Time to move beyond my poverty series. I ended that run by stressing the fact that America’s poor record in addressing economic vulnerability, at least when compared to our peer nations, can partly be explained by explicit national policy failures and outright neglect. That is, other nations that look like us in most important ways have more sensible and compassionate policy regimes. That same insight, assuming it ranks as an insight, might be applied to health care in the U.S.

Let us start with some basic facts. (Note: some numbers vary across reports due to variation in the years used and other technical causes, but the relative positions are unchanged).

The U.S. spends almost $13,000 per year, per person on health care. That comes to some 17.8 percent of our GDP. That is way more than our peer nations spend. Germany, with the next highest outlays, lays out $7,400 per citizen. Canada, our neighbor to the north who share with us much in terms of culture and other external factors, spends $5,900 per Canadien, and like every other advanced nation, covers all of its citizens. Japan, further down the list, lays out only $4,700 per person.

Okay, we spend more than all other countries. But we get more in return … right? In truth, reality could not be further from this seemingly reasonable presumption. Let us start with a global metric … life expectancy. Below, I lay out expenditures as a percent of GDP (Gross Domestic Product) and measured national life expectancy averages:

Nation % GDP. Life Exp.

Germany. 12.8% 83.4 years.

France. 12.4% 85.5. “

Canada. 11.7% 84.7. “

Japan. 11.1% 87.6. “

U. S. 17.8% 79.3. “

Just in case you missed it, we spend way more of our national wealth on health care and still die earlier. One might be tempted to blame issues generally beyond the scope of normal medical interventions (e.g. life style choices). But, even here, the U.S. comes out poorly. The number of annual avoidable deaths (AD per 100,000 persons) suggests a sorry state of affairs in the States:

Nation. Avoidable Deaths

Germany. 195 (per 100,000)

France. 164. ” “

Canada. 171. ” “

Japan. 137. ” “

U.S. 336. ” “

Think about this. Even when normed for population differences, we fail to save twice as many treatable patients in the U.S. as the Canadian system to our north does. And they pay a fraction of what we do in both out of pocket costs (OOP) and in overall costs, at least relative to us. The bottom line is that we are getting the medical shaft. Despite spending outrageous sums, we have fewer docs per 100,000, fewer hospital beds, and longer wait times to see physicians. And God help you if you are one of the 8.6 percent of Americans without any insurance, never mind substandard coverage. Try getting a medical appointment, even in a health care mecca like Madison Wisconsin. It takes forever … even if you have excellent insurance.

This is just my intro teaser to our national health care disgrace. More to come!

Note: A thank you to Mary Rowin for reminding me recently of this issue.