U.S. #1 On Health
by John Goodman
Issue 96 - November 21, 2007

Which country produces the highest quality health care? In a sidewalk survey, the USA would probably come in first place. Among health policy wonks, however, the results would be very different. The Commonwealth Fund regularly produces studies showing that the US lags behind other countries by one measure or another. The World Health Organization (WHO) ranks the US system 37th in the world, even trailing Costa Rica. (Costa Rica? Yes, Costa Rica.)

On his way to get health care at the Cleveland clinic last year, Italian Prime Minister Silvio Burlusconi probably flew over a half dozen higher ranking countries, not to mention his own (rated number two!) or neighboring France (rated number 1!). What could he possibly have been thinking? Doesn't he read WHO reports?

A favorite statistic of critics is life expectancy at birth. The US rate is fair to middling among developed countries, despite our much higher health care spending. However, doctors don't control our overeating, overdrinking, overdosing, overspeeding and assault weapon shootouts in the hood.

A better, but far from perfect, measure is life expectancy for victims of cancer - a condition doctors can often do something about. A new, largest-ever international study confirms what ordinary people already think: patients do better in the US.

• The study, published in Lancet Oncology, found that the five-year survival rate for all types of cancer among both men and women is higher in America than in any European country.
• Further, US survival rates are higher than the European average for 13 of 16 specific cancer types.
• In a separate NBER study, June and Dave O'Neill found that Canadian survival rates also lag behind the US rates.

Frankly, I'm surprised by these results. The reason: a big factor in cancer care is patients' compliance with their treatment regimens. I would have thought that northern European countries with small, homogeneous populations (and a lot less individualism) would knock the socks off of us. But apparently not.

Don't take too much comfort in these results. There are a lot of health policy wonks (probably most of them) who are still rooting for the other teams - with Michael Moore and Paul Krugman cheering them on.

John Goodman is President of the National Center for Policy Analysis.

For the Lancet Oncology study, go to http://www.thelancet.com/journals. Unfortunately, you must subscribe in order to retrieve the study or pay $30 per article. For June O'Neill and Dave O'Neill's study, go to http://www.nber.org/papers/w13429.pdf. Betsy McCaughey reported on all this in a Wall Street Journal editorial that has been expanded into an NCPA Brief Analysis, which can be found at http://www.ncpa.org/pub/ba/ba596/