Lessons for Health Care Could Be Found Abroad

The U.S. health care system is among the best in the world. It has achieved a 5-year breast cancer survival rate that is at least a few percentage points higher than that in almost all other industrialized countries, the highest rate of screening for cervical cancer, better hypertension control, and a sharply reduced smoking rate. Patients rarely have to wait long for needed procedures and medicines. Physicians receive intensive training and keep current with continuous education. Hospitals are well-equipped and fully staffed to meet health needs. This country also spends more on health care than any other country in the world. But contrary to popular belief, the health care here isn't always the best. Many other industrialized countries provide health care that is just as good and sometimes better. For instance, 30-day acute myocardial infarction case-fatality rates are below 7% in Denmark, Iceland, and Switzerland, compared with almost 15% in the United States. Incidence of major amputations among diabetic patients in Finland, Australia, and Canada is less than 10 per 10 000 compared with 56 per 10 000 in the United States. And Australia, Canada, England, and New Zealand all have a better 5-year kidney transplantation survival rate than the United States.

No one country's health care system is necessarily better or worse across all measures of success, and research has shown that quality does not necessarily vary with financing mechanisms or with the amount spent on health care; this suggests that the United States and other industrialized countries could learn from one another. “There obviously are many opportunities for all of us to learn from each other in implementing health policies effectively. We are all facing the same kinds of challenges. We are dealing with them in different ways and that creates opportunities for learning,” said Mark McClellan, MD, the former …