Those Misleading World Health Rankings – Pacific Research Institute

Those Misleading World Health Rankings

The federally chartered Institute of Medicine issued a comprehensive report last month on the state of American health. Saying that “Other high-income countries outrank the United States on most measures of health,” the report concluded that the U.S. “is among the wealthiest nations in the world, but it is far from the healthiest.”

To fix this state of affairs, the authors called on America’s leaders to consider “policies that countries with superior health status have found useful and that might be adapted for the United States.” But the institute’s report doesn’t tell the whole story. Its key measurements aren’t directly related to the quality of American health care. In truth, health care in the U.S. continues to be the envy of the world.

The study looked at 13 developed countries in Europe, along with Australia, Japan, Canada and the U.S. It found that Americans suffer from higher rates of several diseases—including HIV/AIDS, heart disease and diabetes—and rank near the bottom in some common measurements of public health. Consider life expectancy. The U.S. was ranked last for men—with an average 75.64 years, compared with 79.33 in top-ranked Switzerland—and second-to-last for women—at 80.68 years, compared with 85.98 in top-ranked Japan.

Lower life expectancy is less than ideal, but it’s also not a good measure of a country’s health care. In fact, the study’s lead author, Virginia Commonwealth University Family Medicine Professor Steven Woolf, recently told reporters that life expectancy and other noted health outcomes are determined “by much more than health care.” He added: “Much of our health disadvantage comes from factors outside of the clinical system and outside of what doctors and hospitals can do.” For instance, a comparatively high rate of fatal car accidents and murders in the U.S. diminishes overall life expectancy.

Another major gauge of health is infant mortality. As the report’s authors point out, the U.S. has the highest infant-mortality rate among high-income countries. Again, this isn’t a good indicator of the quality of the American health-care system. The elevated U.S. rate is a function of both the technological advancement of American hospitals and discrepancies in how different countries define a live birth.

Doctors in the U.S. are much more aggressive than foreign counterparts about trying to save premature babies. Thousands of babies that would have been declared stillborn in other countries and never given a chance at life are saved in the U.S. As a result, the percentage of preterm births in America is exceptionally high—65% higher than in Britain, and about double the rates in Finland and Greece.

Unfortunately, some of the premature babies that American hospitals try to save don’t make it. Their deaths inflate the overall infant mortality rate. But most premature babies are saved, largely because America’s medical research community is exceptionally innovative. There’s a laundry list of modern medical advancements used to treat a premature baby: suction devices to clear the baby’s mouth and lungs of amniotic fluid, miniature catheters to deliver vital fluids and medications, and emergency incubators equipped with sophisticated temperature-regulation technologies.

Thanks to such technologies, the U.S. neonatal mortality rate has dropped to just 5% today from 95% in the 1960s. The Institute of Medicine report ignores one of America’s chief health-care assets: the country’s superiority in medical innovation.

American researchers are responsible for a disproportionate number of breakthrough medicines and procedures. Scientific research conducted in the U.S. contributed to at least 20 of the top 27 diagnostic and therapeutic advances of the last 40 years, according to a 2009 study for the Cato Institute by economist Glen Whitman and physician Raymond Raad. The European Union and Switzerland contributed to just 14 of those breakthroughs.

This American strength may soon be diminished by ObamaCare. The law saddles the pharmaceutical industry with $28 billion in new taxes through 2019. As of Jan. 1, medical-device firms must pay a 2.3% tax on sales. The tax is projected to extract as much as $29 billion over 10 years.

That is money that can’t go to research and development. Several top device firms, including Stryker, Zimmer, Welch-Allen and Covidian, have already announced cutbacks in research investments.

Make no mistake—there is plenty of work to be done in improving American health. But the statistics in the Institute of Medicine report don’t reflect flaws in the U.S. health-care system. Sustaining a superior level of medical innovation will do far more to improve Americans’ health than adopting the health-care policies from overseas.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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