A healthy investment

National Review, Jan 26, 2004 by Tom Adelson

The United States spends more per capita on medical care than any other industrialized nation. We spend two and a half times more than Great Britain; and we spend 13 percent of our GDP on health care, compared with the 8 percent spent by European countries--all for roughly the same amount of physician care and hospital services. American spending on drugs? $556 per person, versus $262 in Europe. Yet we still rank 19th or 20th in overall health: We die younger; we are sicker here than in our peer countries; our infant-mortality rate is 50 percent higher.

Given the far greater impact of public-health spending overseas, I wonder where the evidence is behind Stephen Moore's attack on Uncle Sam ("The Week," Dec. 31). It's not from Medicare--this federally funded, completely portable insurance plan spends 98 cents of every dollar on medical care compared with the 80 cents that commercial health plans spend (that's $55 billion plus in extra administration costs). Nor is it from Medicaid, which, despite insuring the sickest population, has experienced similar and perhaps lower annual inflation rates than commercial plans.

And were the 1940s an Elysian period for health care, as Moore's article suggests? True, the United States has invested heavily in public health since then, building more hospitals, producing the best-trained doctors in the world, developing new drugs, sanitizing and fluoridating water, and instituting immunization programs. Was there something wrong in that? Of course not--we have results. We've eradicated polio and smallpox. We rarely die from pneumonia or the flu. Crude surgical practices have advanced such that appendicitis need not kill us. Cancer is no longer a death sentence. We now live 30 years longer.

I think we can allow the government, then, to share some credit for our successes.

Tom Adelson

Oklahoma Secretary of Health

Oklahoma City, Okla.