America Ranks Dead Last

France is tops, and the United States dead last, in providing timely and effective healthcare to its citizens, according to a survey Tuesday of preventable deaths in 19 industrialized countries.

The study by the Commonwealth Fund and published in the January/February issue of the journal Health Affairs measured developed countries' effectiveness at providing timely and effective healthcare.

The study, entitled "Measuring the Health of Nations: Updating an Earlier Analysis," was written by researchers from the London School of Hygiene and Tropical Medicine. It looked at death rates in subjects younger than 75 that could have been prevented by timely and effective medical care.

The researchers found that while most countries surveyed saw preventable deaths decline by an average of 16 percent, the United States saw only a four percent dip.

The non-profit Commonwealth Fund, which financed the study, expressed alarm at the findings.

"It is startling to see the US falling even farther behind on this crucial indicator of health system performance," said Commonwealth Fund Senior Vice President Cathy Schoen, who noted that "other countries are reducing these preventable deaths more rapidly, yet spending far less."

The 19 countries, in order of best to worst, were: France, Japan, Australia, Austria, Canada, Denmark, Finland, Germany, Greece, Ireland, Italy, Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, the United Kingdom and the United States.

Some countries showed dramatic improvement in the periods studied -- 1997 and 1998 and again between 2002 and 2003 -- outpacing the United States, which showed only slight improvement.

White the United States ranked 15th of 19 between 1997-98, by 2002-03 it had fallen to last place.

"It is notable that all countries have improved substantially except the US," said Ellen Nolte, lead author of the study.

Had the United States performed as well as any of the top three industrialized countries, there would have been 101,000 fewer deaths per year, the researchers said.