If we’re so rich, why so afflicted?


As a story in Sunday’s paper revealed, Americans spend nearly twice as much as other industrialized countries on health care but, in some cases, we are only half as healthy.

Go down the list: diabetes, hypertension, heart disease, myocardial infarction, stroke, lung disease and cancer. In each case, the study found, Americans had higher rates than a similar population of British citizens between 55 and 64 years of age.

And the disparity seems likely to worsen. Another study last week found that 2.8 million U.S. children run the risk of type 2 diabetes, what used to be called adult-onset diabetes because it was so rare among children.

“Everybody should be discussing it,” says Dr. Michael Marmot: “Why isn’t the richest country in the world the healthiest country?” Marmot is an epidemiologist at University College London, England.

The United States spends about $5,200 per person on health care. England, even with its oft-ridiculed government health care system, spends about half of that per capita.

Critics of public health care have long argued that “socialized medicine” merely results in long waits for equipment, services and tests that are more readily available in the U.S.

Why then isn’t that reflected in what really matters: outcomes? In practically all categories, the British subjects were healthier than their American counterparts.

Critics have also argued that the health of the U.S. population appears worse because of the large number of poor and minority populations here. However, this recent study compared apples to apples – test subjects in both countries were all white and of similar income levels.

Still, Americans fared worse.

Of course, the results can also be turned on their head. In other words, perhaps we pay so much for health care because we are so much sicker.

But, again, why?

Each expert quoted in the story had a favorite theory. One said we drive more and exercise less. Another said there is simply more stress in our workplaces and economic lives. Still another said it could be because we tend to be more socially isolated in large anonymous suburbs.

Of course, none of those reasons has anything to do with doctors and hospitals. They are simply left trying to fix the damage we do to ourselves.

Clearly, the study raises a crucial question for the U.S. Not only is medical care a huge and growing burden on businesses, individuals and the U.S. government, but sick people are less productive and less satisfied with their lives.

Several times in our history, nonpartisan presidential commissions have been appointed to study major issues and propose solutions. President George Bush should do so again.

The central question would be the same one asked by Dr. Marmot: If we are so rich, why are we so unhealthy?

The question is simple. The answer is not.