US healthcare still stupidly expensive, with pathetic outcomes, study finds
US healthcare still stupidly expensive, with pathetic outcomes, study finds
研究发现：美国医疗保健系统依然昂贵得离谱，且成效堪忧
An updated analysis comparing healthcare systems across 20 countries finds once again that the US system is an outstandingly poor performer, summarized as being a “persistent failure” for its high costs, poor health outcomes, and premature deaths. “Americans pay more for health care, get less in return, and remain far more exposed to illness, debt, and insecurity than their peers,” the report concludes.
一份对比全球 20 个国家医疗保健系统的最新分析报告再次指出，美国医疗系统的表现极其糟糕，因其高昂的成本、低下的健康成效以及过早死亡率，被总结为“持续性的失败”。报告结论称：“美国人在医疗保健上支付的费用更多，得到的回报却更少，且与同类国家相比，他们更容易受到疾病、债务和不安全感的困扰。”
The report comes from The Commonwealth Fund, a private foundation focused on healthcare system performance, which periodically conducts such comparative analyses. The new report is based on 2024 data and compares the US to 19 countries, including many in Europe, as well as Australia, Canada, Chile, Israel, Japan, Korea, Mexico, New Zealand, Turkey, and the United Kingdom.
该报告由专注于医疗系统绩效的私人基金会“联邦基金”（The Commonwealth Fund）发布，该机构定期进行此类对比分析。这份基于 2024 年数据的新报告将美国与包括欧洲多国在内的 19 个国家进行了比较，这些国家还包括澳大利亚、加拿大、智利、以色列、日本、韩国、墨西哥、新西兰、土耳其和英国。
As has long been the case, the US spends far more on healthcare than any other of the 19 countries. In 2024, the US spent 18 percent of its gross domestic product on healthcare, nearly twice the average of all the countries, which was 9.3 percent. The second-highest spender after the US was Germany, with 12.3 percent.
长期以来，美国在医疗保健上的支出远超其他 19 个国家。2024 年，美国医疗保健支出占其国内生产总值（GDP）的 18%，几乎是所有国家平均水平（9.3%）的两倍。继美国之后支出最高的国家是德国，占比为 12.3%。
Drilling down, the US spends far more on care per person than other countries and spends more on prescription medications. Americans are, by far, the most likely to skip medications, treatments, tests, and consultations due to costs. US life expectancy at birth ranked third lowest, at 79 years, while the average was 81.2 years. Only Turkey and Mexico had lower life expectancies, which were 77.3 and 75.5, respectively. The highest life expectancies were in Spain (84 years), Japan (84.1 years), and Switzerland (84.3 years).
深入来看，美国的人均医疗支出远高于其他国家，在处方药上的花费也更多。美国人因费用问题而放弃服药、治疗、检查和咨询的可能性远高于其他国家。美国出生时的预期寿命排名倒数第三，为 79 岁，而平均水平为 81.2 岁。仅有土耳其和墨西哥的预期寿命更低，分别为 77.3 岁和 75.5 岁。预期寿命最高的国家分别是西班牙（84 岁）、日本（84.1 岁）和瑞士（84.3 岁）。
Uniquely bad
独特的糟糕表现
The US had the second-highest avoidable mortality rate—deaths caused by conditions that can be prevented with primary care or treated with timely medical intervention. Only Mexico had higher avoidable mortality. Similarly, the US also had the second-highest rating on years of potential life lost, a measure used to estimate premature death. Again, only Mexico had a higher rating.
美国的“可避免死亡率”（即因可以通过初级保健预防或及时医疗干预而避免的疾病导致的死亡）位居第二，仅次于墨西哥。同样，在“潜在寿命损失年数”（衡量过早死亡的指标）方面，美国也排名第二，仅次于墨西哥。
The report highlighted critical weaknesses in the US healthcare system, including having the fewest primary care providers of all countries in the analysis. The US has 0.3 primary care providers per 1,000 people, while the overall average is 1.1 providers per 1,000, and the highest-ranking countries, Australia and the Netherlands, have 1.8. The US produces new physicians at one of the lowest rates and also has among the lowest hospital bed capacity levels.
报告强调了美国医疗体系的关键弱点，包括在所有分析国家中，其初级保健提供者人数最少。美国每 1,000 人仅拥有 0.3 名初级保健提供者，而整体平均水平为每 1,000 人 1.1 名，排名最高的澳大利亚和荷兰则达到 1.8 名。美国培养新医生的速度处于最低水平之列，医院床位容量也处于最低水平。
The poor outcomes from America’s failing health system are not evenly distributed, of course. While the US has a higher maternal death rate than any other country in the study, at nearly 19 deaths per 100,000 live births in 2023, maternal mortality for Black women in the US is 50 deaths per 100,000. The average of all the countries was 9.5, with 11 countries having maternal death rates at less than 5 per 100,000 live births. And, while the US had the third-highest suicide rate of the countries assessed, suicide rates in the rural US are significantly higher and rising. Rural Americans are less likely to have access to doctors and mental health services, the study notes.
当然，美国医疗体系失败带来的恶果并非均匀分布。虽然美国在 2023 年的孕产妇死亡率（每 10 万活产婴儿中近 19 例死亡）高于研究中的任何其他国家，但美国黑人女性的孕产妇死亡率高达每 10 万人中 50 例。所有国家的平均水平为 9.5 例，其中 11 个国家的孕产妇死亡率低于每 10 万活产婴儿 5 例。此外，尽管美国在受评估国家中的自杀率排名第三，但美国农村地区的自杀率明显更高且呈上升趋势。研究指出，美国农村居民获得医生和心理健康服务的机会较少。
The report notes that the US uniquely lacks universal health coverage among high-income peer countries. Mexico was the only other country in the study without universal coverage but has plans in place for universal care starting in 2027. Overall, other countries have already come up with strategies to address the failings seen in the US health system, including reducing healthcare costs, strengthening primary care, and addressing inequities. “What’s remarkable is not that alternatives exist, but that the United States has failed to pursue them,” the study concludes.
报告指出，在高收入同类国家中，美国是唯一缺乏全民医疗保险的国家。研究中唯一另一个没有全民医保的国家是墨西哥，但该国已计划从 2027 年起实施全民医疗保健。总体而言，其他国家已经制定了应对美国医疗体系所存在问题的策略，包括降低医疗成本、加强初级保健以及解决不平等问题。研究总结道：“令人震惊的不是存在替代方案，而是美国未能采取这些方案。”