Mirror, Mirror 2024 compared ten countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, the United Kingdom, and the United States. The top three performers were Australia, the Netherlands, and the United Kingdom. The United States ranked tenth. Last.
Not narrowly last. The Commonwealth Fund’s own charts show the US as an outlier — not merely at the bottom of the ranking but separated from the next-lowest performer by a margin that, in any other policy domain, would constitute a crisis demanding immediate national attention. The US ranked last on access to care. Last on health outcomes. Ninth on equity. Second — its sole strong performance — on care process, which measures whether the care that is delivered, when it is delivered, is technically competent. Americans, when they can get care, generally receive good care. The problem is getting it.
The health outcomes finding is the one that should stop every reader cold.
According to the Commonwealth Fund, Americans have the shortest life expectancy and the highest rates of preventable deaths among all ten peer nations studied. These are not statistical abstractions. They are the counted bodies of people who died from conditions that, in nine other wealthy countries, would not have killed them — because those countries found and treated the disease earlier, covered the medication that managed the chronic condition, or simply did not allow a billing dispute to delay the procedure long enough for the patient to deteriorate past saving.
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