The U.S. Census Bureau reported in August 2008 that 45.7 million U.S. residents were without health insurance. The bureau showed that the uninsurance rate has held steady for more than a decade and in fact, had fallen during the past year.

We seldom consider that the United States provides either private health insurance or public health plans to more than 258 million residents -- which is to say it provides health plans for more of its residents than the combined populations of Canada, the United Kingdom, Germany, France, Spain and Japan.

Except for China and India, no other country in the world provides health care to as many people as the United States does. China's life expectancy is 72 years, while India's is 65. The U.S. life expectancy, now 78, equals that of Germany.

In 2006, the Census Bureau population statistics reported by racial groupings showed that the United States was 67 percent white, 14 percent Hispanic, 12 percent black, 4 percent Asian, and a smattering of other races. U.S. residents have come from every nation, and our newest residents sometimes bring with them decades of health-related problems. Racial, cultural, hereditary and disease histories have a great impact on U.S. societal outcomes; this is far different from most foreign countries.

It is simply impossible, and quite disingenuous, to compare U.S. life expectancy, infant mortality and a host of other statistics to those of countries with homogenous populations. We are not them. Better that we compete with ourselves to improve our health care for all of our population groupings.

Japan generally features the world's longest life expectancy and among the lowest infant mortality rates. Japan is, incidentally, 99 percent Japanese. The Japanese typically eat a lot of fish and fish oil. Americans eat a lot of everything.

We do spend a lot on health care in the United States. During 2006, we also spent $41 billion on pets and $10 billion on pet health care. We outspend every nation in the world on food, clothing, homes, cars, boats, snowmobiles, travel, TVs, and just about everything else. This is what happens in a prosperous nation. Why are we surprised that we spend more than other nations on health care?

The combined 2007 gross domestic product of Canada, the United Kingdom, France, Germany, Spain, and Japan are about equal with that of the United States. We spend a lot on health care, at least in part, because we can; and they cannot.

The increases in total cost and spending on U.S. health care (a problem since 1966), however, is an issue of great concern. So it is in every modern nation. The rate of increase in health care spending in Canada is greater than ours, as it is in Japan and many other countries. Germany spends nearly 12 percent of its GDP on health care, compared with our 16 percent. Increased and runaway health care spending, and attempts to control it, are ubiquitous across the world.

Foreign citizens see the abundance of high-quality care available to us, and want it. Visit any U.S. medical facility near the Canadian border and you will likely find more Canadians in the waiting room than you will find Americans. Visit U.S. airports and what you will not find are planeloads of Americans flying to Canada for health care because the waiting lines are too long in the United States.

Those who prefer a government-run health system point to medical errors in the United States. One disputed 1999 study suggested as many as 100,000 U.S. deaths a year occur as a result of medical error, a number cited in a recent Opinion Exchange article ("5 misconceptions about health care," Dec. 7). Even if true, it pales in comparison to deaths from lack of timely treatment in foreign nations. More than 25,000 people a year die in the United Kingdom because of a shortage of oncologists. Putting this into perspective, it would be as though 125,000 Americans were dying each year because they cannot see an oncologist -- and that does not happen.

During 2007, we Americans (and this includes all of us -- citizens, legal immigrants and all others) spent $2.1 trillion on health care. Do we spend it wisely? No. Do we always get the best care in the world? No. Could we get more bang for the buck? Absolutely, but not by turning to government to manage our health systems.

No government can make us exercise and eat right. If we do not take care of ourselves, we will continue to spend more on health care. And unless we know what we are buying, how much it costs, how much we have to pay out of our own pockets, and the results we can expect, we will never tame the health care beast.

Dave Racer, St. Paul, is coauthor of three books and is a national speaker about United States health-care reform.