>I also think that, if you look harder, you'll see that those coming here for treatment are mostly from countries that don't have modern health systems. I doubt many Dutch people come to the US for treatment.
>
>The US is characterized by very high pinnacles of expertise- think Mayo, Cleveland Clinic, etc etc. Wealthy people who want the very best may travel to the US to access the best possible care. You're right, there are pinnacles in other countries too but they tend to have Socialized systems meaning you can't just fly in with your checkbook.
>
>IME the Western European nations have extremely good care overall. I'm not competent to comment on the relative frequency of centres of excellence compared to the US- though I think the US would be higher- but that's not necessarily relevant to care available to Joe Average anyway.

There is a huge difference between health care and health care systems. Many overlook the fact (or just never mention it) that the Commonwealth Fund ranked the United States first in providing the “right care” for a given condition as defined by standard clinical guidelines and gave it especially high marks for preventive care, like Pap smears and mammograms to detect early-stage cancers, and blood tests and cholesterol checks for hypertensive patients. However, when it comes to chronically ill patients and healthcare costs, the U.S. scored so low that it drove it to the bottom of the list.

When it comes to pinnacles of expertise, I agree the U.S. is at or near the top of the list. When it comes to longterm managed care or chronically ill patients though, the U.S. is only at the top of the list if:

You have full, comprehensive, in-depth health insurance coverage with low deductibles and copayments, and no exclusions for pre-existing conditions;
You live in a major metropolitan area;
You have a long-term relationship with a physician who serves your primary care needs, seeks specialist attention when needed, and finds the right specialist;
You speak and understand good English and so does your doctor, and you are neither sight- nor hearing-impaired;
You are well educated;
You have money and transportation capability;
You are white;
You are naturally skeptical and questioning;
You personally access the internet to help you take charge of your life; and, until recently
You are male.

According to Dr. George Lundberg and the WHO (not affiliated) anyway.

You might find the ratings interesting:

http://health.usnews.com/sections/health/best-hospitals

However:

Oliver Wang and Harlan Krumholz at Yale University asked this question of the US News data and got a rather surprising result. They took the top 50 US News rated hospitals and determined the likelihood of surviving a heart attack at these hospitals for at least 30 days. They found that death rates were slightly lower for the entire group of 50 US News top ranked hospitals taken as a whole. But not all of the US News hospitals ranked highly. When all 6,000 American hospitals were divided into 4 groups based on death rate, 22 per cent of the hospitals ranked “top” by US News were actually in the middle of the pack, and 8 percent were in the worst performing group.

Another recent study showed that of the USNWR ranking of top cardiac hospitals, less than half followed the protocols that top cardiac experts say lead to the best possible care.

Every rating system makes choices to exclude some data --- and that may be just the data that is most important to you. In the case of the US News and World Report data, they heavily weight the reputation that other physicians associate with the hospital among other factors, but do not weight at all the chance of dying after treatment for a heart attack. This is not to say the USNWR hospital ratings are bad, they just can't account for everything that might be important.

To make matters even more complicated, it's not always clear that hospitals or surgeons with higher mortality rates are in fact less competent. There are many reasons. For example great surgeons sometimes agree to treat extremely sick patients who have a high chance of dying. Many believe that even the best statistical “risk adjustment” systems have difficulty compensating for this factor and therefore may prejudice the data against physicians who treat these sicker patients. Paradoxically some believe, for all the virtues of freely available ratings data, they could also lead surgeons to turn away patients most in need of care

http://www.revolutionhealth.com/blogs/jefferygruenmd/hospital-ratings---a--5757