In U.S., Long Life Is for Those Who Can Afford It

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Bill Bradley, in his laconic way, would have had a field day with this one. In a new study of worldwide "healthy life expectancy" rates released Sunday, the World Health Organization said the U.S. ranked 24th, despite spending more on health per capita than any other nation. The United States "stands out as not doing as well as they should be," Chris Murray, director of the U.N. agency's global program on evidence for health policy, told the Associated Press. The culprit? Just what you'd expect from in a country that eschews socialized medicine: Its health care is the best in the world — for those who can afford it. According to the study, rich Americans are the world's healthiest people. But, said Murray, those occupying the lower rungs on the socioeconomic ladder — Native Americans, poor rural black populations and some inner city populations — have healthy life expectancies right out of the Third World.

Helped by their fish-based diet, the Japanese top the list, living an average of 74 years of healthy life (concerned that the chronically bedridden were skewing the curve, the WHO switched from the straight life-expectancy indicator this year). Coming up fast are the Australians, at 73.2, followed by France, Sweden, Spain and Italy. The U.S. notched an even 70. At the bottom? Sierra Leone, at 26 healthy years per person. In fact, the bottom 23 places on the 191-nation list were all countries from sub-Saharan Africa, ravaged by the AIDS epidemic, malaria and other tropical diseases, poor nutrition and unsafe water. "Healthy life expectancy in some African countries," said Murray, "is dropping back to levels we haven't seen in advanced countries since medieval times." These nations lack the facilities, the funds and organization to construct a society that can take care of its own. The United States, where the issue of wider health coverage makes frequent but often short-lived blips on the political radar (Bradley, Hillary before him), has the resources. For the present, though, it lacks the political will to spread them around a little better.