A GLOBAL HEALTH SCORECARD FINDS U.S. LACKING

Over the past 25 years, China, Ethiopia, the Maldive Islands, Peru, South Korea and Turkey had the greatest improvements in “deaths avoidable through health care at their economic level,” a complex but intriguing new measure of global mortality described last week in the Lancet.

By that standard, the United States improved slightly over the same period, 1990 to 2015. But the U.S. ranking is still so low that it’s “an embarrassment, especially considering the U.S. spends $9,000 per person on health care annually,” said the report’s chief author, Dr. Christopher J.L. Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation, created by the Bill and Melinda Gates Foundation.

Elected officials now struggling to reform U.S. health care, Murray added, “should take a look at where the U.S. is falling short.”

The new measure takes into account how well each country — whether rich or poor — fared at preventing deaths that could be avoided by applying known medical interventions. (The metric thus excludes many deaths from epidemics, smoking, obesity, guns, car accidents and so on.)

The report further judged countries relative to how rich they were and how much richer they became from 1990 to 2015. (Some regions, like Latin America, Eastern Europe and parts of Asia, became much wealthier. Africa did not, but its health care delivery benefited from donated vaccines and AIDS drugs, for example.)

Poor countries were judged based on how well they did at simple things, like vaccinating against diphtheria or curing pneumonia. Middle-income countries had to meet higher standards, like successful surgeries for appendicitis and hernia, or treatment for epilepsy and birth problems.

And wealthy countries were judged on all those, plus success at treating breast, colon and skin cancer, diabetes, heart disease and so on.

The highest-ranked countries, besides tiny Andorra, the winner, were Iceland, Switzerland, Sweden, Norway and Australia. The lowest in the rankings were the Central African Republic, Afghanistan and Somalia.

The United States ranked 35th. It ranked worse than many of its peers in curing pneumonia, lymphoma and skin cancer, in managing diabetes and heart disease and in medical mistakes and malpractice.

Some countries, including India, Indonesia and South Africa, got relatively worse at saving their citizens from death even as they got richer.