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Posted at 7:15 PM ET, 08/25/2008

U.S. Health Care Lags Despite Highest Spending

By Paul Volpe

The Fact Checker is away. In the interim, we bring you the best of PolitiFact, a fact-checking project from the St. Petersburg Times and Congressional Quarterly.

The Statement

Politifact

We spend more on health care than any other country, but we're ranked 47th in life expectancy and 43rd in child mortality.

-- The Democratic National Committee on Wednesday, August 13th, 2008 in the Democratic Party platform

It is a common refrain among politicians lamenting the state of America's health care system: spending more on health care doesn't necessarily make the United States a healthier country.

Rating: Mostly True

That's a theme repeated in the report accompanying the Democratic Party's convention platform. It claims, "We spend more on health care than any other country, but we're ranked 47th in life expectancy and 43rd in child mortality."

The first part of the statement is certainly true. The United States has spent more per capita on health care than any other country for decades, and its spending has grown faster, according to the Kaiser Family Foundation.

A recent Kaiser Family Foundation analysis shows that in the most recent figures available, U.S. spending on health care per capita was $5,711 in 2003. The second-place finisher, Luxembourg spends $4,611.

As for life expectancy and child mortality, the Democratic National Committee couldn't provide the source for the platform committee's statistics. But the numbers do match Census Bureau statistics that are used in the CIA's 2008 World Factbook, which shows the United States ranks 47th in life expectancy and 43rd in child mortality.

You might see different rankings depending on where you look. The United States scores better in lists compiled by the World Health Organization or the United Nations.

That's because each of these organizations ranks countries differently. The U.S. Census Bureau includes many more places in its rankings, such as tiny territories and small chunks of countries, as the Wall Street Journal's "The Numbers Guy" blog has pointed out.

Still, no matter whose list you check, there's no denying that the United States' infant mortality rate is higher than other large industrialized countries such as the United Kingdom, Australia, Germany and Japan. And this is true despite the United States being the world leader in spending. We give the Democratic platform committee a True.

By Paul Volpe  | August 25, 2008; 7:15 PM ET
 
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Comments

Welcome back!! One thing to keep in mind about health care statistics is that we are usually comparing apples and oranges:

http://www.dailykos.com/story/2008/7/21/93949/9072/752/554524

Posted by: JakeD | August 25, 2008 7:49 PM | Report abuse

Too bad that Michael Dobbs is not in, because he would do a much better analysis.

Posted by: JakeD | August 25, 2008 7:51 PM | Report abuse

From the wikipedia page on infant mortality: "The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates."

--------------------

So why is our infant mortality rate higher? Because we hold ourselves to a higher standard than the rest of the world.

Posted by: Bob | August 25, 2008 10:07 PM | Report abuse

A "true?" You mean a Gepetto. It's like you haven't read this blog.

Posted by: Steve Charb | August 26, 2008 3:24 AM | Report abuse

Google this for a good explanation of where the US spends more to get same or less outcome.

"McKinsey Global Institute" health care world comparison

The WHO and UN use the same definition as CDC. Thus an apples to apples comparison is available.

Wikipedia may not be the best source of info on this topic as there seems to be a concerted right-wing effort to discredit these statistics. Claiming different definitions as some commentors can muddy the waters and allow option to substitute for facts.

Posted by: No Lying | August 26, 2008 8:46 AM | Report abuse

I just Googled and found the same info re: Germany / France. How about you refute that apples to oranges comparison?

Posted by: JakeD | August 26, 2008 11:06 AM | Report abuse

My wife is a caterer and she can tell you why health care is so expensive (besides the enormous fees doctors have to pay for malpractice insurance thanks to guys like John Edwards)

$15,000 birthday parties for their 5-year old spoiled brats
6 fancy european sports cars in their garages
on and on....

I know I shouldn't knock "having things", but when a guy works hard all his life and then loses everything because he gets ill and virtually becomes enslaved to the medical profession for the rest of his life then something is wrong.

