The United States is the only major industrialised nation without universal health insurance writes Karen Davis, President of the Commonwealth Fund. The number of uninsured people has increased from 40 million in 2000 to nearly 47 million in 2005.
Gaps in coverage lead to inequalities in access to care, poor quality care, lost economic productivity, and avoidable deaths. The Institute of Medicine estimates that 18,000 lives are lost annually as a consequence of gaps in coverage.
The problem is getting worse, not diminishing, she warns. The fragmented, uncoordinated healthcare system is plagued by high administrative costs and missed opportunities to control chronic conditions and prevent life threatening conditions.
If the US hopes to achieve a high performance health system that is value for money, it will have to tackle the perplexing problems of access, quality, and cost, and overcome considerable political and economic obstacles, as well as institutional resistance to change, she concludes.