This review documents health care outcome in relation to health expenditure in the US and in the European Union (EU) and it attempts to interpret the root cause of observed differences. In comparison with the US where the per capita expenditure for health care is close to 8,000 international dollars, health expenditure in the Western European Countries (WEC) (France, Germany, Britain, Italy) is approximately only half of that in the US. In the Central and Eastern European Countries (CEEC) it is 20 per cent or less of the US health care budget. Infant mortality in the US is much higher than in the WEC and some CEEC (Czech Republic, Poland, Hungary and Slovakia) countries are even better off in infant mortality than the US. Concerning the male life expectancy, Caucasian Americans rank the lowest of the WEC, representing a statistical boundary between the WEC and the CEEC. Like the American caucasian males, the American Caucasian females rank at the lowest range of the WEC. Afro-American females have values substantially worse, almost along the lowest ranking CEEC. European societies have been established for centuries, cherishing strong social values. The US is a much younger rapidly developing multi-ethnic community that derived its progress from adhering to traditions and principles of free choice. Witness to the rate at which the US society can resolve difficult social problems is the enormous progress in eliminating racial discrimination during the past fifty years.

Institute of Preventive and Clinical Medicine Bratislava Slovakia

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