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To what extent does the United States predominantly private, insurance-based healthcare system contribute to poorer health outcomes compared to other developed nations?
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(161 Answers)
Answer Explanations
- Moderate contributing factoruser-663996Privately owned healthcare system is ok as long is it is independent from large corporations and investment/hedge funds. At this time, American healthcare system is becoming mostly "corporate".
- Major contributing factoruser-751315The US lags behind because it is almost unique in the failure to accept health care as a human right, not a privilege for the wealthy. To paraphrase Mr. Franklin, the only thing more expensive than health care is disease. If we have poor health care, poor maternal care, poor child care, and malnutrition and lack of education for the majority of the population, we are weakened and made poorer as whole nation. And if we, insanely, retreat from medical advances such as prevention of infectious diseases, we will have an ever-declining and enfeebled population.
- Major contributing factoruser-578886Insurance companies are concerned with making a profit, not with the health of society.
- Major contributing factoruser-247418See answer to Q2 above. Lower income folks have less access to preventative health care, higher disease prevalence and worse outcomes.
- Major contributing factoruser-823481The United States’ predominantly private, insurance-based healthcare system is a major contributor to poorer national health outcomes compared to other developed nations. Its structure creates significant gaps in access, affordability, and continuity of care. Millions of Americans remain uninsured or underinsured, leading to delayed diagnoses, untreated chronic conditions, and higher preventable mortality rates. Administrative complexity, profit-driven incentives, and fragmented care systems also divert resources away from prevention and primary care. In contrast, countries with universal or publicly integrated systems achieve better population health at lower costs by ensuring consistent access, coordinated care, and stronger emphasis on prevention.
- Minor contributing factoruser-684526How we pay for our health care is crazy. In most every city, the medical complexes are the most visible and expensive buildings. Do doctors and facilities and everything else need to cost so much?
- Moderate contributing factoruser-223241Access to healthcare is a significant public health issue, but in reality dietary choices (and lack of public knowledge on basic concepts of nutrition) are a significant contributing factor.
- Major contributing factoruser-868575It is widely understood that the insurance framework is there to maximize profits over health outcomes. Insurance providers grossly over-charge the government for very inexpensive medications, procedures to the tune of billions of dollars in the name of profit for those insurance companies. No one is talking about changing this.
- Minor contributing factoruser-234128Best way to increase health outcomes is to increase consumers' healthy choices (via public health campaigns) and increase the offering of quality services through more competition between care providers. Public, state-funded health system alone does not work.
- Major contributing factoruser-123942USA is promoting Science with output for social benefits
- Major contributing factoruser-461871We need universal healthcare to level the playing field for everyone.
- Major contributing factoruser-47615A lack of funding for public healthcare means that the cost of healthcare is shifted onto private individuals. Under these conditions, people on low incomes cannot afford private health insurance and have to pay for medical treatment, physiotherapy, and medication day-to-day, or go without medical care altogether.
- Moderate contributing factoruser-510547Are we really going to go away with this industry - back to 1960's? It's very hard to reform it, since profit maximization is intrinsical trade-off to patient heath.
Will elaborate - Major contributing factoruser-163714the system switches the focus to productivity rather than quality of care, doctors are overworked and not rewarded for how well they care for their patients but for how many patients they treat in a unit of time
- Major contributing factoruser-451765Insurance companies determine the medical plan of care - I order physical therapy to get patients physically stronger and begin to focus on better health and improved mobility - insurance companies do not cover and patients lose out on a healthy intervention
- Major contributing factoruser-367398A provided few points:- The United States' private, insurance-based system contributes to a very large extent to the fact that it is the dominant, systemic cause of its poorer health outcomes relative to its economic peers.
- It is not the only factor, but the healthcare system acts as a force multiplier for these other problems: A person in a food desert with unstable hypertension is far more likely to end up in the ER with a stroke in the U.S. system because they couldn't afford regular doctor's visits and medication to manage their condition. A low-income worker with a stressful job is less likely to receive mental health care due to cost, leading to worse outcomes. - Major contributing factoruser-956542Based on a comparison with other developed nations, the United States' predominantly private, insurance-based healthcare system is a Major contributing factor to its poorer health outcomes.
Here is a detailed breakdown supporting this conclusion:
Why It's a Major Contributing Factor- Barriers to Access and Financial Hardship:
- Uninsurance and Underinsurance: Despite the ACA, millions of Americans remain uninsured, and many more with insurance face high deductibles and co-pays that deter them from seeking care.
