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International comparisons show that the United States spends more on health care than other industrialised nations.1 According to 2000 data, the United States led the way in per capita healthcare spending at $4631, more than double the Organization for Economic Cooperation and Development (OECD) median of $1983 (in purchasing power parities based on the US dollar).2
Despite massive medical care expenditures, the US lags behind its industrialised counterparts in major indicators of population health. For example, researchers have reported that the US has lower life expectancy at birth and higher maternal and infant mortality.3,4 Equally important, cross national studies consistently show that US citizens are less satisfied with their healthcare system than Canadians or Europeans.2
Another key indicator of population health, not previously used in cross national comparisons, …