Learning From the Best

What top hospitals can, and can’t, tell us about healthcare.

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We're publishing our annual ranking of America's Best Hospitals at a moment when America's entire health industry is under the microscope. President Obama has decided that now is the opportunity to change the way the country gets its healthcare. He has opened up a trunkful of arguments, most notably about cost, effectiveness, and fairness. The debate will be with us for months to come, if not longer.

Our hospital rankings have long provided some important benchmarks at the top end of the quality spectrum. We looked in depth at nearly 5,000 of the nation's hospitals and selected the top performers in key specialties, as well as those rare few that do many things with excellence. We have also continued the separate rankings of children's hospitals that we began two years ago.

Besides the numbers, we look at some of the people and technologies that are improving medical care. The surgical robot is just one example of what we're starting to see in regular use. Laser surgery, body scans, and indestructible replacement parts for aging bodies are all becoming common. Many of the improvements have to do with communication, long a shortcoming in medical institutions. Patient data can be sent where they are needed more quickly. Doctors and equipment can be tracked in hospital hallways. Telemedicine, which allows specialists to diagnose patients far away, is gaining critical mass. Big investments by the best hospitals are cutting error rates and improving patient outcomes.

We also know, as we've reported for years, that technology alone won't solve our problems. For every "best hospital" there are plenty of not-so-good hospitals. And even the best are criticized for often being among the costliest. After all, the cost of a life is what so much of this debate comes down to—and why it's so difficult to resolve. Healthcare is infinitely perfectible and therefore infinitely costly. How do you put a limit on it? Should you? Does someone at some point have to say, "No, that's all the care you are entitled to?" And who would that person be?

Of course, there are other factors. Our aging population creates unforeseen challenges, to say nothing of our gross national obesity epidemic. Medicare has changed the nature of doctors' practices, while malpractice suits have imposed stiff costs on them. Many Americans lack health insurance, though the reasons aren't always simple.

I'd like to hear your thoughts on the healthcare debate. What is on your list of the best ways to make the system more effective and efficient? Join the discussion below.

We want to add your voice to this crucial and complicated debate.