The new study, funded by Commonwealth and appearing in the Jan/Feb ’08 issue of Health Affairs, looks at “deaths from certain causes before age 75 that are potentially preventable with timely and effective health care.” Relevant causes of death include diabetes mellitus, intestinal infectious diseases, whooping cough, childhood respiratory diseases, leukemia and others.

The authors, both from the London School of Hygiene and Tropical Medicine, found that America’s success in staving off these health problems has decreased over time. Between 1997/1998 and 2002/2003, preventable deaths fell by an average of 16 percent in all 19 industrialized countries considered; but the decline in the U.S. was only 4 percent. In 97/98, “the U.S. ranked 15th out of the 19 countries on this measure—ahead of only Finland, Portugal, the United Kingdom, and Ireland—with a rate of 114.7 deaths per 100,000 people.

“By 2002–03, the U.S. fell to last place, with 109.7 per 100,000. In the leading countries, mortality rates per 100,000 people [for 2002-2003] were 64.8 in France, 71.2 in Japan, and 71.3 in Australia.” (See graph below, courtesy of Commonwealth)

These are compelling statistics because they look specifically at the point of health care intervention: how well do we save lives that are in fact savable? The answer is, not very well at all—and we’re not making much progress. In fact, when compared to other countries we’re falling further behind.

But hey, no worries—at least we spend more than any other country in the world on health care. That’s got to count for something, right?

You’ll have to excuse my sarcasm, but many opinion-shapers refuse to acknowledge the incredibly simple equation: when a health care system spends more than any other in the world and is still unable to stop preventable deaths, something’s seriously wrong. We’re first in spending and last in effectiveness.

And, surprising no one, the spending situation is getting increasingly dire. The newest U.S. health spending numbers are out, and they’re not pretty. Let’s go to the Wall Street Journal, which gives us the best snapshot of what’s going on:

• Health spending totaled $2.1 trillion in 2006 -- or 16% of gross domestic product. That was up 6.7% from 2005, which experienced a growth rate of 6.5%.

• Total spending amounted to $7,026 a person, up from $6,649 in 2005, according to the study by the Centers for Medicare and Medicaid Services.

• In all, Medicare spending increased at the fastest pace since 1981 -- nearly 19%, to $401.3 billion in 2006 from $338 billion in 2005. Meanwhile, spending for Medicaid, the federal-state insurance program for the poor, slipped 0.9%, to $310.6 billion in 2006.

• A major factor in the faster pace of growth in retail drug spending in 2006—8.5%, compared with 5.8% in 2005—was greater use of prescription drugs. That accounted for roughly half of the growth in drug spending in 2006, up from 20% in 2005. This was in part due to the new prescription D program. Seniors are taking more drugs. But are they taking more effective drugs? No one knows.

Put these two reports together and they are compelling. The Wall Street Journal-reported numbers provide a very clear snapshot of our sky-rocketing health care spending, and while the Commonwealth study offers a hard look at preventable deaths—one of the most simple and direct gauges of health care effectiveness you can imagine. I hope this turns heads and changes minds—not so much among voters, who more or less understand that here’s a crisis, but among leaders who constantly regurgitate comforting falsehoods about our health care success.

I wouldn’t count on it though. Like so many other issues that should be decided on evidence, more often than not health care debates turn on ideology—and it’s notoriously hard to reason with dogma.

Niko Karvounis is a Program Officer at The Century Foundation.