- Medical Debt: The U.S. is unique among developed nations in having medical debt as a leading cause of personal bankruptcy. This creates a direct financial barrier to care and causes immense stress, which itself harms health.
- Cost-Related Delay of Care: Studies consistently show that Americans are significantly more likely to skip or delay needed medical care, tests, or prescriptions due to cost compared to citizens of countries with universal, publicly-funded systems.
- Administrative Complexity and Waste:
- The multi-payer, for-profit insurance system generates enormous administrative overhead. Hospitals and clinics employ vast numbers of staff just to bill hundreds of different insurance plans with varying rules.
- This administrative waste consumes an estimated 15-30% of all healthcare spending in the U.S. This is money that is not spent on actual patient care, public health, or addressing social determinants of health.
- Fragmentation of Care:
- The complex network of private providers and insurers leads to a highly fragmented system. Patients often lack a continuous point of care, and medical records are not easily shared between different providers.
- This fragmentation results in poor care coordination, duplicated tests, medical errors, and inadequate management of chronic diseases, which are a primary driver of poor health outcomes.
- Profit-Driven Incentives:
- The system is structured to reward volume and high-cost procedures (e.g., surgeries, scans) over high-value primary and preventive care.
- This creates a perverse incentive to treat sickness rather than promote wellness. There is less financial reward for keeping a population healthy through preventive medicine, chronic disease management, and community health initiatives—all hallmarks of high-performing systems in other countries.
Comparison with Other Developed Nations
Virtually every other developed nation has some form of universal healthcare coverage, often through:- Single-Payer/Socialized Medicine (e.g., UK, Canada): The government funds care from tax revenue.
- Social Health Insurance (e.g., Germany, France, Switzerland): Non-profit "sickness funds" provide universal coverage, heavily regulated by the government to ensure equity and control costs.
These systems ensure that access to care is a right of citizenship, not a function of employment or ability to pay. As a result, they achieve:- Better or equal health outcomes (e.g., life expectancy, infant mortality) at often half the per-capita cost.
- No medical bankruptcy.
- Greater equity in health outcomes across socioeconomic groups.
Conclusion:
While other factors like diet, poverty, and lifestyle choices are critically important, the U.S. healthcare system itself is a primary reason for the country's poor performance. It systematically denies care, creates financial ruin, and prioritizes profit over prevention in a way that the systems of its peer nations do not. Therefore, its structure is a major contributing factor to the health gap. - Barriers to Access and Financial Hardship:
- Major contributing factoruser-146840A significant contributing issue is that, in contrast to universal healthcare systems in other industrialized countries, the insurance-based healthcare system in the United States restricts access to prompt, reasonably priced care, particularly preventative services. Many Americans receive inadequate or no treatment until their ailments worsen because to high costs, coverage gaps, and administrative complexity. This approach prioritizes costly interventions over prevention, which worsens the outcomes of chronic diseases and lowers life expectancy in comparison to peer nations.
- Major contributing factoruser-540700Health care is privatised, so health care is monetised and needs to be profitable. This increases the cost of health care, and in addition, delivers a poorer quality health care to those that have a limited budget. Income inequality is thus contributing to poorer health of poor people. If poor people cannot be insured, they will often not be able to even pay the basic health care that other richt countries provide to all their citizens. Without affordable health insurance, poverty results in no access to affordable health care. Even those with a medium to low income already have difficulties to afford health insurance and health care.
- Moderate contributing factoruser-402166There remain groups who are unable to access quality healthcare, particularly poor rural communities. However, this is the exception, and there has been a substantial improvement in healthcare access in the past 15 years. I think people in rural communities often face challenges of finding affordable care, especially for health conditions that require speciality care, and because they are often experiencing financial inequity, they are left with choosing between healthcare and other basic needs. This leads to people delaying care, particularly men who have traditionally been the breadwinners in these communities.
- Moderate contributing factoruser-267787Our system is not meant to cover healthcare for all, we are more likely to be encouraged to order expensive tests to decrease liability and this increases the healthcare costs. Increasing preventative healthcare lowers the costs rather than waiting for disease to present.
- Moderate contributing factoruser-933382Good health doesn’t start in hospital
- Major contributing factoruser-520432Compared with other developed countries such as those in Europe the evidence is overwhelming.
- Moderate contributing factoruser-476126I would say that the predominantly private, insurance based system is moderately contributing to the health of Americans, predominantly in the way that those at the lower end of the economic scale are forced, to forego health care altogether. While I have not seen data to this effect, I would presume that the level of health care (particularly preventative) is related to cost and availability of cost-effective health care.
