Back in 2000, the World Health Organization published a report that rated the U.S. 37th in health care worldwide, putting poorer countries like Morocco, Cyprus and Colombia further up on the list.

The rankings took into account factors such as life expectancy, inequities in health and access to health care, medical responsiveness in diagnosis and treatment, and how fairly the systems are financed.

Media responses to the ranking fell into two camps: one camp disputed the methodology of the report while the other used the study to criticize the American health care system.

Michael Moore brandished the WHO stat in his recent movie “Sicko,” once again stirring debate and sending people scurrying to one side or the other.

How does one make sense of things?

Unfortunately for partisans of both sides, comparing America’s health care system to the rest of the world is exceptionally difficult, and there’s no simple storyline to grab on to.

Despite being the richest country in the world, the U.S. doesn’t win the longevity award. In fact, we’re not even in the top ten for life expectancy. What does that say about our health care system?

At first blush, nothing flattering. But sorting causes and effects is one of the most difficult things to do, and in this case, some of the causes may have nothing to do with health care.

As Atlantic Monthly writer Megan McArdle noted recently, Americans die in large numbers because of car wrecks and poor diet, neither of which is directly related to our system of health care.

Additionally, for whatever reason, many Americans abstain from healthful physical activity. According to the Centers for Disease Control, a quarter of U.S. adults are not active at all. Surely that one-fourth depresses our worldwide ranking.

Americans have uncommonly good access to care—state of the art clinics and emergency services abound. And America is still the epicenter of medical research and development.

However, many people can’t afford care because they lack insurance. According to 2007 U.S. Census statistics, 47 million Americans, including 9 million children, don’t have health insurance. And that’s up from 44.8 million in 2005.

All this is to say that there are many complexities that arise whenever one talks about health care. The fact that Americans aren’t flocking to Morocco to get health care is perhaps an indication that the WHO report—and our 37th ranking—is inaccurate.

Very few politicians, however, advocate maintaining the status quo of American health care. Most of our leaders take pains to propose “solutions” to what is presumably an imperfect system. And according to a recent Gallop poll, only 52 percent of Americans are happy with their health and medical care, a lower percentage than in India, Iran, Sierra Leone, or Malawi.

But is that because our system is worse, or is it because we Americans expect more than do Sierra Leoneans?

So are we justifiably number 37 in health care? Maybe that’s not even a worthwhile question to ask. Perhaps a better one is this:

What can we do to become number 1?

Courtesy of Insuahh.com