On the Critical List: The US Institution of Medicine
United States’ medicine, once regarded as the best in the world, is in a sorry state of health. The US ranks lowest on almost every dimension of health system performance relative to other major westernized nations.(1) It not only lags well behind Japan, Western Europe, and Australasia – it even falls behind Poland, the Czech Republic, and Slovakia.(2) Twice as many Americans die before the age of 60, as compared with Europeans3; infant mortality in the US is double that of many countries in Europe, and life expectancy at birth is lower(3); Japan has over 3 times as many acute care hospital beds,(4) and Greece has over twice as many doctors.(4) America has a health care system that is, frankly, third-rate.
To add insult to injury, the US has by far the most expensive health care system in the world. We spend $7,290 per capita on health care annually, more than double the Organisation for Economic Co-operation and Development average. The UK by contrast spends $2,992 and ranks second in international comparisons.(1)
To explain why we have the most expensive health care system in the world and yet one of the lowest performing, we need to take a perspective that focuses on the US institution of medicine as a whole. We expose the hidden rules by which this institution operates and discuss how its powerful organizations shape, control and perpetuate this ailing system.
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— Salinder Supri, PhD, Karen Malone, MA (Distinction)
This article originally appeared in the March 2011 issue of The American Journal of Medicine.