My question is this: How many pairs of shoes does someone have to own?

How many Ferrari's do you need in your garage, are two enough?

It's immoral.

Posted by: JR | August 26, 2008 1:13 PM | Report abuse

Jake, you're a republican. When reality doesn't support you, just go ahead and attack reality, because whatever you do you will never admit you were wrong or you failed.
Infant mortality is higher and life expectancy is lower in the United States than any other large industrialized nation, even if we let you parse the data, it doesn't change that fact. We also pay more for the substandard care than any other country. If you can't see something wrong with that, then you MUST be a Republican, which is just a way to say you are part of the problem, not part of the solution.

Posted by: dijetlo | August 26, 2008 7:26 PM | Report abuse

JR:

"Their" brats, meaning doctors? Maybe they are just trying to make up time they never get to spend with their kids / spouses? It's quite a sacrifice to become a doctor, and not all of them have three or more Ferraris. May I suggest your wife's statistical sample is off, especially if she is a high-end caterer? Besides, doesn't this prove "trickle down" economics? Your answer is taking away every financial incentive to being a doctor?

dijetlo:

I am a registered Independent. Please address the "reality" of Swiss statistics not including babies as "live births" unless they are over 30 cm.

Posted by: JakeD | August 27, 2008 7:39 AM | Report abuse

Lies, damn lies, and statistics. Please address the standard for live birth and equalize the comparison. If the author will not address, then I have no choice but to discount the information.

Posted by: jdw | August 27, 2008 11:35 AM | Report abuse

Just for the sake of convenience, let's set aside the figures for infant mortality for a moment. I think the definition of death is fairly common among all countries and cultures, so let's focus on life expectancy.

The United States spends the most of any industrialized country for the least result in terms of life expectancy; and life expectancy is a generally accepted indicator of the overall efficacy of a health system. So our current health care system is clearly substandard compared to our peers (for the population as a whole -- the subset of rich Americans probably fares quite well compared to their international peers, though still at a higher cost).

You can quibble about the infant mortality numbers, but the basic point is indisputable. Well, "by someone of good faith" I should add, there's always someone willing to dispute the indisputable and defend the indefensible, especially on the WaPo boards.

JakeD claims to be a single-issue voter. Anti-abortion, that's it. All his other moral standards are quite flexible; once the unwanted children are born, he's done with them. So, despite his nominal status as an "Independent" he's actually quite in thrall to a single party, you are correct, dijetlo.

Posted by: drossless | August 27, 2008 12:48 PM | Report abuse

drossless,

The basic point is very disputable until someone puts up some numbers with a clear provenance.

Also, what are we spending the money on? Are cosmetic procedures accounted for? Are spending amounts aligned to GDP?

I get very leery when I am told 'clearly' and 'indisputable' when the facts are not all present. I don't know if our health care is better than, say, France, or if some facets are better here than there. I would like to know, and by what margin, as that would be a consideration.

Posted by: jdwill | August 27, 2008 1:55 PM | Report abuse

I'm happy to see dobbs gone. I appreciate this editorial decision from the WP.

@JakeD

The Daily Kos article you site actually says that the belief that we use the same statistical methodologies as other countries. It says your claim to the contrary is a myth.

I'm confused as to why you would site as evidence an article that disagrees with your claims. Perhaps you don't read so well?

From the DailyKos article you cite:
"we're supposedly counting micropreemies that aren't even considered live births in other countries. It's a persistent rumor, but it's demonstrably false."

Thanks for refuting your own claim JakeD! You make the job of the rational peeps around here a lot easier.

Posted by: fact wrecker | August 27, 2008 5:22 PM | Report abuse

typo is previous post.
remove "the belief that" from sentence two of the post. The sentence should read:

The Daily Kos article you site actually says that we use the same statistical methodologies as other countries.

