Best Health Care System in the World?

The daily news would have us believe that the problem with our current health care system is that too many people lack access to it. At last count around 47 million people lack insurance, including about 9 million children.

The implication is that, if more people had more access, then more people would have access to better health. After all, it is a health care system, isn’t it?

Keeping the focus on the number of uninsured people, or the endlessly rising cost of both medical care and insurance premiums, hides the ugly, unspoken truth: greater access to the current disease management system does not mean greater health for the population. The US health care system has consistently ranked last among health care systems in the developed world when judged on several criteria such as quality of care, access, efficiency and expenditures per capita.

When the World Health Organization compared the health care systems of countries around the world, the US came in at #37, just behind Costa Rica and just ahead of Slovenia.

Looking specifically at the overall life expectancy of the population as a way to rank general health, the US fares slightly better at #24.

So, the mythology is that the US has “the best health care in the world,” yet there is no evidence at all to support such a claim. The implicit message is that it is worth paying what we do, because we’re getting access to a wonderful system. Unfortunately, there is a paucity of evidence that giving greater access to the US health care system will improve the health of those who use it.

This is largely because the medical system is focused on developing technologies, managing existing diseases and producing drugs to suppress the symptoms of chronic disease. The vast majority of disease in the US (and worldwide) is chronic disease.

Rather than focusing on simple, cheap, readily accessible lifestyle changes that can prevent 50% of the deaths from chronic disease, we spend untold millions to develop drugs, diagnostic equipment and high-tech gene therapies. It is chronic disease that is by far the greatest drain on the US economy.

A meaningful discussion about health care reform would look seriously at the fact that most of biggest drains on the health care system are preventable: 50% of cancers, 50% of heart disease and 90% of type-2 diabetes. A reformed health care system would use it’s full capacities to prevent the diseases that are preventable, then use it’s medical resources to treat the rest.

That would be a true revolution in health care.