9 OCTOBER 2004, Page 36

From Stephen Senn

Sir: According to Mark Steyn (Private enterprise', 2 October) Britons and Canadians have a 'miserable government health service'. That may be so, but les miserables are doing rather well, According to WHO the Canadians have a life expectancy advantage of two and a half years compared with Americans (79.8 to 77.3). This may not sound like much, but when you consider that Americans have an advantage of only two to three months compared with Costa Ricans and Cubans (77.1) it looks pretty good. The US N so had that even the Brits (78.2) can beat them by nearly a year. In fact you have to look pretty far to find a 'developed' nation that does as badly as the US.

The cheese-eating surrender-monkeys, for example, are right up there at 79.7, nearly level with Canada. Of course, when it comes to health spending, then it must be conceded that the US is, indeed, the stellar performer: 13.9 per cent of GDP, according to OECD. Only Switzerland at 11.1 per cent comes close, but with a life expectancy of 80.6, the Swiss are getting rather more for their money. Americans pay more for the health they don't get than any other country. 'Live free or die', as they say in New Hampshire, but in the US as a whole they seem to be paying rather a lot to die.

Stephen Senn

Glasgow, Scotland