From our president: Dead first

The U.S. makes an embarrassing showing in an Institute of Medicine report released in January that compares the health of people in 17 wealthy countries.

The one place we shine: People older than 80 living in the U.S. are likely to have a longer life than their peers in several other countries.

By most other measures, the U.S. does miserably. We have the highest infant mortality rate, poorer health, and the shortest lives.

The report gives plenty of reasons—individual and systemic—why the U.S. is at the bottom. We eat more, weigh more, and are more apt to use guns violently. We're more likely to take a car than walk, to drive drunk, and to leave the safety belt unbuckled. On the macro side, the U.S. health-care system encourages providers to test and treat in ways that often don't keep people healthy. We simply don't focus enough on cost-effective primary care.

The U.S. spends more on health care than any other nation in the world, but overall, we're not getting the value we should. An estimated 30 percent of health-care dollars is wasted on care that doesn't help or, worse, can do harm. Our system is fragmented and inefficient, and millions of Americans don't have reliable access to it.

The U.S. has some of the best medical professionals in the world, but they're hampered by a structure that encourages them to overtest and overtreat, without enough scrutiny of procedures' effectiveness. Among the goals of health-care reform is to add to our knowledge of which procedures are effective and to change how care is delivered by rewarding providers to keep people healthy in the first place. Over time, combined with targeted public health efforts, that will vastly reduce unnecessary care and slow the steep rise in costs we've seen for decades.

Consumers Union believes that to become a healthier nation, we must concentrate on policies that foster access, education, healthy lifestyles, prevention, and coordinated care while ensuring that high-tech, specialized care is available to those who need it.