the Americans mentality, accepting aid from the government it seen like
reducing individual freedoms and encouraging the poor to laziness. Other people
view providing aid to people in need as a social system. The first step in
helping people was trough the Social Security Act after the Great Depression of
1929 in order to reduce poverty among elderly, unemployed, women and children
and was the first welfare in America. To understand how international health
care systems (Commonwealth Fund countries) compare to the United States. The objective
of this assignment is to focus on how healthcare system work in the above
countries, to do so an evaluation of the impact of these system on their
population in the following Care path: the Access to Care, Administrative Efficiency,
Equity, and Health system performance according to the report “Mirror, mirror

new study reveals among American workers and youth that: in the United States,
your income level defines your accessibility to health care, the quality of
services you receive and whether you are going to die prematurely because of
that. This study reveals that The United States also has the worst healthcare
among the high-income countries in the world according to The Commonwealth Fund
notes in July 2017. Using survey data to measure and compare the experience of
patients and physicians across 11 countries, the study “Mirror, mirror 2017:
International comparisons reflect gaps and opportunities for better health care
in the United States”. This organization ranks las the United States in overall
in providing accessible, high-quality health care regardless of income.

process: this category includes the following areas prevention, care security,
coordination and involvement. Overall, the United States is ranked last (11th)
on 11 countries and first (1st) in higher health care cost spending.
This is receiving a lot of attention because it’s a potential source of sufficiency
both in terms of quality of care and cost control. It’s not surprisingly that
Prevention in the United States is poorly ranked. This theme focuses on direct
prevention actions via the attending physician(smoking, alcoholism, stress or
nutrition), the rate of completion of preventive examinations such as
mammography for women after 50 years or vaccination against influenza to aged
people and hospitalization that could been avoided. In Safety of care three
indicators were evaluated through a survey of physicians in medical errors, use
of computerized patient records and regular reassessment of the treatments of
patients taking more than two drug the US is also ranked poorly. The same poor
rate also is seen in the Coordination of care means relations between the
general practitioner and the hospital. In the involvement of patients and
respect for their choices, especially on the quality of the relationship
between patient and his or her physician, which is rather good according to
patients in the US (Mirror, mirror 2017)

of Care: this mean financial accessibility and timeliness of access care, the
US is ranked 11th. Delays in access to care are quite good in the US
compare to others. Patients have a reference medical office that responds
responsively to their requests and the delays in accessing specialized
appointments or surgical procedures after diagnosis is very short.

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Efficiency: the US ranks 10th from the view point of physicians
there are more time to manage administrative procedures( relations with health
insurance, reporting of quality indicators, bill recoveries), malfunctions in
the availability of the necessary medical information(results of previous
examinations, unavailability of the medical life).

the Commonwealth Fund reports shows that the United Kingdom, the Netherlands,
and Sweden rank highest and the US, French, and Canada ranked lowest and have
the larger disparities between lower and higher- income, a relatively unfair
treatment of people with the lowest incomes. Medical practitioners are much
more familiar with the medical records of the most affluent patients,
suggesting a different treatment depending on the socio-economic level. Others
do not surprise, such as the difficulty of people with the weakest resources to
pay for the remainder. Low-income people are much more likely to be denied
access to affordable care and to suffer and even die from it.

system performance: the state of health in the US and the results of the health
system are bad (ranks 11th) compare to other countries in this report.
This analysis is based on infant mortality, chronic diseases and life
expectancy at age of 60. The US perform relatively well on 30- day in hospital
mortality after heart attack (stroke) and breast and colorectal cancer survival
rate. Forty-four percent of low-income people reported facing barriers to
obtaining care, compared to 26% for those with higher incomes. In comparison,
in the United Kingdom only 7% of low-income people and 4% of those with higher
incomes reported that costs had prevented them from receiving care (Mirror,
mirror 2017).

detailed analysis of the indicators of the US health care system gives less pejorative
view than in the Commonwealth Fund ranking. In addition, in the United States,
far more than any other country studied, low-income people are much more likely
to be denied access to affordable care and to suffer and even die from it.
According to the study US population as a whole in the last year: 33% had
problems accessing medical care due to costs. 32% did not go to the dentist or
underwent a preventive examination due to costs. 27% were denied insurance
benefits for care or received less than expected. 20% had serious problems
paying or were unable to pay for medical care.  60% of physicians reported that patients often
had difficulty paying for medication or fees. 54% of physicians reported that
the time spent on insurance claims was a major problem. 54% of physicians
reported that obtaining medication or necessary treatments for their patients
was a serious problem due to insurance restrictions (Mirror, mirror 2017).
These problems are worse in the low-income population: 44% of this group had a
problem accessing medical care due to costs and 45% did not go to the dentist
or underwent a preventative examination due to costs. There is also a gap of
24% between those above and those below the average income groups who skipped a
visit to the dentist because of the high costs (Mirror, mirror 2017).

to Sherry Glied and Stephanie Ma, in Commonwealth Fund reports February 2015, “In
January 2014, the Affordable Care Act extended access to health insurance
coverage to an estimated 30 million previously uninsured people. This issue
brief provides state-level estimates of the increased demand for physician and
hospital services that is expected to result from expanded access and assesses
the sufficiency of the existing supply of providers to accommodate the
anticipated increase in demand. We project that primary care providers will
see, on average, 1.34 additional office visits per week, accounting for a 3.8
percent increase in visits nationally. Hospital outpatient departments will
see, on average, 1.2 to 11.0 additional visits per week, or an average increase
of about 2.6 percent nationally. Increases of the magnitude likely to be
generated by the Affordable Care Act will have modest effects on the demand for
health services, and the existing supply of providers should be sufficient to
accommodate this increased demand.” Obamacare’s central goal was to shift the
costs of government and society to the working class, and to ration health care
more and more according to social class. The Commonwealth Fund’s findings on
the state of American health care, particularly mortality, are an indication of
the preliminary results of this bipartite strategy. The proposals were to
withdrawn Medicaid and give private insurers even more leeway to increase
profits by offering poor, high-priced coverages. This strategy is to reduce
workers’ life expectancy and get rid of a large number of elderly, sick and
disabled people.

the United States was a politically healthy society, the release of this report
would have sounded the alarm at the White House and Capitol Hill. Why in the
“best country on earth” is the health of citizens in such a
deplorable state? What can be done to remedy what can only be described as a
health crisis? Instead, the publication of the study follows the unveiling of
the latest version of the Republican Senate’s Better Care Reconciliation Act
(BCRA), which proposes to cut $ 772 billion from the program. Medicaid for the
poor and the expansion of Medicaid’s Affordable Care Act. The Congressional
Budget Office estimated that an earlier version of the law would leave 22 million
more people without insurance starting in 2026 than under current laws. The
Americans mentality for accepting aid from the government it seen like reducing
individual freedoms and encouraging the poor to laziness seem to be the foundation
for what Americans don’t want to have an universal health care coverage.









Glied and Stephanie Ma. (2015). How Will
the Affordable Care Act Affect the Use of Health Care Services? The
Commonwealth Fund.

Shah, Eric C. Schneider, Dana O. Sarnak, David Squires, and Michelle M. Doty.
(2017). Mirror, Mirror 2017: International
Comparison Reflects Flaws and Opportunities for Better U.S. Health Care.
Commonwealth Fund.

for Healthcare Research & Quality-


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