucial mid-term congressional elections in November.