America, Where Even the Desperately Ill Say They're Healthy

The Organisation for Economic Cooperation and Development has released their latest health indicators report, and while you may not find 200 pages of charts and graphs on cross-national health comparisons as fascinating as weirdos like me do, let me just point to a couple of interesting things. Most of the findings will be pretty familiar to people who have followed the health-care issue in the last few years, but there's at least one thing that surprised me, which I'll get to in a minute. First though, I have to point to this graph, which shows just what an outlier the United States is in terms of what we spend on health care and what we get. It shows the relationship between spending and life expectancy:


As you can see, there's a strong relationship between health spending and life expectancy—for everyone except us. Japan, for instance, has a life expectancy of 82.8, compared to our 78.7, despite the fact that they spend less than half as much per capita as we do.

But here's my favorite finding. On most health measures, the United States scores below countries in Scandinavia and Western Europe, winding up around the middle of the OECD pack. Although we have low rates of smoking, for instance, we've got the highest rate of obesity. There are some measures we score better on and some where we score worse, but that's about what it averages. But take a look at this:


That's right: we may not be anywhere close to number one in actual health status, but we're number one in perceived health status. USA! USA!

This obviously has a lot to do with culture. Look at Japan, where only 30 percent of people say they're in good health, compared to almost 90 percent of Americans. In truth, the Japanese are pretty much the healthiest people in the world. They have the longest life expectancy, the lowest rate of heart disease (we come in 22nd on that one), the fifth-lowest rate of cancer mortality (we're tenth), and the third-lowest rate of infant mortality (we're 31st). Yet either they have a different conception of what "healthy" means than we do, or they're a nation of pessimists. Here in America, on the other hand, when you ask even the morbidly obese diabetic how his health is, he says, "I'm doing great!"

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