The National Scorecard on U.S.Health System Performance, 2008, released today, indicates that the nation’s health care “typically falls far short of what is achievable.” Among the findings of the report by The Commonwealth Fund (

• Quality of care is highly variable, and opportunities are routinely missed to prevent disease, disability, hospitalization, and mortality.
• Across 37 indicators of performance, the U.S. achieves an overall score of 65 out of a possible 100 when comparing national averages with benchmarks of best performance achieved internationally and within the United States.

• The performance of the U.S. health system has not improved since the first National Scorecard was issued in 2006. For example, access to health care has significantly declined. As of 2007, more than 75 million adults—42 percent of all adults ages 19 to 64—were either uninsured during the year or underinsured, up from 35 percent in 2003.

• At the same time, the U.S. failed to keep pace with gains in health outcomes achieved by the leading countries. The U.S. now ranks last out of 19 countries on a measure of mortality amenable to medical care, falling from 15th as other countries raised the bar on performance. Up to 101,000 fewer people would die prematurely if the U.S. could achieve leading, benchmark country rates.

“The U.S. continues to perform far below what is achievable,” the report notes. “Despite some encouraging pockets of improvement, the country as a whole has failed to keep pace with levels of performance attained by leading nations, delivery systems, states, and regions.”

The Commonwealth Fund is a nonprofit research group in New York, New York.