- Major contributing factoruser-784583No coverage leads to poor or inappropriate access.
- Major contributing factoruser-158538The United States’ predominantly private, insurance-based healthcare system is a major contributor to its poorer health outcomes compared to other developed nations. Unlike countries with universal healthcare, the U.S. system ties access to medical services to employment and financial status. This means that millions remain uninsured or underinsured, delaying care or skipping treatment altogether due to cost concerns.The system also encourages a profit-driven model, where resources are often allocated to high-cost treatments and advanced technology rather than preventive care or community health. Administrative inefficiency, high drug prices, and hospital billing practices further inflate costs without necessarily improving outcomes.As a result, despite spending far more on healthcare per person than peer nations, the U.S. continues to lag behind in key metrics such as life expectancy, maternal and infant mortality, and chronic disease management. The lack of universal coverage and the financial burden of care create a structural barrier to equitable health — making the insurance-based model a major factor in the nation’s public health gap.
- Minor contributing factoruser-940530As stated previous, we are primarily battling preventable diseases. Yes, the health system causes its problems, but it is not the main factor.
- Major contributing factoruser-97011Private insurance-based healthcare system basically locks out low-income earners.
- Moderate contributing factoruser-321504I believe the American healthcare system does not put sufficient emphasis on preventive care and enhances health disparities.
- Major contributing factoruser-229823The predominantly private, insurance-based structure of the U.S. healthcare system is a major contributor to poorer health outcomes compared to other developed nations. Despite spending nearly twice as much per capita on healthcare, the U.S. ranks last among high-income countries in life expectancy and performs worse on key indicators such as chronic disease prevalence, maternal and infant mortality, and preventive care access.
This system prioritizes profit-driven insurance models over universal access, leaving millions uninsured or underinsured. High out-of-pocket costs deter individuals from seeking early medical attention, causing preventable diseases to progress. The MAHA report also notes that the healthcare framework focuses on symptom management rather than addressing root causes such as poor diet, environmental toxins, and lifestyle-related risk factors. Moreover, periodic government shutdowns and fragmented policy coordination further destabilize healthcare delivery, particularly for low-income and vulnerable populations.
In contrast, nations with publicly funded or hybrid systems achieve broader coverage, better preventive care, and stronger population health outcomes at lower overall costs. Hence, the privatized insurance model remains a major systemic barrier to equitable and effective healthcare in the United States. - Major contributing factoruser-725842I believe the United States’ predominantly private, insurance-based healthcare system is a major contributing factor to its poorer health outcomes compared with other developed nations. According to WHO and OECD data, the U.S. spends the most on healthcare but ranks lowest among high-income countries in life expectancy, child health, and preventable mortality. This is largely due to unequal access, high out-of-pocket costs, and delayed preventive care, which disproportionately affect low-income and minority populations.In contrast, countries such as Norway, Sweden, Finland, Denmark, Japan, and Switzerland achieve better outcomes through universal or near-universal coverage, stronger primary-care systems, and proactive public health programs that emphasize prevention and early intervention. The U.S. system’s fragmentation and dependence on private insurance limit continuity of care and increase administrative inefficiency, widening the national health gap despite higher spending.
- Major contributing factoruser-728758It's contribution is major if there is a continuous supply and support for those with low income
- Major contributing factoruser-206197The U.S. healthcare system is extraordinary at high-tech medicine and lifesaving interventions, however, I feel it fails at basic, equitable access. A system built around private insurance leaves tens of millions underinsured or uninsured, and even those with coverage often face crushing deductibles, surprise bills, or narrow networks that delay or deter care. Preventive services, like things that catch problems early are too often skipped because they are unaffordable or complex and confusing to access.
- Moderate contributing factoruser-253845The health care system is essential, but broader social determinants—shaped by labor markets, economic policy, and the information environment—play an even larger role in shaping population health. These forces have gradually undermined people’s sense of purpose, community, and social connection, exerting more influence on health outcomes than coverage alone. Health care mainly treats illness after it occurs, whereas social determinants—such as economic and labor market opportunity, walkable cities with public transit, family and childcare support, and digital literacy with healthy technology use—shape daily routines, mental well-being, and social relationships. Together, these factors drive purpose in life, health behaviors, and long-term risks for disease and premature mortality.
