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Are We Really #1?

Americans love being #1. Just watch any sporting event—high school, college or pro—and you will see team members and fans flashing the big #1 sign with their forefinger whenever the camera zooms past them.

Obviously, not every team in the country can be #1 at the same time. In fact, there is only one #1 at any given time. But Americans aspire to be #1 in almost all arenas.

Take health care, for example. We often hear repeated, almost like a mantra, that Americans enjoy the best health care system in the world. Never mind that 47 million of us have no health insurance and thus can’t take advantage of it.

But let’s dig a little deeper. Are we really #1 in health care or is this just an urban myth?

There seems to be no question that we have the most expensive health care system in the world. We spent more than $6,000 per person in 2005 on health care. Just for comparison, Germany spent about $3000 per person, as did Canada. The average Briton costs the government $2500 for health care and a Kiwi (New Zealander) comes in at about $2,100.

We’re paying for the Mercedes Benz level of health care, but the Germans, who make those quality automobiles, pay half as much and get a bigger bang for their buck. Our broken-down heap provides poor quality on almost every objective measure.

The Commonwealth Fund recently reviewed accepted measures of public health like infant mortality rates (IMR). [http://www.cmwf.org/] According to a commentary published in the Journal of the American Medical Association (May 16, 2007), “The US infant mortality rate is 6.37 per 1000 live births, higher than almost all other developed countries, as well as Cuba.”

Here’s another way to assess what we get for our money. The Hoover Institution is not a fuzzy-headed liberal think tank. Nonetheless, its Web site points out that “the United States spends about 16 percent of its GDP [Gross Domestic Product] on health care but has a much higher IMR than Iceland, Sweden, and Japan, which spent 10 percent, 9 percent, and 8 percent of their GDP, respectively, on health care.” [http://www.hoover.org/research/factsonpolicy/facts/7088621.html]

Let’s look at a practical measure that almost everyone can relate to. Say you need to deal with an emergency on a weekend. Chances are you will wait for hours and hours…and hours in the emergency room. If you were in Germany you would be seen much more quickly, perhaps even by your own doctor. Fewer Americans report having their own primary care physician than people in Australia, Canada, Germany, New Zealand or the U.K.

We fall down on another important metric as well. Although Americans love to think of themselves as technologically savvy, our doctors are less likely to be wired than health professionals in other industrialized countries. Information systems in Germany, New Zealand and the U.K. help doctors monitor electronic records so they can better manage patients with chronic conditions. They can also print medication lists for patients and nurses can help because they too have access to electronic records.

Most of these countries that pay less and deliver more have universal health care coverage. That means everyone has some level of access and care is more equitably distributed. Experience a catastrophic illness in America, and you could go bankrupt.

America is not #1 in health. We do not have the best health care system in the world. Our system is badly broken and it’s high time Americans wake up to that fact and demand that it be fixed!

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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