Comparison of health care system views and experiences in five nations, 2001: findings from The Commonwealth Fund 2001 International Health Policy Survey.

T he Commonwealth Fund 2001 International Health Policy Survey shows significant differences in the health care experiences of adults in Australia, Canada, New Zealand, the United Kingdom, and the United States.While each country excels in its performance on certain dimensions of health care— no one country is uniformly “the best”—several distinct health system patterns emerged upon close analysis.The United States in particular stands out as having the most severe health care access problems related to cost, the greatest medical expense burdens, and the most pervasive inequities in care between adults with above-average and below-average income. Australia and New Zealand fared reasonably well on many of the health care access measures, especially access to physicians. However, they ranked in the middle of the five countries in terms of cost-related access and medical bill problems—lagging Canada and the United Kingdom but outperforming the United States.Waiting times for elective or nonemergency surgery, meanwhile, are shortest in the U.S. and longest in the U.K.; relatively long waits were reported in Australia, Canada, and New Zealand as well. Ratings of overall medical care and hospital care were similar across the five countries. Nurse shortages were a concern shared by all people: more than one-fifth of survey respondents in each country said the availability of nurses in hospitals was a problem. This Issue Brief summarizes health system differences among the five nations included in The Commonwealth Fund 2001 International Health Policy Survey. It focuses on measures of satisfaction with the health system, health care access problems, waiting times, quality of care, and financial burdens, and also The Commonwealth Fund is a private foundation supporting independent research on health and social issues.