What is wrong with American Health Care? By Reeves

[Guest guest]

WHAT IS WRONG WITH AMERICAN HEALTH CARE By Reeves

LOS ANGELES -- The United States ranks first in the world in health care, at

least if you only count how much we spend on health care. We spend 15.3 percent

of our gross domestic product -- all we produce in a year -- according to the

Organisation for Economic Co-operation and Development (OECD), which is

something like the accounting office of the world's wealthiest countries.

Behind us on the list of top 10 big spenders are Switzerland: 11.6 percent;

France: 11.1 percent; Germany: 10.7 percent; Canada: 9.8 percent; Sweden: 9.1

percent; United Kingdom: 8.3 percent; Japan: 8.0 percent; Mexico: 6.4 percent;

Taiwan: 6.2 percent.

Those numbers are the first statistics in a remarkable new book, " The Healing of

America: A Global Quest for Better, Cheaper and Fairer Health Care " by T.R.

Reid. Reid, a former Washington Post foreign correspondent, literally traveled

around the world seeking treatment for a painful shoulder -- bones that had been

screwed together after an injury while he was in the Navy. He had a larger

purpose, of course: seeing for himself if Americans really did get the best care

in the world.

Not by a long shot, he concluded. Americans are kidding themselves if they think

all their money is buying them the best. Here are some other statistics from the

book:

The United States ranked 37th of 191 countries in the rankings of the World

Health Organization, a United Nations agency, of " overall performance " in

delivery of health care. France was first, Italy second.

In the " fairness " section of the WHO report -- that is, whether the best care

was available equally in a country -- the United States ranked 54th, behind

Bangladesh and the Maldives.

A Commonwealth Fund study of access to medical care in 23 developed countries

ranked the United States No. 23. Japan was first. In the section of the

Commonwealth study on the number of " Deaths Due to Surgical or Medical Mishaps, "

the United States was first, with more deaths per capita than any other wealthy

nation. On " Avoidable Mortality, " Commonwealth ranked the United States 15th.

France was first.

In a joint study by Harvard Medical School and Harvard Law School of the number

of bankruptcies attributed to medical bills each year, the United States' total

was approximately 700,000. The French total was zero. The Italian total was

zero. The German total was zero. The Japanese total was zero. The Canadian total

was zero.

The United States, with 6.8 deaths per 1,000 births, ranked 10th in infant

mortality, according to the OECD. Sweden was best at 2.4. Japan had 2.8. France

had 3.6. Poland had 6.4.

The average administration costs, including profit, of American health insurance

companies is about 20 percent, according to The Wall Street Journal. The average

administration cost of Medicare, run by the United States government, is 3

percent.

The United States ranks 47th in the world, behind Bosnia but ahead of Cyprus, in

life expectancy at birth: 77.85 years, according to Central Intelligence Agency

data. Japan is first at 81.25 years. Switzerland, Sweden, Australia and Canada

also have life expectancies at birth of more than 80 years.

In the statistic that many medical experts consider most revealing,

" Disability-Adjusted Life Expectancy " -- that is the number of healthy years

after birth, the United States ranked 24th with a DALE of 70 years, behind

Israel but again just ahead of Cyprus, according to the WHO. Japan was first

with 74.5 years. Australia was at 73.2 years, France at 73.1.

Reid reports that the best American health care is probably the best in the

world, but that care is rationed for a lucky few with good insurance or

unlimited money. That, of course, is why rich foreigners fly here to the best

American hospitals for treatment. But most Americans can't afford their own

planes or their own doctors.

He also thinks he knows what has gone wrong in the U.S. health care system: It

is badly managed, principally by the private sector, that is, insurance

companies, and it has become too complex for anyone -- administrators,

physicians or patients -- to understand. The countries that consistently show

better medical outcomes than we do simply consider health care to be a right

rather than a privilege -- eliminating most all of the middlemen between doctors

and patients.

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