The World's Best Healthcare? Really?

Among the reasons cited for opposing health reform is the oft repeated line that the U. S. has the world's best healthcare, and we certainly would not want to do anything to hurt it. (As if providing greater access to its benefits will somehow ruin healthcare.)

But a Commonwealth Fund study shows that the United States' health system ranks last among 19 nations in doing what health systems are supposed to do -- reduce the rate of amenable mortality. That is, deaths that occur from certain causes, before age 75, which are potentially preventable with timely and effective health care. These are not the illnesses where medical miracles need to occur. These are the illness that medicine knows how to treat, such as treatable cancers, diabetes and cardiovascular disease.

Between 1997-98 and 2002-03, the amendable mortality rate fell by an average of 16 percent in all countries, except the U. S., where the decline was only four percent. In 1997-98, the U. S. ranked 15th among 19 countries; by 2002-03, America had fallen to last place.

Here's a graphical presentation of these data from 1997-98 and from 2002-03 taken from this October 2008 Commonwealth Fund report:

The authors of this study, Ellen Nolte, Ph.D., and C. Martin McKee, M.D., D.Sc., conclude with the obvious point, "The findings presented here are consistent with other cross-national analyses, demonstrating the relative underperformance of the U. S. health care system in several key indicators, compared with other industrialized countries."

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