I've been struggling with how to handle Health Affairs' new study "Measuring the Health of Nations." It's the sort of report whose conclusions are easy to summarize but whose import is hard to accurately convey. The short version is that our health system is killing people. And not just a couple. Hundreds of thousands. The researchers examined amenable mortality -- "deaths from certain causes that should not occur in the presence of timely and effective health care" -- in a variety of OECD countries. In English, it assessed how effective health systems are at reaching the sick. The conditions under examination are lethal if not treated, but the afflicted can be saved, and even healed, if given timely care. The researchers examined this same group of conditions in 1998. Then, we performed poorly, but not catastrophically so. Our amenable mortality rates were about 8 percent above the average, and 50 percent above the French, but we were not the worst. Comparatively speaking, we were 15th out of 19 assessed countries. Four years later, we were 19th out of 19. Every other country posted significant progress in reducing amenable mortality. Save for us. In 2002-03, for both males and females aged under 75, America had the highest rate of amenable mortality -- which is to say, preventable deaths -- in the OECD. That means we were behind Canada, behind the United Kingdom (whom we'd beaten in 1998), behind France, behind Ireland. And not by a little -- France's preventable death rate was only 58 percent what ours was. Had we achieved the average gains -- not their rates, but simply the improvements -- posted by the other countries, we would have saved 75,000 lives. Had we achieved the gains of the top performers, we would have saved 101,000 lives. Repeat that to yourself: 101,000 lives. That's more than the total population of Boulder, Colorado. Imagine if a weapon had been detonated in Boulder, killing all 91,000 residents. Imagine the outcry, the fury, the rage, the tragedy. Imagine what we, as a nation, would do. How determined we would be to punish those responsible, to ensure this never happened again. It happened. It happened here, without anyone really noticing, while politicians stood on stage and earnestly told us that "we have the best health care in the world."