Posted by: fact wrecker | August 27, 2008 5:25 PM | Report abuse

You all kinda missed the point. I think here and at the convention, the fact is America as a whole should be getting more for what we are expected to pay.
Im not totally on board with government annexed health care , seems a little too communistic for me, but on the other hand, if the Gov. doesnt step in , we all will be working second jobs just to afford health care.And its not just the charges we see on our insurance statement, or if we have a office visit and get a bill for that. Im talking about the out of control charges the health care industry are holding america hostage with.Not to mention the institutionally exaggerated billing that is litterally stealing from our government, and no one mentions a word about it.
the free industry of health care has gotten out of control, with hospitals being owned by insurers, how can there be objective comparison, and non competitive billing.They basicall write the values of a service, bill themselves, and then charge the government again for it, if your talking Medicare, Medicaid or Soc disability.
Im not sure how widespread the VA billing spreads around this country, but the antics ive seen with my own two eyes, doctors sending a pedapalegic man of 20 years to a neurologist, and physical therapy??and i bet the government pays twice for that.
Our health care system(quite a funny name for a Profitable entity)has been broken for years, and needs a serious enema to get it back on track.

Posted by: bill | August 27, 2008 11:53 PM | Report abuse

@jdwill,

As I said, there's always someone to quibble. If a Democrat said the sky is blue, someone would be complaining about how sometimes it is actually white, gray, red, or even purple, and denouncing Democrats' nefarious and self-serving deceptions and the statistics that support them.

So sure: all health statistics are suspect and we actually know nothing about our health and how it compares to other countries. I'm sure your motivation for arguing that has nothing to do with how unflattering such a comparison turns out. And in any case, it appears that you take comfort in that fact that we have better "facets" of health care here, like cosmetic surgery, whatever our unknowable life expectancy or infant mortality rates may be.

Posted by: drossless | August 28, 2008 1:01 AM | Report abuse

@drossless

You completely missed my points.
- I would like to know real facts, not statistically faulty comparisons.
- If France is better at health care, I will be among the first to lobby for us to catch up.
- If we spend more that others because of more elective things like cosmetic surgery, lets take that out of the equation for comparing more fundamental care.
- GDP matters because we want to know what percentage of income is spent, not absolute amounts.

As for the Dems and the color of the sky, you are having a conversation with yourself. I have no dog in that fight.

I am very concerned about health care in the US and would like to see it improve. But you can't fix something if you can't measure it, and so better numbers is what I am after.

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Posted by: liza | August 28, 2008 5:16 PM | Report abuse

>>I am a registered Independent.
Sure, if you say so...you still sound like a Republican though.

>> Please address the "reality" of Swiss statistics not including babies as "live births" unless they are over 30 cm.Posted by: JakeD | August 27, 2008 7:39 AM

Peanut, did anybody compare our mortality rates to Switzerland?
Are you reading the same posts the rest of us are looking at?
I think you were told, and it was demonstrated, we trail every other large industrialized country.
Not Switzerland.
Now, since you're the expert on Switzerland, how many births resulted in infants of less than 11 inches in length.
Then you'd have to be able to tell me how many infants born at less then 11 inches in length in the US survived, how many were live births and died, how many were classified as still born.
With that data, you could actually determine the variance in the two data sets.
None of that in necessary, however. Drossless makes the excellent point that though you are trying to make a distinction without a difference in regards to what constitutes a live birth vs a still born birth, we can more easily look at death rates (which are less susceptible to partisan parsing) and see that the statistics don't support you there either.
I haven't seen you respond to that point and honestly doubt I will.

Posted by: dijetlo | August 28, 2008 9:31 PM | Report abuse

Check out Australia's system. Like Canada we have Universal Medicare. All taxpayers pay a medicare levy. All emergency care is free. Yes free. This and we have private medical insurance. So you have choice. At the higher end. Not at the basic level where all need the help. We also have something called the Pharmaceutical Benefits Scheme. The Drug Companies hate it. It keeps the prices of medication down. This is a recognition that in some areas the market needs regulation. In exactly the same way that banks are regulated so there is money in them when you go to get your money out.

