It’s easy to pile on the dyspeptic American health care
system... most everyone who follows health care has read or heard of the January Institute of Medicine report comparing U.S. health care with that in
other developed nations. It’s the
1,000,234 study to suggest that if the Emperor isn’t undressed, he at least he
caught a very bad cold: We rank 16th-17th
in life expectancy, and fare much worse than our peer nations in infant
mortality, injuries and homicides, AIDS,
obesity, diabetes, heart disease and other health disorders. And for this privilege we pay an average of
twice what other industrialized nations spend in GDP terms.
But there is an “on
the other hand.” And it’s only fair to waive the stars and strips, however
limply.
The United States health care system benefits from three
traits that are largely unique to America:
(1.) our world-class academic medical establishment, (2.) our commitment
to government funding of science and (3.) an entrepreneurial chromosome that is
the envy of all other countries. Fusing
these together has helped create a medical enterprise that has delivered
medical therapies benefiting tens of millions both in the United States and
across the globe.
Simply put, no national matches the U.S. in the quality of
medical education and the output of medical discoveries coming from academia. According to several sources, seven of the
top ten medical colleges worldwide are American. Since 1983 more than fifty percent of Nobel
Prizes in Medicine or Physiology have been awarded to Americans. And while governments in other countries
fund medical research, no nation funds institutions such as our National Institutes
of Health and National Science Foundation, both of which conduct their own
research and underwrite university and community studies that have changed the
face of medicine.
The biotechnology industry originated in the USA and is a
grafting of academic research and venture capital that in the last thirty years
has created more than 150 thriving companies with some, such as Amgen and
Gilead, having market capitalization greater than traditional health care
companies. More than half of medicines
recently approved by the FDA were derived from processes initiated by the
biotech industry. While some may downplay the importance of new technologies, you cannot tell a
leukemia or colorectal cancer patient that targeted therapies aren’t important.
But still the question remains, “how can we be so
progressive in the creation of health institutions that generate knowledge and
discover medicines, and so remedial in delivering the results of these
outputs?” The answer is complex and
uniquely embedded in our national makeup.
