You probably already know that Americans spend more on medical care than residents of any other country. That's not because Americans use too much health care.

Canadians see a doctor an average of 5.7 times each year. The French see one 7.8 times a year; the British, 5.9 times; and the Japanese, a staggering 13.4 times. In America, it is four — or at least it used to be.

A new analysis from the U.S. National Bureau of Economic Research explored the impact of global recession on the use of routine health care by citizens in five countries: Germany, England, France, Canada and the United States.

It found that compared to people in those other countries, U.S. residents were significantly more likely to report cutting back on routine preventive care.

Some 26.5 percent of Americans said they've reduced their use of routine medical care since the meltdown began in 2008. No other country reported a cutback rate higher than 12 percent; the average for the other four nations was 8.8 percent.

That should come as no surprise. For the past several years, pollsters have been asking Americans if they skipped filling a prescription or seeing a doctor because of the cost. Even before the recession, a substantial portion of the population answered yes to those questions.

Americans pay a higher portion of their own medical costs than citizens of any other developed nation.

The U.S. Department of Labor reported that last month the medical component of the consumer price index did something that it hasn't done in 35 years: It fell.

Not by much — just 0.1 percent, compared to an increase of 0.3 percent in the overall consumer price index. Still, the medical component has fallen only six times over the last 63 years.

Reduced costs for health care? Good news, right? Maybe not. Health care costs may have gone down because people are buying less of it.

A recent study in the medical journal Cancer found that about one in every six cancer survivors forgoes some recommended care because of the cost.

Cancer is an expensive disease to treat. Many cancer patients run up against lifetime coverage limits in their health insurance policies, after which their care isn't covered.

For years, America's solution to controlling health care spending has been to make people pay more out-of-pocket costs for their own care. It works, kind of.

But people often don't just cut back frivolous, unnecessary or wasteful care. Sometimes they cut back on care that could prevent the recurrence of a very expensive and deadly disease, such as cancer.

When Republican political candidates are making noise about repealing national health care reform, it's worth taking a look at the alternatives.

Remember all those doctor visits in Germany, Japan, Great Britain, France and Canada? Even with those extra visits, the five countries spend an average of about 47 percent per capita of what the United States spends. Those countries fund health care the same way they fund unemployment insurance or retirement programs: through social insurance.

Then there's the "blunt instrument" approach long favored by some conservatives: Shift all costs onto individuals. If you want private health care, buy it yourself. Otherwise, go to a public health clinic or hospital.

That's the way Mexico does it, and the World Health Organization says Mexico has the 61st-best health care system in the world. Is that a model we want to emulate?

REPRINTED FROM THE ST. LOUIS POST-DISPATCH