Dr. Jacqueline Gerhart: Is the U.S. Really Sicker Than Other Countries?
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Dr. Gerhart: I read a report on CNN's website last week that Americans are sicker and die younger than people in other countries. On what is that based?
Dear Reader: Yikes! Anyone who can respond to this question with a universally accepted answer should go into health care reform and health care politics. Thousands of jobs and careers focus on understanding the successes and failures of our health care system. Let me give a broad overview.
The report you are referring to is titled "U.S. Health in International Perspective: Shorter Lives, Poorer Health" and was released by the Institute of Medicine and the National Research Council on Jan. 9.
Key points are:
- Twenty-seven other countries a have longer average life expectancy than the U.S.
- We are at the top of the rankings in cancer survival, low blood pressure, low cholesterol and low rates of smoking.
- We are worse than other countries at obesity, disabilities, infant mortality, drug-related deaths and homicides.
Much of the published report simply reconfirms data from the 1980s. The idea that our country's health care doesn't "measure up" to our peers is not new. Compared to other "rich nations," our country has higher rates of AIDS, cardiac death and early childhood mortality. And we continue to make poor health decisions, as shown by increases in heavy drinking and obesity.
As a result of the report, the National Institutes of Health will be conducting research into the successes of the other countries and how they can be applied here in America. Some identified successes in other countries include easy access to preventive medicine, low-cost care and education on healthy lifestyles.
Improving health care while driving down costs is very difficult. Doctors, insurance companies, pharmaceuticals, hospitals and even patients themselves all tend to drive up costs.
For example, I've had a patient literally ask me for "the Cadillac package." In other words, he wanted me to order every lab test and MRI that I could to ensure he is "healthy."
But in ordering hundreds of tests, a few are bound to come back slightly abnormal - which then can lead to further testing and higher costs. It is our job as health care providers to help guide patients to make appropriate health care decisions regarding testing and frequency of testing. And it is also our job to do so in a cost-effective manner without compromising care.
Lack of access to affordable health care and insurance aren't the only things making our country sick. In fact, the NIH study shows that even insured, college-educated Americans with primary care access have poorer health outcomes than their European peers.
So, stay tuned. Much like the fiscal cliff, our health care is heading toward it's own cliff edge. But instead of a "New Year's deadline," the deadline is our own lives. Further investigation, and action are needed.
Thanks for the question. Despite its political and societal undertones, I did feel it was important to publish. This column is not written with any specific political leanings.
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 01/22/2013