Posted by: Scott of Sydney, Australia | August 29, 2008 9:12 AM | Report abuse

LaRouche Outlines Organizational Policy Now!--08/29/08--LaRouche issued...."The nomination of Senator Barack Obama, as combined with the prospect of the nomination of Senator John McCain, has settled almost nothing other than the fact of those nominations themselves. The world as a whole is presently gripped by a growing potential for a genuine thermonuclear-weapons crisis like never before and the greatest financial-economic crisis since Europe's 14th Century has the entire world presently in its grip--whether some governments and leading political figures wish to recognize that reality, or not.--"The present international financial system is hopelessly bankrupt, and could not be saved. It could only be reorganized in a bankrutpcy designed to defend people, not financial speculators.--"Neither of the two candidates has any present capability for successfully meeting the grave challenges of economic breakdowns of entire economies, and threats of nuclear exchanges, which must be expected as serious possibilities between now and November.--
"As recent patterns of developments have already shown, we have an intellectual capability of unique importance in this process. Our most prominent role, as through the work of LPAC, is to provide the intellectual leadership on crucial economic and other strategic issues which neither of those candidacies is presently equipped to deal competently without outside advice, including that provided by our initiatives.--"Therefore, our LPAC campaign has far greater importance for the weeks immediately ahead, than at any time prior to this point. We shall therefore mobilize accordingly.''

Posted by: Anonymous | August 29, 2008 10:57 PM | Report abuse

The US health care system is designed to line the pockets of medical practitioners, drug companies, insurance companies, and the government. It has very little to do with helping people. This is why the US has an average life expectancy among industrialized nations while spending a disproportionate amount of national income on health care.

Posted by: J | August 30, 2008 9:17 PM | Report abuse

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Posted by: kvobc5e0hm | August 31, 2008 1:32 AM | Report abuse

Until a few weeks ago I only had knowledge of the health care systems of the United States and Canada. I always felt that universal health care was not really an option due to high cost and comparitively low quality of care. I recently read some information on the National Public Radio (NPR) website that has drastically changed my perception of what is possible.

If I had to summarize the data from NPR I would say that France, Germany, Great Britain, Japan, Netherlands, and Switzerland have found a way to provide better overall health care than the United States for all citizends and LEGAL residents for significantly less money. There are pros and cons to each country's system, but I think we in the US can learn a lot from them.

A quick international health care comparison tool:
http://www.npr.org/news/specials/healthcare/healthcare_profiles.html

Additional information from NPR:
http://www.npr.org/templates/story/story.php?storyId=91972152

Health spending as part of GDP:
France: 11.1%
Germany: 10.7%
Great Britain: 8.3%
Japan: 8%
Netherlands: 9.2%
Switzerland: 11.6%
United States: 15.3%, lowest life expectancy of the group

I am for implementing universal health care coverage, regulating the industry, spending less money, living longer.

Posted by: Jonathan from TN | August 31, 2008 2:20 PM | Report abuse

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Posted by: Test | August 31, 2008 2:23 PM | Report abuse

one thing that is BLATANTLY being overlooked with these statistics...are we American's HEALTHIER than the rest of these "industrialized nations"? NO!! WE ARE FATTER AND LAZIER THAN IN HISTORY! In 1900 the average lifespan in America was 47. Today it is, according to the latest CDC numbers have the US life expectancy longer than ever at 77.6 Again, I ask? Is it because we are eating better and getting more exercise? NO! We are the fattest, laziest nation on the planet. For you who want to BLAST the medical community AND the pharmaceutical industry? You need to be THANKING them for keeping your lazy, overweight butt alive! I, for one, DO NOT want to pay for someone else to have medical care! It's called "death by fork"! I work out, eat right and take care of myself...why? because it's called PERSONAL RESPONSIBILITY...and for you that are going to blast me for hereditary conditions...I get it! My son has epilepsy and my mother has Alzheimer's Disease...I pay for ALL of my son's health care needs and I am a single mom. Again, it's called PERSONAL RESPONSIBILITY! I don't have a huge house, a new car or a 57' plasma TV on my wall...I BUDGET my money and (like my grandmother taught me) I save for "a rainy day"...

