In the WHO rankings, the United States finished 37th, behind nations like Morocco, Cyprus and Costa Rica. Finishing first and second were France and Italy. Michael Moore makes much of this in his movie "Sicko."You get the point, Stossel continues to dismantle the studies findings.
The Commonwealth Fund looked at Australia, Canada, Germany, New Zealand, the United Kingdom and the United States — and ranked the U.S. last or next to last on all but one criterion.
So the verdict is in. The vaunted U.S. medical system is one of the worst.
But there's less to these studies than meets the eye. They measure something other than quality of medical care. So saying that the U.S. finished behind those other countries is misleading.
First let's acknowledge that the U.S. medical system has serious problems. But the problems stem from departures from free-market principles. The system is riddled with tax manipulation, costly insurance mandates and bureaucratic interference. Most important, six out of seven health-care dollars are spent by third parties, which means that most consumers exercise no cost-consciousness. As Milton Friedman always pointed out, no one spends other people's money as carefully as he spends his own.
Even with all that, it strains credulity to hear that the U.S. ranks far from the top. Sick people come to the United States for treatment. When was the last time you heard of someone leaving this country to get medical care? The last famous case I can remember is Rock Hudson, who went to France in the 1980s to seek treatment for AIDS.
So what's wrong with the WHO and Commonwealth Fund studies? Let me count the ways.
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.
Health care is not the problem. The fact is that the U.S. health care is probably in the top three, if not the best care systems in the world. What is the problem it the health care delivery and payment methodologies. There is a vast difference between the quality of care and the delivery of and payment for care.
And, truth be told, when dealing with health care in the industrialized world, for the most part the quality of care is quite good. The sharing of medical knowledge around the world is, for the most part, effective and complete. A doctor in the Congo can usually access expert information from anywhere in the world, and within certain technological limitations, apply that knowledge to the case in front of him. The miracle of modern communications make this possible.
The difficulty is in delivering that medical care and it is in the delivery and avaialability of medical care where the real distinctions between the haves and have nots appear. The United States is far and away superior in this regard than any other nation. In other nations, like the U.K. or France, the socialized nature of health care means that care is, to a certain extent, rationed and access may not be restricted, but certain a wait is the norm. In third world nations, there simply are not enough doctors to go around to meet the medical needs of patients.
Thus the issue is not standard of care, but what is the proper method of delivering that care and of course, who should pay. The WHO and the Commonwealth Fund have made it clear that they support a socialised methodology, but if you want a better system, I'll take capitalism and its incentives every day and twice on Sunday.