Where do medical innovations come from?

On a talk show tonight the host proclaimed that most medical innovations come from the United States while challenging a caller to identify one from France.  To research that, I looked at the countries of Nobel Prize in Physiology or Medicine award recipients.  These are the listed countries of institutions the individuals work at, not the country of origin of the individuals.  For the years 1984 - 2008, the countries are listed below.  (Fractional shares of the prize are typically awarded, thus the decimals.)

United States = 17.16666

United Kingdom = 2.5

Germany = 1.8333333

Switzerland = 1.16666666

Austria = 1.0

France = 0.5

Italy = 0.5

UPDATE: The 2009 prize for medicine was split into thirds, all of which went to individuals in the United States.