Wednesday, June 21, 2000

U.S. ranks 37th in health care

We spend the most, WHO reports, but France, Italy tops in quality

By Lauran Neergaard
The Associated Press

        WASHINGTON — The United States spends more per person on health care than any other country, yet in overall quality its care ranks 37th in the world, says a World Health Organization analysis. It concluded that France provides the globe's best health care.

        Italy ranked No. 2, says the World Health Report, being published today — a highly contentious first attempt to compare world health systems.

The complete list of 191 countries ranked by the World Health Organization.
        Tiny countries with few patients to care for — San Marino, Andorra, Malta — are on the organization's surprising best list. Singapore, Spain, Oman, Austria and Japan round out the top 10.

        That doesn't mean the French and Italians are the world's healthiest people. Japan actually won that distinction.

        Instead, the WHO report basically measures bang for the buck: comparing a population's health with how effectively governments spend their money on health, how well the public health system prevents illness instead of just treating it and how fairly the poor, minorities and other special populations are treated.

        When each country's measurements were added together, even study co-author Dr. Christopher Murray, a Harvard health economist and the health organization's chief of health policy evidence, was surprised. He had expected Scandinavian countries or Canada to be the world's best, because they're always presented as models.

        Instead, Norway hit No. 11, Canada 30.

        Britain, with its much-debated free national health service, came in 18th.

        While good at expensive, heroic care, Americans are very poor at low-cost preventive care that keeps Europeans healthy, said Princeton University health economist Uwe Reinhardt.


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