Variations in Amenable Mortality — Trends in 16 High-Income Nations

By Ellen Nolte, Ph.D., and Martin McKee, M.D., D.Sc.
The Commonwealth Fund, September 23, 2011


The rate of “mortality amenable to health care” — that is, deaths that are considered preventable with timely and effective health care — declined for people under age 75 across 16 high-income nations between 1997–1998 and 2006–2007. While all countries showed improvement, the United States improved the least.

Key Findings

In 2006–2007, amenable mortality accounted for 24 percent of deaths under age 75 in the 16 countries studied.

The highest levels were in the United States, with 95.5 deaths per 100,000 people.

Addressing the Problem

Although amenable mortality fell consistently in all countries, the scale and pace of improvement varied. The United States’s poor performance and relatively slow improvement compared with other nations may be attributable to “the lack of universal coverage and high costs of care,” the authors conclude.

So, the United States has “the best health care system in the world,” except for all the others. Our amenable mortality – deaths that are preventable with timely and effective health care – is the worst amongst the 16 high-income nations studied.

The authors suggest that our poor result may be attributable to the lack of universal coverage and the high costs of care. Unfortunately the Affordable Care Act (ACA) will provide neither universal coverage nor adequate measures to control health care spending.

The policy community certainly understands that we could cover everyone and control excessive spending by enacting a single payer national health program – an improved Medicare for all. So why have they disappeared behind closed doors to work on ACA – a model that won’t get us there?

Please, policy wonks, come out of the closet!