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Posted by: arni | September 1, 2008 6:07 PM | Report abuse

Above, we see a perfect example of someone who won't let facts stand in the way of their opinions. Statistics on exercise, and obesity is similar for all western countries. What is different is our reliance on a private system of health services delivery, with little or no governmental regulations. Part of the profits generated by this system is spent on lobbying politicians and spreading false information to the public about single point, regulated means of paying for health care delivery. Not to worry, though, there is plenty of money left to support the corporate executives in the style to which they are accustomed.

Posted by: Bob | September 3, 2008 12:22 AM | Report abuse

Above, we see a perfect example of someone who won't let facts stand in the way of their opinions. Statistics on exercise, and obesity is similar for all western countries. What is different is our reliance on a private system of health services delivery, with little or no governmental regulations. Part of the profits generated by this system is spent on lobbying politicians and spreading false information to the public about single point, regulated means of paying for health care delivery. Not to worry, though, there is plenty of money left to support the corporate executives in the style to which they are accustomed.

Posted by: Bob | September 3, 2008 12:24 AM | Report abuse

REPUBLICANS SAY THAT EVERYTHING IS WONDERFUL. NOT HAVING HEALTH CARE IS OKAY. THE PEOPLE IN IRAQ ARE MORE IMPORTANT THAN THE PEOPLE ON THE GULF COAST

Posted by: DM | September 3, 2008 9:50 AM | Report abuse

...when a guy works hard all his life and then loses everything because he gets ill and virtually becomes enslaved to the medical profession for the rest of his life then something is wrong...

Posted by: JR | August 26, 2008 1:13 PM

-------------------------------

I think, the anti-Health Care advocates would simply say, "Well, that's your own fault for wanting to stay alive."

Obama '08

Posted by: wolf | September 3, 2008 12:37 PM | Report abuse

Bob,
You're confused. The United States employs a lower standard than most other industrialized countries. We count any baby showing any sign of life whatsoever as a live birth. Even so, we have more dead babies than 46 other industrialized countries.

Posted by: Sharon Avery-Fahlstrom | September 3, 2008 5:20 PM | Report abuse

I am a low-middle class American living from paycheck to paycheck. Healthcare is expensive but worth it. I was recently bitten by a snake, really, a snake. The medical cost alone...hospital stay, anti-venom...etc, cost nearly $10,000.00 Well, not many of us can afford that type of bill, but the medical care I recieved saved my life. I may put 30% of my paycheck into my PPO, but it is worth it. I think we need to stop asking for handouts in this country. Yes, A national health care plan sounds great, but I recently worked alongside a doctor from Japan who said that America is the envy of the world when it comes to health care. Do we really want our government running our health care plans? Think again, it doesn't matter what % of the GDP we use to pay for a plan; it will raise our taxes or send us to recession. We are the biggest whinners on earth, we all feel like we are victims because we picked a career field that under appreciates our efforts, we buy big cars that consume fuel, we would rather remodel our oversized homes and spend money on everything else but health care...its no wonder we are such a unhealthy nation.

Posted by: HouseCall | September 9, 2008 7:57 PM | Report abuse

From the wikipedia page on infant mortality: "The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates."

--------------------

So why is our infant mortality rate higher? Because we hold ourselves to a higher standard than the rest of the world.

Posted by: Bob | August 25, 2008 10:07 PM
***************************************
Drivel.

We also have far more hospital infections and significantly lower life expectancy for both sexes.

Is our lower life expectancy because we consider patients dead at a point when other countries would consider them still alive? That is the upshots of this ridiculous argument.

Posted by: Anonymous | September 9, 2008 10:47 PM | Report abuse

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