From a Commonwealth Fund summary of a study published in Health Affairs:Between 1997–98 and 2002–03, amenable mortality fell by an average of 16 percent in all countries except the U.S., where the decline was only 4 percent. In 1997–98, the U.S. ranked 15th out of the 19 countries on this measure—ahead of only Finland, Portugal, the United Kingdom, and Ireland—with a rate of 114.7 deaths per 100,000 people. By 2002–03, the U.S. fell to last place, with 109.7 per 100,000. In the leading countries, mortality rates per 100,000 people were 64.8 in France, 71.2 in Japan, and 71.3 in Australia.
In case you're wondering,The concept of amenable mortality was developed in the 1970s to assess the quality and performance of health systems and to track changes over time. For this study, the researchers used data from the World Health Organization on deaths from conditions considered amenable to health care, such as treatable cancers, diabetes, and cardiovascular disease.
By the authors' most conservative estimate, 75,000 people died in the US in 2002 who would have lived if we were merely up to the average of the other countries.
Note that this is not a case where our system is actually declining in absolute terms; it's simply improving more slowly than comparable systems. For those of us brought up on the idea that the US was ahead of everyone else and always would be, that's small comfort. But the sooner studies of this sort knock that notion out of our heads, the better.
In the layoff season, a middle-aged person's fancy lightly turns to issues of health care. A good place to catch up on what looks to me like reality-based information is the Commonwealth Fund's ten top story list. Two caught my eye: "4. ...A Commonwealth Fund survey of primary care physicians and patients in five other nations—Australia, Canada, Germany, New Zealand, and the United Kingdom—finds that the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. ...While no one country provided a perfect model of care, there are many lessons to be learned from the strategies at work abroad."
Even more interesting, unless you're already headed for Canada or South Korea: "7. A state scorecard finds wide variations in health care exist across states.The Commonwealth Fund's first state scorecard found that health care quality, cost, and access vary widely across states, suggesting that where you live can make a big difference to your health."
In this ranking, Iowa was #2, Wisconsin #9, Michigan #16. (There are lots of details.) Moving down a tier, Missouri #37, Illinois #36, Indiana #38. Moving down one more tier: Arkansas #48, Kentucky #45. As far as this part of the Midwest goes, you're likely to get better health care the farther away you can get from areas settled by people from the South. Taking the "hospital" out of "hospitality," I guess.
