That's what happened this summer when the World Health Organization did a study that ranked the health care systems in 190 countries. They looked at efficiency, overall health, and the way health resources are distributed to the populations of the various nations.

The United States did about as well as Rush Limbaugh running the 800-meter high hurdles. We came in 37th, behind all of Europe and a lot of smaller countries like Singapore and Costa Rica. We even finished behind Olympic host country Australia, where medical lab results are reported as, "Poor dinkum, mate," or "Good on ya, then." We came in behind countries you couldn't find on a map with the help of Ben Stein, the Official Game Show Host of the 2000 Olympic games.

It's embarrassing for anyone who works in our health care system. We came in 37th. That's not the silver medal, or even the bronze. Keep going, down past copper, and manganese, and stainless steel, all the way down to "foil gum wrapper" -- that's about how well we did. We are the Jamaican bobsled team of health care. We are -- and it hurts me to say this -- the Minnesota Twins of health care. There are only 32 teams in the NFL, which means at No. 37 we would get creamed even by teams like the Chicago Bears. The practice squad. In street shoes.

So who won? Which country has the best health care system in the world? The answer is: France.

This makes no sense. How can France possibly be healthier than we are? They invented French fries. They eat crepes at every meal, I hear. They have that whole "Jerry Lewis" fixation. How can they finish ahead of a country that has Pringles "Right" crisps, and low-fat microwave pancakes, and Dr. Laura, the Official Shrill, Obnoxious Radio Personality of the 2000 Olympic Games?

Actually, we did well in a couple of categories. For example, we were the No. 1 undisputed world champions at spending money. We spend more of our gross national product on health care than any other nation, coming out to about $3,700 per person. (Sorry, no rebates if you didn't get sick.)

Unfortunately, "spending" doesn't count. It's not even an exhibition event. For that kind of money, we should be the healthiest country of all, but most of the money is spent on a small portion of the population. The richest people in the United States are in tiptop shape, because they get whatever they want. They get expensive MRI scans every time they sprain an ankle, and go in once a year for stress tests and colonoscopy, the Official Invasive Medical Procedure of the 2000 Olympic Games.

About half of the rest of us have insurance, and we do OK. Most of the time we get what we need, although we might have to fight with our insurance companies to get it. Then there's the big chunk of us on the bottom, the ones without health insurance. They get no health care at all, not even the cheap, easy things like immunizations, because they can't afford to pay.

That's how we finished No. 37, alongside Cuba and parts of Africa. To be the best, to win the gold, you have to take care of all your people, not just the ones with money. Otherwise, it's like running really fast for the first 3 miles of the marathon, and doing the duck-walk the rest of the way. It's like having Olympic sprinters Michael Johnson and Maurice Greene run the first two legs of the 400-meter relay, and then having me and my friend Doug run the other laps. Actually, we would be lucky to finish 37th, even with only 12 teams competing.

Every four years the Olympic Games let us honor our athletes. We know, thanks to short biographical video clips shown between the events, how hard they have worked and how much they have sacrificed in order to compete with the rest of the world. It's a rare chance to cheer for athletes you can actually respect, instead of the usual millionaire crybabies you normally see on TV. And, win or lose, we watch because we admire them. We watch because we dream of being like them. We watch because, for a few short weeks in the fall, nothing else is on.

It's like that in health care, too. We work hard. We train. And, like our athletes competing in the Sydney games, some of us are awake and doing our best work at 3:30 a.m., thanks to caffeine, the Official Legal Stimulant Substance of the 2000 Olympic Games.

But unless we open the doors and let everyone onto the playing field, we may never get a chance at any medal higher than tin.

Mark DePaolis is a writer and physician who practices in Brooklyn Center, MN.

© Copyright 2000 Star Tribune

###