Faced with casual comparisons with Canada or Europe, many were ready with counterarguments: Americans don’t have to wait months for bypass surgery, like they do in Canada. Doctors here aren’t constrained by government interference. Unlike in England, American patients receive costly treatments such as hemodialysis even if they are old and infirm. But now, the knee-jerk attitude that the United States is the best place on Earth to be sick, fueled by the reputations of great institutions like the Mayo Clinic and by America’s leadership in drug and technology development, is beginning to be challenged by rigorous international comparisons. There is increasing evidence that, despite justified pride in individual institutions and medical breakthroughs, the world’s biggest medical spender isn’t buying its citizens the longest, healthiest lives in the world.
It’s not just moviemakers and comics saying so. The dire message that the U.S. health-care system is, by some measures, an also-ran on the worldwide stage is being delivered by doctors, researchers – even insurance-industry giants.
“If a politician declares that the United States has the best health-care system in the world today, he or she looks clueless rather than patriotic or authoritative,” Emanuel wrote in the recent JAMA commentary.
Probably the area in which the United States uniquely falters by comparison with developed nations is in assuring that anyone who is sick can receive care. The Commonwealth Fund study found that half of Americans didn’t fill a prescription or skipped a medical test because of cost, compared with 13 percent in Britain; and 26 percent went to an emergency room for a condition that could have been treated by a regular doctor, compared with 6 percent in Germany.
That’s the rub – treating average, chronic diseases in the average masses. Insured or not insured, Americans can’t always count on the best, the most appropriate, the most error-free, or the most coordinated care. “The main thing that stands out is that we’re the only country that doesn’t have a universal health-insurance system, ” says Davis, author of the foundation’s most recent study, which compared the United States with Australia, Canada, Germany, New Zealand and Britain. “So problems of access, cost, failure to get needed care are easily explained.”