In his recent letter to the paper, Mr. Bob Olson repeats a trope that has dominated media coverage of health-care reform, that the United States is 38th in world health care. The source of that number comes from the U.N.’s World Health Organization (WHO). This is not based on any facts, but rather on how well WHO officials believe that the country could have done in relation to its resources.

The scale is heavily subjective. The WHO believes we could have done better because we do not have universal coverage. What apparently does not matter is that our population has universal access because most physicians treat indigent patients without charge and accept Medicare and Medicaid payments, which do not even cover overhead expenses. The WHO does rank the U. S. No. 1 of 191 countries for “responsiveness to the needs and choices of the individual patient.” Isn’t responsiveness what health care is all about?

Data published in the Bulletin of the American College of Surgeons indicates that cardiac deaths in the U. S. have fallen by two-thirds over the past 50 years. Polio has been virtually eradicated. Eight of the top 10 medical advances in the past 20 years were developed or had roots in the U. S. We have the shortest waiting time for nonemergency surgery in the world; England has the longest. In Canada, 1 million patients now wait for surgery and another million wait to see specialists.

Who determines how much a nation should pay for its health? Perhaps it’s not that America spends too much on health care, but that other countries don’t spend enough.

Dave Lewis