The U.S. outspends all other industrial countries on health care, and yet we do not enjoy better health. Quite the opposite: an American baby born in 2006 can expect to live to 78—two years less than a baby born across the Canadian border. Out of the 30 major industrial countries, the U.S. ranks 28th in infant mortality. A large part of the gap in infant mortality can be traced to high infant death rates in certain populations—particularly African-Americans, who make up about 13 percent of the total population. In 2005 infant mortality for non-Hispanic blacks in the U.S. ran to 13.6 deaths per 1,000 live births compared with 5.76 deaths per 1,000 live births for non-Hispanic whites. The root causes of such disparities—which include differences in education, environment, prejudice and socioeconomic status—are notoriously intractable.
An easier fix may be under our noses: primary care. The idea is to have a clinician who knows your health history, will continue caring for you over the long term, and can recommend specialists and coordinate your treatment if you need to see them. Primary care can handle the health problems that most people have most of the time.