HEALTH CARE TRAVELOGUES? I'm not sure I share Kevin's lament about how little in-depth reporting there is on other country's health systems. Part of the reason is that you can't do much besides cherrypick data when offering these articles. Comparing across populations can be something of an apples-to-oranges problem, with the health characteristics, lifestyle imputs, and cultural factors making straight comparison of outcomes somewhat useless. So I can tell you, for instance, that we know "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," but I'm not really sure where it gets us, save away from the absurd idea that our health system is somehow obviously superior. Furthermore, it's hard to take some of the problems of other systems seriously when we spend twice as much as they do. If France wants to blow a couple thousand more per person, they could buy more CT scanners. This is a long way of teasing an upcoming article of mine, which examines five other health systems and tries to extract structural takeaways from them. In other words, what do they do right that we could easily replicate, or what principles within their system's could be applied with relative confidence to our country. Vis-a-vis the actual question at hand here, which is how to reform our system, I think that approach is more useful than simply examining other countries, which, in my experience, tends to obscure as much as it illuminates. --Ezra Klein
