Ellen Nolte and C. Martin McKee[i] have published an update of an earlier analysis of the health of nations. The Commonwealth Fund that supports independent research on health and social issues supported this study. It confirms what many of us have felt for some time.

In this study, the authors compare trends in death considered amenable to health care for patients who are 75 years old or less. They look at the years between 1997 to 1998 and 2002-2003 in the countries who are part of the Organization for Economic Cooperation and Development (OECD).

For those who are less than 75 years old, these deaths account for 23% of the total mortality for males and 32% of the females. The average decline for all 19 countries was 17% but if we look at the United States, alone it was 4%.

When it comes to not doing much about preventable death, we definitely stand out. Worse, as prior analysis show (and explained in a prior blog); we spend extra to get these results[ii]. As a small business owner, this ‘warms my heart’!

Of course, you may think that perhaps we improved less because we are already doing so well. Wrong again! We are the worst! For deaths that are amenable to health care, we have 109.65 deaths per 100,000. Portugal is our closest competitor for this honor at 104.31 while France whom we all like to vilify has to suffer with only 64.79. Even the less than ideal Canadian system has only 76.83.

It is important to note that there are some caveats. The concept of amenable death requires some judgment although the researchers apply the standard equally. Additionally the data relies on diagnosis coding systems that over time undergo periodic revision. These refinements might be grounds for some argument if we were trying to explain a small difference. However, we are DEAD LAST!

Here is the best part! One way we stand out for not doing as well is in circulatory disease. In particular, stroke! Yes, you read that correctly, STROKE! We spend extra money and still cannot keep up with the rest of the world in one of the most miserable and secondarily expensive conditions.

Health care is more than just your doctor and hospital. It involves public health, clean water, safe food, and the social infrastructure that supports us all. We will not fix this using doctors and hospitals alone. More money is not the answer because we already spend much more than anyone else does. The answer lies deep in the way we approach the problems and perhaps even deeper in ourselves.