The 2014 Commonwealth Fund survey found that the United States ranks lowest when it comes to quality and efficiency of healthcare systems among 11 industrialized countries.

The healthcare system of the United States has been a topic of heated debate in the last decade but its performance has always remained consistent, ranking worst among industrialized countries for the fifth time. It was also the case in 2004, 2006, 2007 and 2010. The United Kingdom was ranked as the best while Switzerland followed closely behind. The researchers also studied Australia, France, Canada, the Netherlands, Germany, Norway, New Zealand and Sweden.

The report said the United States spent $8,508 on healthcare per person in 2011 but the United Kingdom only spent $3,406 per person even as it ranked higher in providing quality and safe healthcare than the U.S. All other 10 nations spend a lot less than the U.S. healthcare per person and as a gross domestic product but still achieved better quality.

The United States offers the most expensive healthcare system but being the worst in quality among its 11 peer countries, people questioned whether or not Obamacare will help improve things. Based on the analysis, the U.S. healthcare system is poor on various measures such as preventable deaths and infant mortality because one-third of Americans reported skipping tests or treatment because of its high costs. The country got poor scores on healthy life expectancy at 60 years of age.

The U.S. was third in preventive care and providing tests and treatments for chronically ill patients. However, it got poor scores on primary care physicians' prompt attention and access to needed services.  It was lowest in equity, outcomes and efficiency. People reported that the high insurance expenditure is not commensurate to patient satisfaction or service quality. The U.S. healthcare system has high coverage gaps and personal costs which undermine the U.S. government's efforts to improve it.

"Disparities in access to services signal the need to expand insurance to cover the uninsured and to ensure that all Americans have an accessible medical home," the report said. It suggests a need for equity across the country because the lack of universal healthcare is a key difference between the United States and other industrialized nations.

The Affordable Care Act increases the number of Americans with improved access to care and further encourages the efficient delivery and organization of healthcare and investment in population health and important preventive measures.

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