Last year I delivered the Presidential address to the South Atlantic Association of Obstetricians and Gynecologists in which I discussed the fact that the United States spends much more money on our health care than any other country in the world. In spite of this huge difference in spending, we don’t do as well as many other countries when we look at the statistics which measure quality such as life expectancy, perinatal mortality and many others. A report by the respected Institute of Medicine in 2013 revealed that we also have a higher number of people with chronic conditions such as type 2 diabetes, obesity, hypertension and heart disease. So it would seem at first glance that our health care system is not up to the same level as other developed countries around the world and we should be ashamed of it.
But first impressions can sometimes be deceiving and we need to look a little deeper. Many of us have benefitted from “miracles of medicine” and survived conditions that once may have been fatal because of incredible scientific advances. We also have a huge and incredibly diverse population and one which has always welcomed immigrants and people from around the world. The other developed countries we have been compared with have much more homogeneous populations and are much smaller. Our population is larger than the combined populations of Australia, New Zealand, Sweden, Denmark, Norway, Canada, France, Germany, Netherlands, United Kingdom and Switzerland. With size comes many problems of the distribution of medical care and many issues of social inequality. Other major issues are related to personal choices and responsibility that people make to smoke, not exercise and take care of themselves in general. It is well known that there is a huge increase in chronic conditions associated with obesity and smoking. We shouldn’t blame the resulting illnesses on inadequate quality of our healthcare system for what are self-induced habits and life styles. An interesting statistic is that 5% of U.S. population account for 50% of the money spent on healthcare.
So I don’t think we should be quite so hard on ourselves and our healthcare system in the United States for being second rate. America is still the place people from around the world come to for their healthcare when facing difficult problems The profession, which is made up of dedicated, caring individuals will continue to strive to improve the health of all our citizens as we always have. Our efforts need to be ongoing in trying to correct the social inequalities in our population, the access to healthcare and assist people in taking more responsibility for their own health with life style changes.