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4 Percent of Us Consume 50 Percent of All Health Care

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I'm winging my way across the United States, over Wyoming, bored. Thumbing through the Delta Airlines Sky magazine, an advertisement touts: "The Best Plastic Surgeons in America." The ad says that Los Angeles, New York, Atlanta, Phoenix (can Latinos in Arizona get a boob job without an identity card?) and Salt Lake City are home to some of the best.

Indeed, modern medicine can now transform our bodies and our facial features. In his book "The Paradox of Choice," Barry Schwartz says:

In 1999, over 1 million cosmetic surgical procedures were done on Americans -- 230,000 liposuctions, 165,000 breast augmentations, 140,000 eyelid surgeries, 73,000 face-lifts and 55,000 tummy tucks. Though it's mostly women (89 percent) who avail themselves of these procedures, men do it too.

Restoring the looks of a disfigured burn victim is to be applauded, since a modest facial improvement can have huge psychological benefits. Therefore, plastic surgery has a place in the field of health care practice.

That said, we know that health care culture and practice -- especially in the United States -- can be unnecessarily invasive: Health care as a body shop, doctors as medical mechanics and curative, not preventive, care.

As America's Health put it:

The nation's health care system has become extremely adept at treating certain illnesses and disease, such as cancer and cardiovascular disease. However, Americans are struggling in the battle to modify risk factors, such as smoking, poor eating habits and lack of exercise, which may contribute to chronic diseases in the first place. The United States currently spends more per capita than any other nation on health care, including $1.8 trillion in medical costs associated with chronic diseases.

The contrast between health care in developing and developed nations is startling and -- it must be said -- unfair. A single children's hospital in Cambodia reveals the story.

A good friend who was last week in Cambodia wrote:

Toured the Angkor Hospital for Children, the first pediatric teaching hospital in Cambodia. To call it a hospital, suggesting long gleaming halls and multiple stories, is misleading. The hospital has about 20 beds, each with a parent keeping a child company during his or her stay. The open air clinic/triage room has long wooden benches on which families often sleep on while waiting for their children to be seen. It's a free hospital, but the families that come are very poor and often have to borrow money from fellow villagers to travel or sell a pig or cow to pay for it. The children are, of course, adorable. Most come with diarrhea, complications from malnutrition or dengue fever.

Among the most alarming facts about Cambodia, we find that 35 percent of children are NOT immunized for polio, measles or diphtheria, 36 percent of children under the age of five are underweight, 69 babies out of every 1,000 die in childbirth and 90 out of 1,000 die before they are 5years old.

However, none of these tragic numbers are surprising because 35 percent of the entire population does not drink safe water, 72 percent lack decent sanitation and around 40 percent of Cambodians survive on less than $1.25 per day, according to Friends Without Borders.

Our humanity, if not our common sense, tells us that something is wrong when 4 percent of the world's population consumes half of the world's health care.