I’ve seen this statistic trotted out a lot (that the US has the best cancer survival rate), and I knew there was something wrong with using that to describe the proficiency of an entire health care system, but I guess I never really thought it through until now.

The problem is that it describes how well a system cares for sick people. I know, I know, that’s what health care is about, right? Well, no. That’s “sick care”, as some people aptly call it. It means that while you’re healthy you get nothing, and when you become sick enough to require emergency treatment you get it. If you have insurance, your story ends there. If not, and you survive, you’re bankrupt and likely in debt for the rest of your life.

That’s the difference between health care and sick care. In sick care I don’t doubt that we’re NUMBER ONE! But when you look at health care metrics, it’s not so rosy. I took the liberty of looking up some health care metrics from the World Health Organization and chose a subset of countries to avoid having to crunch too much data. I basically chose all the countries I could think of that you would expect to have a good health care system: Australia, Austria, Canada, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Japan, Netherlands, Poland, Portugal, Spain, Sweden, Switzerland, United Kingdom, United States. Let’s take a look at how the US fares:

• Life expectancy: Last
• Healthy life expectancy: Tied for last with Denmark
• Adult mortality rate: Last
• Infant mortality rate: Last
• Cancer mortality rate: 10th out of 20**

But here’s where we do have a very commanding lead. Nearly doubling the mean value for the countries selected:

• Per capita total expenditure on health: First at 6096 US dollars per year.

Now, I’m not saying that the US has the worst health care system out there, but it’s certainly not the best. And for the money we’re spending, it should be. Can a free market system work for health care? Maybe. But I have a hunch it only works on a blackboard with a 100%-informed population, all able and willing to purchase and hold insurance with no gaps in coverage over their entire lifetimes.

**Notice how this figure changes when you use the entire population (as the W.H.O does) rather than just start counting once a person is admitted into an ER? That’s because when you figure in the entire population, preventative measures will effect your statistics. So, despite the fact that we’re so good at keeping people from dying once they get to an ER, we’re so bad at keeping them out of the ER in the first place that you are actually just as likely to die from cancer in the US as you are in any of the other countries I’ve looked at.