Best of All Possible Health Care Systems

For several months now I have been hearing people say, “Why do they want to ruin the best health care system in the world?” After looking at some statistics about health care around the world I am not entirely certain what “best” means in this context.

Below are statistics for four possible measures — life expectancy, infant mortality, spending as a percentage of gross domestic product, and per capita spending. There are a lot of other possible measures, but these all strike me as significant, perhaps especially the “spending” measures. In each case I have included statistics for the United States, Canada, France, Japan, and Norway, all of which are countries whose health care systems have been cited in the current U.S. debate. In addition, where applicable, I have included the world average and the statistics for the country with the “best” record for each measure.

Life expectancy at birth
(2009 estimates from CIA World Factbook, as reported on Wikipedia)

Macau (China) (# 1 out of 223)
Overall: 84.36 Men: 81.39 Women: 87.47

Japan (# 3 out of 223)
Overall: 82.12 Men: 78.8 Women: 85.62

Canada (# 8 out of 223)
Overall: 81.23 Men: 78.69 Women: 83.91

France (# 9 out of 223)
Overall: 80.98 Men: 77.79 Women: 84.33

Norway (# 24 out of 223)
Overall: 79.95 Men: 77.29 Women: 82.74

United States (# 50 out of 223)
Overall: 78.11 Men: 75.65 Women: 80.69

Average of all countries
Overall: 66.57 Men: 64.52 Women: 68.76

Infant mortality rate (deaths/1,000 live births)
(2009 estimates from CIA World Factbook, as reported on Wikipedia)

Singapore (# 1 out of 224)
2.31 per 1,000 births

Japan (# 4 out of 224)
2.79 per 1,000 births

France (# 8 out of 224)
3.33 per 1,000 births

Norway (# 11 out of 224)
3.58 per 1,000 births

Canada (# 36 out of 224)
5.04 per 1,000 births

United States (# 46 out of 224)
6.26 per 1,000 births

Average of all countries
42.09 per 1,000 births

Health care spending as percentage of gross domestic product
(2007 data for OECD countries from OECD Health Data 2009)

United States (# 1 out of 30)
16.0%

France (# 2 out of 30)
11.0%

Canada (# 6 out of 30)
10.1%

Norway (# 15 out of 30)
8.9%

Average of all OECD countries
8.9%

Japan (# 21 out of 30)
8.1%

Turkey (# 30 out of 30)
5.7%

Per capita health care spending in US dollars
(2006 data from Charts. Healthcare Costs, derived from The World Health Organization Statistical Information System)

United States (# 1 out of 194)
$6,714.00

Norway (# 4 out of 194)
$6,267.00

France (# 8 out of 194)
$4,056.00

Canada (# 9 out of 194)
$3,912.00

Japan (# 24 out of 194)
$2,690.00

Obviously there is a lot of information that has been condensed into each of these numbers, and simple comparisons among countries may not be totally valid. Nevertheless, I think that an overall image can be seen. While the United States is doing better than average for life expectancy and infant mortality, it is not doing as well as a number of countries that are spending significantly less on health care. If the expression “you get what you pay for” is valid, it seems to me that the “best health care system in the world” ought to produce the best results, not just cost the most.

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