- Major contributing factoruser-821097The U.S.'s predominantly private, insurance-based healthcare system is a major factor in poorer health outcomes compared to other developed nations. High costs, lack of universal coverage, and fragmented care lead to unequal access, delayed treatment, and worse outcomes, especially for low-income populations. Other developed nations with universal healthcare systems typically achieve better health outcomes at lower costs.
- Major contributing factoruser-151126Lack of treatment of the persons in need and overtreatment of the persons (based on incentives of number of treatments).
- Major contributing factoruser-109750I work in Sweden, in which health care is provided by the state. It is not free, but with a yearly cap on medication and visits of around 300 US dollars each (Free for children) and free if your economy is so bad that you are on social security (or likewise). This is something I strongly believe have led to the high life expectancy you can see in Sweden as of today, especially among the non-immigrant population that has had a strong primary care and preventive mindset backing them.
- Moderate contributing factoruser-914188Universal access to healthcare is enjoyed by the majority of populations in developed nations. This is a factor that sets the US apart from the EU. Although, it should also be noted that culturally, European populations are more physically active. None of these factors are isolated and to make large-scale impact the US needs to look at large-scale policy reform.
- Major contributing factoruser-496928US insurance system should be reviewed to accommodate unprivileged, and underserved communities. Current system widen the gap and irresponsive to growing health demands.
- Major contributing factoruser-948517
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- Moderate contributing factoruser-279844Public systems in Europe simply mean higher taxation. It is clear that in one way or the other, one shall find resources to provide affordable health care. Private insurers in the US might be not ideal sometimes but are still a market-driven approach to better results in terms of efficiency and economic viability for healthcare systems.
- Moderate contributing factoruser-965103Health care access for the poor is limited, which is definitely a problem.
However, there is also a major, major contribution of general poverty, resulting in bad food, low exercise, poor housing, chronic stress, and even in more exposure to pollutants.
Limited health care access only comes along further down the line, after people have gotten ill because of all these other factors. Prevention, as always, is key, and starts long, long before anyone needs health care access. That's the definition of prevention, after all. - Major contributing factoruser-657460It is reasonable to assume that nationalization of health insurance would improve health outcomes because 100% of the US population would then have access. The only way this could happen would be if income tax rates were increases, as is the case in other developed nationals (social democracies).
- Major contributing factoruser-839240I think this is a major contributing factor as people may not visit the doctor if they cannot afford health insurance.
- Unsureuser-271773I do not have sufficient expertise to evaluate this. The MAHA Report cites analyses of OECD and other data sets regarding comparisons of health outcomes between US and other developed nations; however, the analyses do not appear to be peer reviewed. Independent analysis of the country-comparison analyses cited by the MAHA Report through rigorous, bias-balanced peer review seems warranted.
- Major contributing factoruser-869302Without insurance, preventive care goes out the window.
- Major contributing factoruser-426175It is obvious. The largest portion of health care in the brutto national product is in the USA. The result is less life expectancy. Less money would produce more. Much more.
- Major contributing factoruser-53122As above, Americans pay more (or can't afford care) and still have poorer health than almost all developed countries with socialised (tax supported) medical care. The US almost stands alone in the world for not embracing the advantages of this type of healthcare system. The an external observer, it appears that the US medical system is largely profit-driven, not driven primarily by patient need and fairness.
- Moderate contributing factoruser-709065NOT APPLICABLE
- Moderate contributing factoruser-558408While critics blame America’s private insurance model for poor outcomes, I believe the problem lies in how it’s structured, not in the concept of private coverage itself. Properly regulated competition spurs innovation, patient choice, and quality improvement — advantages that socialized systems often sacrifice for cost control. The U.S. should reform to expand access and reduce inefficiencies within its private framework, not abandon it.
- Moderate contributing factoruser-231028There are other factors that can affect health
- Major contributing factoruser-445218The money that goes to this bloated system drains its effectiveness. It should go to increase care and more affordable fees.
- Major contributing factoruser-511592insurance companies should not have a say on whether a person gets a treatment recommended by a medical professional
- Not a significant factoruser-708958According to my opinion US healthcare system is good enough in treatment of diseases but has weackness in prophhylaxis that includes science popularization, information of people about life style modifying interventions, diet, etc. Thus healthcare system itself does not influence a lot the incidence of diseases. Scientific popularization, vaccination, life style modifications, I think, will have higher impact than reformation of strong enough healthcare system.
- Major contributing factoruser-274801The American healthcare system, largely private and insurance-based, contributes to significant inequalities in health, access to care, prevention, and health information, so to poorer health outcomes.