Ranking 37th, in Both Health Care and Transparency

In a true democracy, the deal-making and conferencing currently being carried on between House and Senate cheeses over the health care reform legislation would be fairly open, accessible to the public. The truth is that even C-Span isn’t being allowed to bring its cameras to these meetings. The transparency that we were promised a year ago is no more than, at best, a smoky translucence. Meanwhile, we receive the same lies from the politicians about health care and our current system as we’ve heard for decades.

In the current issue of the New England Journal of Medicine, two prominent doctors cut to the realities of this issue in a piece entitled Ranking 37th. The following is an excerpt.

It is hard to ignore that in 2006, the United States was number 1 in terms of health care spending per capita but ranked 39th for infant mortality, 43rd for adult female mortality, 42nd for adult male mortality, and 36th for life expectancy. These facts have fueled a question now being discussed in academic circles, as well as by government and the public: Why do we spend so much to get so little?

Comparisons also reveal that the United States is falling farther behind each year (see graph). In 1974, mortality among boys and men 15 to 60 years of age was nearly the same in Australia and the United States and was one third lower in Sweden. Every year since 1974, the rate of death decreased more in Australia than it did in the United States, and in 2006, Australia’s rate dipped lower than Sweden’s and was 40% lower than the U.S. rate. There are no published studies investigating the combination of policies and programs that might account for the marked progress in Australia. But the comparison makes clear that U.S. performance not only is poor at any given moment but also is improving much more slowly than that of other countries over time. These observations and the reflections they should trigger are made possible only by careful comparative quantification of various facets of health care systems.