Despite Rush Limbaugh’s declarations after being hospitalized for chest pains last week that he got the best health care in the world “right here in the United States” and that “I don’t think there’s one thing wrong with the United States health system,” our system of delivering health care continues to rank poorly against that of many other countries.

In fact, the World Health Organization has ranked our health care system 37^th in the world.

Those statistics need to be acknowledged, as two physicians and public health experts — Christopher Murray of the University of Washington in Seattle and Julio Frenk of Harvard’s School of Public Health (and Mexico’s former Minister of Health) — point out in an article posted online Wednesday by the New England Journal of Medicine (hat tip, Gary Schwitzer’s HealthNewsReview blog):

And, it seems, the more we spend, the less we get:

(The NEJM article has a great chart if you prefer to see such comparisons visually.)

Not interested?
“There are no published studies investigating the combination of policies and programs that might account for the marked progress in Australia,” note Murray and Frenk. “But the comparison makes clear that U.S. performance not only is poor at any given moment but also is improving much more slowly than that of other countries over time.”

(You’d think Limbaugh would care about this statistical trend, as he turns only 59 on Tuesday and thus has a couple more years left in that 15-60 age category.)

Universal health coverage only a beginning
Murray and Frenk point out that the current health care policy debate “has been overwhelmingly centered” on extending insurance coverage and slowing down the growth of costs through better efficiency.Yet, although universal health care coverage would save an estimated 18,000 to 44,000 lives, it’s just the starting point.

“Narrowing the gap in health outcomes between the United States and other high-income countries or even slowing its descent in the rankings would require much more than insurance expansion,” Murray and Frenk write.

What’s needed? Murray and Frenk want greater investments in policies “targeted at promoting proven strategies — including tobacco taxation and smoking-cessation programs, screening and treatment for high cholesterol and blood pressure, banning of trans fat, creating of incentives for people to engage in physical activity, and subsidizing the cost of consumption of n-3 fatty acids [the omega-3 fatty acids found in fish, walnuts, flaxseed, and certain other foods]."

Targeting proven strategies is the hard part, as we all know.