With the debate over healthcare reform literally raging, one of the frequent claims of those who oppose reform has been that the United States has the finest healthcare system in the world and that the government shouldn’t mess with it.  I’ve been wondering where this notion comes from, because it is not true. 

Oh, we are good at a lot of stuff: we have great people in healthcare, and lots of high tech machines and buildings.  Medical miracles take place here everyday.  But despite all that the fact remains that other nations around the world—including nations with some of the largest and most sophisticated economies—spend HALF of what the US does on a per capita average, provide access universally, and have quality outcomes that are usually better than the United States'.  The brutal fact we must face—to borrow a concept from Jim Collins’ Good to Great—is that from an economic, social, and quality perspective, the US most certainly does not have the best healthcare system in the world.   

So why do so many Americans think that we do?  One reason could be that since the mid-1980s, hospitals have spent billions of dollars on advertising messages emphasizing that “Hospital X is the best.”  Hey, advertising works.  Repeat a message often enough and it begins to be accepted as gospel.  After two-and-a-half decades of hearing that American hospitals are the best, we Americans firmly believe it, facts be damned. 

I’m not knocking hospitals or advertising.  A hospital without patients will not be a hospital for long, and advertising is a proven technique for attracting and retaining patients. It’s just a cost of doing business.

But I am suggesting that perhaps one of the unintended consequences of a generation of hospital advertising is that it has made it difficult for Americans to look at our system of healthcare with a clear sense of the facts necessary to implement true reform.  A commonly cited statistic suggests most Americans are happy with their local access to care, but they also recognize that our national healthcare system is deeply dysfunctional and needs to change.  In other words: “My local hospital is the best and I want to keep it that way. It’s all the other hospitals that need to be reformed.”  This is a hospital advertising message that has been deeply internalized.

Notwithstanding President Obama’s desire to face the healthcare issue as quickly as possible in his Administration, perhaps the White House could have softened the field in the battle for public opinion by engaging in a sustained advertising campaign that laid out the brutal facts about American healthcare.  It is not too late to do so.