双语环球新闻：美元都用到哪去了？

　　Comparing the health systems of different countries is a tricky business. Even if you look at countries in the same income bracket, there are plenty of factors, from demography to culture, that confuse the picture. But a new study of data from 19 prosperous nations draws one firm conclusion: despite being the top spender per head on health, the United States lags painfully, and increasingly, behind other wealthy countries in the overall performance of its medical system.

　　That harsh judgment is made by Ellen Nolte and Martin McKee, researchers at the London School of Hygiene and Tropical Medicine. They looked at deaths that should have been preventable by proper health care in people under the age of 75. These include deaths resulting from bacterial infections, treatable cancers, diabetes and surgical complications; over a fifth of male deaths and nearly a third of female deaths result from such causes.

　　They found that the group as a whole did well in tackling this problem: the decline in what they call “amenable mortality” averaged 16% across these countries from 1997 to 2003: the decline was 17% for men and 14% for women. But the news was not so good in the United States; it had the worst record of the countries studied. America cut “amenable” deaths by only 4% during that period; it fell to bottom of the table.

　　比较不同国家的卫生体制是一件复杂的事。即使观察处在相同收入等级的国家，也有众多的因素如从人口分布到文化差异使情况变得复杂。但是，对来自于19个富裕国家的数据的一项新的研究得出了一个可靠的结论：尽管人均健康消费排第一，美国在医疗体制的总体表现上越来越落后于其他富裕国家，这一点很悲哀。

　　这个无情的结论是由“伦敦卫生和热带医学学院”的艾伦·诺尔特和马丁·麦凯基得出的。他们查阅了75岁以下人群中死于通过适当的医疗保障本可避免死亡的病因。这些病因包括细菌感染、可医治的癌症、糖尿病和手术并发症。超过1/5的男性死亡和差不多1/3的女性死亡出自这些原因。

　　他们发现这个组在对付这个问题上总体表现良好。这些国家从1997年到2003年“可预防的死亡率”平均下降16%，其中男性下降17%，女性下降14%。但是，对美国来说消息不是很好。在被研究的国家中，美国的记录最差。在那段时间里，美国的“可预防”死亡只减少了4%，落到了表格的最底部。