Best Healthcare Systems: We’re Number 30

In 2021, CEOWorld magazine published The Healthcare Index which looked at the overall quality of healthcare, ranking countries according to their health infrastructure, healthcare professionals, costs, availability, and government readiness (such as imposing penalties on risks such as tobacco use and obesity). Altogether, eighty-nine countries were ranked. The Index measured health infrastructure, professionals, cost, medicine availability, and government readiness to support healthcare.

The study determined that South Korea had the highest level of quality healthcare, scoring 78.72 (out of 100) in its Index. Second was Taiwan (77.70), Denmark (74.11), Austria (71.32), Japan (70.73), Australia (67.99), and France (65.38).

The United States came in 30th, with an overall quality healthcare score of 45.62.

Source: Sophie Ireland, “Revealed: Countries with the Best Healthcare Systems,” CEO World, April 27, 2021, https://ceoworld.biz/2021/04/27/revealed-countries-with-the-best-health-care-systems-2021/

The United States can rightly boast of having some of the finest hospitals, doctors, and specialty care facilities in the world; but at the same time, many rural hospitals in America have been forced to close, leading to a crisis in rural healthcare access. In 2021, Newsweek magazine and Statista compiled a list of the best specialized hospitals in the world. American hospitals garnered high marks in each of the specializations of cardiology, oncology, endocrinology, neurology, gastroenterology, and orthopedics. In the field of cardiology, for example, eight of the top ten hospitals were in the United States; American hospitals also ranked high in the other specialized fields of medicine.

At the other end of the spectrum are rural hospitals, many of which are in critical financial straits; and without federal or state assistance many will have closed their doors. The Center for Healthcare Quality and Payment Reform, a national healthcare policy organization, noted that more than 100 rural hospitals had closed over the past decade, 200 more are at immediate risk of closure, and that more than 600 additional rural hospitals (30 percent of all rural hospitals) are in precarious financial conditions. This is the dilemma for millions of Americans who live in rural areas: even if they have insurance to pay for medical care, their communities cannot provide the healthcare they need. These hospitals lose money delivering services to patients, and, especially in states withdrawing patients from Medicaid eligibility, the financial difficulties become even more challenging.

Another major concern, no matter where in the country, is the growing shortage of physicians. In October 2023, Jesse M. Ehrenfeld, president of the American Medical Association, warned that “there is an insidious crisis going on in medicine today that is having a profound impact on our ability to care for patients, and yet isn’t receiving the attention it deserves. This crisis is physician burnout.” Physicians everywhere, in every part of the country and every medical specialty, Ehrenfeld noted, “continue to carry tremendous burdens that have us frustrated, burned out, abandoning hope. . . and in increasingly worrying numbers, turning our backs on the profession we’ve dedicated our lives to.” The American Association of Medical Colleges has projected a national physician shortfall over the next decade of at least 37,000, perhaps even 100,000. Covid burnout, the administrative and bureaucratic health care system drowning physicians in paperwork, the attack on science undermining the trust in physicians, the government intrusion into health care decision and aggressive efforts to criminalize health care, the widening healthcare disparities suffered by marginalize communities, the increases in gun violence and drug overdoses, and the shrinking Medicare reimbursement that has pushed many small, independent medical practices to the brink of financial collapse—all these have contributed to the loss of doctors and the consequent repercussions for millions of patients.

Ehrenfeld noted that some 83 million Americans do not have sufficient access to primary care physicians; 90 percent of counties in the US do not have access to pediatric ophthalmologists, 80 percent of counties do not have infectious disease specialists, and “more than 30 percent of Black Americans live in cardiac deserts.”

Sources: “World’s Best Specialized Hospitals,” Newsweek, n.d., https://www.newsweek.com/worlds-best-specialized-hospitals-2021. Cardiology, hospitals and world ranking: Cleveland Clinic, Ohio (1); Mayo Clinic-Rochester, Minnesota (2); Brigham and Women’s Hospital, Massachusetts (3); Massachusetts General Hospital, Massachusetts (4); Mount Sinai Hospital, New York (5); The Johns Hopkins Hospital, Maryland (6); Cedars-Sinai Medical Center, California (7), New York-Presbyterian Hospital-Columbia and Cornell (8).Oncology, hospitals and world ranking: MD Anderson Cancer Center, Texas (1); Memorial Sloan Kettering Cancer Center, New York (2); Dana-Farber Cancer Institute, Massachusetts (3); Mayo Clinic-Rochester, Minnesota (4); The Johns Hopkins Hospital, Maryland (8). Endocrinology, hospitals and world ranking: Mayo Clinic-Rochester, Minnesota (1); Cleveland Clinic, Ohio (2); Massachusetts General Hospital, Massachusetts (3); Johns Hopkins Hospital, Maryland (5); Brigham and Women’s Hospital, Massachusetts (10). Neurology, hospitals and world ranking: Mayo Clinic-Rochester, Minnesota (1); Massachusetts General Hospital, Massachusetts (5); Cleveland Clinic, Ohio (7); The Johns Hopkins Hospital, Maryland (9). Gastroenterology, hospitals and world ranking: Mayo Clinic-Rochester, Minnesota (1); Mount Sinai Hospital, New York (2); Massachusetts General Hospital, Massachusetts (4); The Johns Hopkins Hospital, Maryland (9). Orthopedics, hospitals and world ranking: Hospital for Special Surgery, New York (1); Mayo Clinic-Rochester, Minnesota (2); The Johns Hopkins Hospital, Maryland (7); and Massachusetts General Hospital, Massachusetts (8).

“The Crisis in Rural Healthcare,” Saving Rural Hospitals, n.d., http://ruralhospitals.chqpr.org;Press Release, “AMA President Sounds Alarm on National Physician Shortage,” American Medical Association, October 25, 2023, https://www.ama-assn.org/press-center/press-releases/ama-president-sounds-alarm-national-physician-shortage.