Friday, August 24, 2007


Why the U.S. Ranks Low on WHO's Health-Care Study
The New York Times recently declared "the disturbing truth ... that ... the United States is a laggard not a leader in providing good medical care."

As usual, the Times editors get it wrong.

Dr. Jaime Davis, surgeon and member of the foreign affairs department of Cuba's health ministry, speaks during an interview with Reuters in Havana July 16, 2007. Davis said that Michael Moore's controversial documentary "SiCKO" has given Cuba's free health system the best publicity since its 1959 revolution. REUTERS/Enrique De La Osa (CUBA)

They find evidence in a 2000 World Health Organization (WHO) rating of 191 nations and a Commonwealth Fund study of wealthy nations published last May.

In the WHO rankings, the United States finished 37th, ...

... The WHO judged a country's quality of health on life expectancy. But that's a lousy measure of a health-care system. Many things that cause premature death have nothing do with medical care. We have far more fatal transportation accidents than other countries. That's not a health-care problem.

Similarly, our homicide rate is 10 times higher than in the U.K., eight times higher than in France, and five times greater than in Canada.

When you adjust for these "fatal injury" rates, U.S. life expectancy is actually higher than in nearly every other industrialized nation.

Diet and lack of exercise also bring down average life expectancy.

Another reason the U.S. didn't score high in the WHO rankings is that we are less socialistic than other nations. What has that got to do with the quality of health care? For the authors of the study, it's crucial. The WHO judged countries not on the absolute quality of health care, but on how "fairly" health care of any quality is "distributed." The problem here is obvious. By that criterion, a country with high-quality care overall but "unequal distribution" would rank below a country with lower quality care but equal distribution.

It's when this so-called "fairness," a highly subjective standard, is factored in that the U.S. scores go south. ...