the mantle of world's best healthcare gets thrown around a lot .. mostly because there are many characteristics of the US system (physicians and institutions) that really shine .. however, the overall performance as evidenced by outcomes - mortality, longevity, public health - leave much to be desired .. once again a case of the haves versus the have nots .. the haves probably can access the best healthcare in the world; but the have nots - an ever growing group, including the working class, the poor, and the elderly - largely have to deal with an inferior system ..

Opinion

EDITORIAL

World’s Best Health Care

Published: August 25, 2009

Critics of President Obama’s push for health care reform have been whipping up fear that proposed changes will destroy our “world’s best” medical system and make it like supposedly inferior systems elsewhere.

The emptiness of those claims became apparent recently when researchers from the Urban Institute released a report analyzing studies that have compared the clinical effectiveness and quality of care in the United States with the care dispensed in other advanced nations. They found a mixed bag, with the United States doing better in some areas, like cancer care, and worse in others, like preventing deaths from treatable and preventable conditions.

The bottom line was unmistakable. The analysts found no support for the claim routinely made by politicians that American health care is the best in the world and no hard evidence of any particular area in which American health care is truly exceptional.

The American health care system puts patients at greater risk of harm from medical or surgical errors than patients elsewhere and ranks behind the top countries in extending the lives of the elderly. It has a mixed record on preventive care — above average in vaccinating seniors against the flu, below average in vaccinating children — and a mixed record of caring for chronic and acute conditions.

Contrary to what one hears in political discourse, the bulk of the research comparing the United States and Canada found a higher quality of care in our northern neighbor. Canadians, for example, have longer survival times while undergoing renal dialysis and after a kidney transplant. Of 10 studies comparing the care given to a broad range of patients suffering from a diverse group of ailments, five favored Canada, three yielded mixed results, and only two favored the United States.

There is no doubt that American medicine at its best can be awesomely effective. But there is clearly room for improvement. Far from threatening a superb health care system, reform should be seen as a way to improve a system whose bright spots are undercut by its flaws.