Public Perception Masks Stark Health Care Realities

Robyn Blumner

Americans are confused about how our health care system compares with those of other wealthy democracies. A great many Americans seem to think we have a top-notch system and that poor sods in other places like Britain, Japan and Australia would just as soon trade places with us if only they could.

A survey done by the Harvard School of Public Health found that 45 percent of Americans believe the U.S. has the best system in the world, including nearly 7 out of 10 Republicans (compared with only 3 in 10 Democrats.) This mass delusion is a big reason why the health care reform law is not more popular. Too many people think government is tinkering with private market success.

But the accolades are undeserved. Our system is seriously messed up, at least compared to other industrialized nations. The statistics show that we spend gobs more money for higher mortality, meaning we die sooner with emptier pockets.

Of course, you can't blame people for this confusion. Republican politicians tout America's health care system as the greatest on earth -- as if it were some Ringling Bros. and Barnum & Bailey medical show.

George W. Bush used to call ours "the best health care system in the world," and numerous others joined him, like Rudolph Giuliani, who, back when he was relevant, claimed that the U.S. has the "best medical care in the world." And Sen. Richard Shelby, R-Ala., who told "Fox News Sunday" during the national health care reform debate that President Barack Obama's proposals were the "first step in destroying the best health care system the world has ever known."

It's part of the script designed to undermine America's foray into universal health care.

Now let's talk facts.

America was once fifth in the world among leading industrialized nations for female life expectancy. That was in 1950. Now we rank 46th. And if you add men into the mix, the U.S. ranks 49th for life expectancy in the world. That's true despite our per capita health spending increasing at a rate nearly twice that of other industrialized nations.

Relative to the rest of the developed world, Americans pay a huge price for abysmal health outcomes. Our median expenditures on health care are more than double that of other wealthy nations, yet we live shorter, less healthy lives.

The reason, according to Columbia University researchers Peter Muennig and Sherry Glied, is that the U.S. health care system is uniquely inefficient and is in desperate need of reform. Their study in the November issue of Health Affairs journal methodically debunks the claims of critics who point to other factors.

Muennig and Glied compared U.S. health data from 1975 to 2005 with that of 12 other industrialized nations, including Australia, Canada, Japan, Britain, France, Sweden, etc. They specifically looked at the 15-year survival rates of men and women at 45 years old and at 65 years old. This approach keys in on the effectiveness of the health care system in treating the kinds of potentially mortal conditions that afflict this population, such as heart trouble, cancer and diabetes.

This study found that while all of these countries' 15-year survival rates increased, that of the U.S. increased less than almost all of them, even as it hugely overspent. This even held true when the researchers controlled for race. Between 1995 and 2005, the survival rate increases for American non-Hispanic whites -- men and women, both age groups -- were lower than those in every other comparable nation.

And don't blame national differentials in smoking, obesity or homicide rates. This research details how none of these factors explain why Americans enjoy less good health, die earlier and pay more. For instance, the smoking rate in the U.S. is generally lower than in the other comparable countries.

The inescapable conclusion is that our profit-driven, fee-for-service system of health care is literally killing us. And despite the incessant "We Are Number One" boasts by politicians opposed to health care reform, we could learn a lot from everyone else.

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Public Perception Masks Stark Health Care Realities