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To the Editor: The Special Communication by Drs Herzlinger and Parsa-Parsi¹ and the Commentary by Dr Reinhardt² discussed the Swiss health care system as a possible model for health care in the United States, whose current system is frequently defended. One wonders why either of the world’s 2 most expensive health care systems would be considered as models for care, given that they provide the highest cost per benefit of any countries in the world.

International data comparisons for more than 200 autonomous and semiautonomous regions of the world are available at Nationmaster.com.³ The United States, which ranked first in expenditures ($4271 per capita per year in 2000), ranked 48th in mean life expectancy in 2002, with a ratio of health care costs per year of life expectancy beyond age 75 years of $1360. Switzerland, which ranked second in expenditures ($3857 per capita per year in 2000), ranked eighth in . . . [Full Text of this Article]

Thomas M. Vogt, MD, MPH
tom.m.vogt@kp.org
Kaiser-Permanente Center for Health Research
Honolulu, Hawaii

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