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This paper compares U.S. values for 23 health variables with the median values of 33 other OECD (Organization for Economic Cooperation and Development) countries. For an additional 11 health variables only relative U.S.-OECD comparisons are reported because median values for the OECD countries could not be reliably determined.
The most important differences are much higher spending in the U.S., a smaller share publicly financed, and a different mix of care: the U.S. emphasizes more high tech services more readily available, and more amenities in hospitals and clinics. The OECD countries have more physicians and acute care hospital beds. The U.S. has lower life expectancy, attributable to excess mortality under age 70. Cigarette smoking is less prevalent in the U.S., but obesity is more prevalent.
Possible explanations for these differences are explored under three categories: distrust of government, resistance to redistribution, and political factors including the greater influence of “special interests” in the U.S. political system and the absence of a significant Socialist or Labor party.
The paper concludes that achievement of cost control and universal coverage in the U.S. will require a reform that takes into account America’s unique history, culture, and political system.