06/30/2010 05:12 am ET Updated May 25, 2011

Health: American Return on Investment

Al only gave me a day before he called back. "So what's the scoop on health care? Are Americans the best or the worst off? All this noise about the new health care bill, socialized medicine and public options has me getting ready to volunteer for a death panel."

"It takes time to understand the numbers, but as far as I can tell we have the best and the worst."

"You've spent way too much time at the UN. Give me a straight answer!"

"The real answer is that the US health care system is filled with extremes. We have some of the greatest medical innovations and technologies as well as some of the top medical schools and research in the world. This is the land of MRI inventions, the first artificial heart, and countless drug discoveries by biotech and pharmaceutical companies. If you can afford it, the United States provides world class health care...but, that's the catch."

"Don't start preaching to me about France and socialism. Here we don't like big government, government bad private sector good. Aren't you an American?"

"Al, we Americans need to recognize we do things differently from other wealthy countries. We should ask ourselves two basic questions: how do we compare to other wealthy countries and what can we learn from them? As one of my colleagues once put it, "this is a terrific place to be treated for Marfan's syndrome, be separated from your congenital twin or have quadruple bypass surgery but I'd never want to deliver my baby here!"

"Facts, give me facts."

"Here's the basic fact about American health: compared to most wealthy countries, the United States spends twice and up to six times as much on healthcare per person, yet has one of the lowest life expectancies."

"Duuh, there's a reason why I keep lots of my money in health insurance and pharmaceutical companies. Where else in America can you find a guaranteed double digit growth industry?"

"Al, since you're so interested in ROI, here's a thought for you. If we think of health expenditures as an investment in longevity, then the United States has a terrible return on its investment, astoundingly lower than any other wealthy country."

Al stopped laughing. He paused, cleared his throat then calmly said. "If we're not the best, then why not?"

"We've got about 20-30% of the world's economy as well as the five largest healthcare companies, the two largest pharmaceutical companies...doesn't that make you wonder who's profiting in our healthcare system?"