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The American Health Care Disadvantage

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Ben Pierce,  professor of biology at Southwestern and organizer of Southwestern’s 36th annual Brown Symposium, shares some of what he has learned about the American health care system

The ongoing national controversy and angst surrounding health care insurance for Americans has obscured an important fact about our health care: Americans pay more and yet get lower-quality health care than many other people in the world.

In 2010, the United States spent $2.6 trillion on health care − an average of more than $8,000 per year for every man, women and child. This is much more than any other country pays for its health care. People in many other developed countries − countries comparable to the United States in standard of living, education and technology − pay only about half of what we spend in America. Austria, Belgium, Canada, Denmark, Finland, France, Germany, Iceland, Ireland, New Zealand, Sweden and the United Kingdom spend less than $4,500 per person on health care. 

Some argue that our extravagant spending is reasonable, given that we have the best health care in the world. Unfortunately, facts do not support this argument.

In 2013, the U.S. National Research Council and the U.S. Institute of Medicine published a study that compared health care outcomes in the United States with those of peer countries. The title of this report, “U.S. Health in International Perspective: Shorter Lives, Poorer Health,” succinctly summarizes the findings: in spite of spending far more on health care, Americans live shorter lives in poorer health. 

For example, among the 17 peer nations, the United States ranked 16 in mortality rates from noninfectious diseases. The United States was at the bottom of the list for infant mortality, with 6.7 deaths per 1,000 live births, compared to less than 4 deaths per 1,000 births in Sweden, Japan, Portugal, Italy, France and 11 other peer nations. Americans had higher death rates from cardiovascular disease, infections, respiratory disease, diabetes, injuries, and many more medical conditions. Patients in the United States are slightly better off in terms of cancer, but for virtually every other condition, we are more likely to die than people in comparable countries.

Why does medical care in America cost so much and deliver so poorly? Unfortunately, there is no simple answer. Researchers have examined many potential factors, including our fragmented health care system, the large number of uninsured Americans, income inequality, lawsuits, rates of smoking and drinking, and others. While all of these may contribute to the problem, none alone explains the American disadvantage in health care. Even affluent Americans with apparently healthy lifestyles often experience poorer health than those in other peer nations. 

National health care is a highly complex phenomenon, influenced by numerous social, economic and political factors. Educating ourselves about these issues is one way to improve our personal and national health.

An opportunity for such education will occur Feb. 6-7, when Southwestern University in Georgetown hosts a two-day symposium titled “Healing: The Art and Science of Medicine.” The symposium, which is free and open to the public, will bring to Central Texas six nationally known speakers and an artist who will examine the scientific foundations and human dimensions of healing and how they influence the practice of medicine in the 21st century. Details on the symposium are available at www.southwestern.edu/brownxxxvi.