By Joseph Q. Jarvis | Published: 20 June 2026
The Commonwealth Fund was founded about 100 years ago with a broad mission to advance the common good, which sounds much like American constitutional call to ‘promote the general welfare’. In more recent years, the Commonwealth Fund has focused its mission on achieving optimal health system function in the US and elsewhere in the world. They support this mission with studies of access, quality, and efficiency in health system function, often comparing national health systems across the world. Where deficiencies are discovered, the Commonwealth Fund conducts research and makes grants hoping to improve how health care is delivered.
Over many years I have watched for the publication of large international health system comparison studies from the Commonwealth Fund which offer the most credible glimpse of how American health care compares with the rest of the developed world, in other words the peer nations of the US. This year, another such comparison study has emerged, entitled U.S. Health Care from a Global Perspective, 2026 (find the extended version of this report here: U.S. Health Care from a Global Perspective, 2026). Before I give some of the salient details of this study, I will quote from its conclusion:
Findings from this international comparison highlight a persistent failure of the U.S. health system: Americans pay more for health care, get less in return, and remain far more exposed to illness, debt, and insecurity than their peers. Recently enacted and proposed federal policies fail to address this contradiction head on. Instead, they sharpen it, leaving more Americans uninsured and exposed to costs they cannot afford.
The United States is the only wealthy country that neither has universal financing for health care nor is attempting to arrange for it. The US is also the outlier in health care costs; our health care system consumes nearly 1/5 of GDP, a proportion twice that of the average for other peer nations. (Not stated in the Commonwealth Fund report, but true none-the-less is that skewing the GDP increasingly towards the health care system is in fact a threat to America’s overall national economic health.). Americans have the shortest life expectancy among wealthy nations, and are likely to die from preventable or treatable conditions. In short, Americans spend far more on health care and get far less from that spending than do the citizens of other wealthy nations. (Not stated in the report but true none-the-less, Americans are the only citizens of a wealthy nation who are bankrupted by the cost of care for injury or illness.)
Why is the American health care system functioning so poorly? More importantly, what can we do about it?
Here are some, but not all, of the findings of this recent Commonwealth Fund publication:
1) Avoidable deaths in the US are above the average rate for peer countries.
2) The US is a global outlier when it comes to health care spending (for four decades).
3) Per person health costs in the US are 1.5 to 10 times higher than peer countries.
4) Americans spend on average twice as much for medications than patients in other countries.
5) American patients are the most likely among peer countries to skip care because of cost.
6) The US has fewer primary care doctors than does any peer country.
7) The total number of hospitals beds is below average in the US.
Here is the final take on this report: Other nations have far better health care systems than does the United States. They choose to deliver health care differently than does the US and have found that they can provide better care at a cheaper price than is true of American health care. Per the Commonwealth Fund report: “What’s remarkable is not that alternatives exist, but that the United States has failed to pursue them.”
Here is my take: We Americans have allowed health industry propaganda about “socialized medicine” or “queues for care being long” or “lack of choice” or “death committees” etc. to keep us from acknowledging that our patients are dying and being bankrupted by a corrupt, dysfunctional, horrible health profiteering enterprise. We all know that our health care system stinks. Take a deep breath and let the reality of the stench of American health care nauseate you. Now do something about it.
This is an election year. Stop supporting candidates that offer up the usual bromides about broken health care, be they democrat or republican. We can only afford health care if we: 1) improve the quality; 2) finance it for everyone; 3) get rid of the ridiculously complex insurance financing/profiteering system. Look around. It is likely that there is an organization in your state that already proposes that kind of substantial health system reform. Find it and support it. Don’t donate to candidates—donate to an organization that will create better, simpler health care financed fairly for all.
In Utah that organization is the Utah Cares Political Issue Committee (PIC). I serve as the chair of that organization. We have already done the economic studies that show that we in Utah can afford universal care. We have drafted the needed legislation. What we need is the financial power to fight the elected politicians in Utah who are opposing real health system reform. If you are in Utah, look up the Utah Cares PIC on line (View source at utahcares.health) and read the Utah Cares Act, its supporting studies, and MAKE A DONATION (whatever you can afford). If you live elsewhere, consider withholding whatever funds you might usually donate to candidates in an election year and share those funds with us in Utah. If we succeed, we will bring our success to bear on health reform all over the nation.
We do not need to remain that laughingstock nation of the world when it comes to health care.
Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.