Trudy Lieberman of Columbia Journalism Review has an excellent article which scrutinizes John McCain's often-repeated claim that the United States has "the best healthcare in the world."

She writes:

The Commonwealth Fund, which each year compares the U.S. system to those of other countries, has found serious shortcomings in the American way of health care. Among other things the study concludes that "The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance," including quality, access, efficiency, equity, and healthy lives. "Among the six nations studied-Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States-the U.S. ranks last."

All of which raises the good question: what does McCain mean when he says the U.S. has the best healthcare in the world?

It's hard to tell. Maybe that Americans who have good insurance and get care at the best facilities from the best doctors recieve care as good as any in the world. (Although that is an assumption, not a fact as far as I know. The Commonwealth Fund report is silent on this question.)

Looking forward to the general election, the Democrat nominee is likely to make the U.S healthcare system look as bad as possible. McCain is likely to make it look as good as possible.

Does the healthcare system really need significant reform? And what should the goals of reform be?

Ideally, the political season would provide a "teachable moment" when those questions can be taken up and the public can learn some answers. 

Just don't count on either candidate being the teacher.