America’s Health Outcomes Depend on Smoking and Obesity Rates and Subsequent Chronic Diseases, Not on Health System

One of the enduring myths about health care is that a nation’s health depends on its health system. In his 2011 book Excellent Health: Setting the Record Straight on America’s Health Care (Hoover Institution Press), Scott W. Atlas,MD, professor of radiology at Stanford, dispels this notion in an exhaustively researched book featuring 78 figures, 32 tables, and 18 pages of references, Doctor Scott Atlas, a senior fellow at the Hoover Institute, presents evidence that America’s health system is superior to government-controlled counterparts in other parts of the globe.

Doctor Atlas's thesis is straightforward. America’s health outcomes, if measured by longevity and infant mortality, are in the middle of the pack compared to socialized countries, but these outcome measurements are subjective and insensitive to what happens on the ground and do not reflect the U.S. excellence compared to these countries. Americans with chronic diseases, says Atlas, have superior access to treatment, more effective results, and longer survival for these diseases.

The truth, based on evidence on the medical literature, is that America’s health outcomes are dictated by our culture, specifically by our unhealthy behaviors, our heavy smoking history, which exceeds that of other nations, and our overeating,lack of exercise,and other factors, which causes us to lead the world in our obesity rates.

And yet, when it comes to survival rates for chronic diseases, such as cancer and health disease, superior control of risk factors for those diseases, and better access to treatment, the American system is excellent compared to government controlled systems. America’s problem is not its health system, but the prevalence of smoking and obesity, which is often beyond control of doctors and the health system.

Atlas’s final sentence is his book reads:

“It is quite a tribute to the quality of U.S. medical care that Americans have superior outcomes for many of the deadly diseases associated with destructive behaviors like cigarette smoking and obesity, given that there is such a startling inequality in the underlying health liability of the population due to extra burden of biological risk factors for these dissases before medical care is even initiated.”