It's tempting to attribute some of the U.S. advance on the health front to its medical system and the technological progress it has fostered. Between 1980 and 1990, for example, according to Metropolitan Life Insurance Co.'s current Statistical Bulletin, age-adjusted death rates from circulatory disease among Americans aged 35 to 74 fell by 29% for men and 25% for women.
Yet as Met Life's statisticians note, comparable improvements were chalked up by virtually all highly industrialized countries, all of which except the U.S. have national health systems. America's standing in the rankings (around 10th) has hardly changed. Indeed, the data indicate that the most progress was made by Canada, which slashed its death rates for both men and women by about 39%. In fact, Canada's mortality rates from circulatory ailments in 1990 were more than 20% below those of white Americans (whose rates were at least 30% lower than nonwhites).
Is this an argument for Canada's single-payer health system? Hardly. But it does underscore the difficulty of evaluating systems by looking at results in a single country.