american healthcare

tom hunter (3,216) Says: 
June 29th, 2012 at 2:34 pm

Based on Measures of Quality, Efficiency, Access, Equity, and Healthy Lives

Lies, damned lies and statistics …..

I’ll look at the link at some point but I suppose it will be the usual stuff focusing on life expectancy and infant mortality. But the latter numbers are unreliable for international comparisons and the former appear to be affected more by basic things such as demographics, clean water and sewerage systems, and diet. Similarly infant mortality rates are five times the national average on Indian reservations (which have publicly financed health care through the Indian Health Service) and quite low in places like Utah and Washington.

When it comes to things that can actually be linked directly to health care it’s quite a different story – like cancer:

American women have a 63 percent chance of living at least five years after a cancer diagnosis, compared with 56 percent of women in Europe. For American men, the numbers are even more dramatic. Sixty-six percent of American men live five years past a diagnosis of cancer, but only 47 percent of European men do.

Of cancers that affect only women, the survival rate for uterine cancer is 5 percentage points higher in the U.S. than the European average, and 14 percent higher for breast cancer. Among cancers that affect only or primarily men, survival rates for prostate cancer are 28 percent higher in the U.S., and for bladder cancer, 15 percent higher.

 tom hunter (3,216) Says: 
June 29th, 2012 at 5:19 pm

It should be fun to watch!

Children up to the age of 26 were already covered under the SCHIP legislation, as poor people were covered by Medicaid for the last four decades.

It’s a rather sad commentary on the left that two apparently failed Government healthcare programs are going to be fixed by creating and even larger, more extensive government health care program over the top of them.

As far Romney is concerned he may not even have any arguments to deal with since most of the Democrats have been reluctant to mention it on the stump. Given that the mandate has now been converted into the largest tax increase on the middle class in decades that should make the stump debates even more fun than you imagine.

 Sonny Blount (1,525) Says: 
June 29th, 2012 at 5:25 pm

It is absurd to expect the ‘cost’ of healthcare to be directly comparable between the US and other counries. Here are some reasons:

Different countries are treating different populations of people, the US has 3 times the obesity rate of Sweden, and therefore 3 times the obesity related costs.

Different services are being performed, the US has the most plastic surgeons in the world by a huge margin, their be 100 times the number in US as in a country like Sweden. So many of the costs in the US system are voluntary and standards are different, British teeth are not acceptable over there.

Healthcare is one of the top places to spend disposable healthcare. Because the US are wealthier, people are able to spend a higher part of their incomes on healthcare and they do. If you can get a room to yourself and better meals while in hospital, people want this and will pay.

The US is one of the hotbeds of medical innovation. Because there is a market for $100 a pop pills that may save your life, there is an incentive to innovate and eventually we are able to get those same pills 5 to 10 years later for $10. People pay for these latest and greatest medicines because they would rather be alive and bankrupt than dead with money in the bank.

The US model is not the free market model. It should be a lot better than it is, but socialism is not the right response to their problems.

And then there are other things:

The largest international study to date found that the five-year survival rate for all types of cancer among both men and women was higher in the U.S. than in Europe. There is a steeper increase in blood pressure with advancing age in Europe. A 60% higher prevalence of hypertension. The aggressive treatment offered to U.S. cardiac patients apparently improves survival and functioning relative to that of Canadian patients. Fewer health- and disability-related problems occur among U.S. spinal-cord-injury patients than among Canadian and British patients.

Britain has only one-fourth as many CT scanners per capita as the U.S., and one-third as many MRI scanners. The rate at which the British provide coronary-bypass surgery or angioplasty to heart patients is only one-fourth the U.S. rate, and hip replacements are only two-thirds the U.S. rate. The rate for treating kidney failure (dialysis or transplant) is five times higher in the U.S. for patients between the ages of 45 and 84, and nine times higher for patients 85 years or older.

Overall, nearly 1.8 million Britons are waiting for hospital or outpatient treatments at any given time. In 2002–2004, dialysis patients waited an average of 16 days for permanent blood-vessel access in the U.S., 20 days in Europe, and 62 days in Canada. In 2000, Norwegian patients waited an average of 133 days for hip replacement, 63 days for cataract surgery, 160 days for a knee replacement, and 46 days for bypass surgery after being approved for treatment. Short waits for cataract surgery produce better outcomes, prompt coronary-artery bypass reduces mortality, and rapid hip replacement reduces disability and death. Studies show that only 5 percent of Americans wait more than four months for surgery, compared with 23 percent of Australians, 26 percent of New Zealanders, 27 percent of Canadians, and 36 percent of Britons.

There are also weird outcomes, such as the logical conclusion that under a system where one pays, one would skimp on preventative care. However …

… the proportion of middle-aged Canadian women who have never had a mammogram is twice that of the U.S., and three times as many Canadian women have never had a Pap smear. Fewer than a fifth of Canadian men have ever been tested for prostate-specific antigen, compared with about half of American men. Only one in ten adult Canadians has had a colonoscopy, compared with about a third of adult Americans.

These differences in screening may partly explain why the mortality rate in Canada is 25 percent higher for breast cancer, 18 percent higher for prostate cancer, and 13 percent higher for colorectal cancer. In addition, while half of all diabetics have high blood pressure, it is controlled in 36 percent of U.S. cases, compared with only 9 percent of cases in Canada.

I would not get too cocky about the cost aspect either as it’s another apples to oranges comparison between our 80:20 public/private system and their 50:50 system. Our costs are low because, among other things, we suppress the incomes of doctors and nurses – which also means we lose them to places like the USA. That sort of rationing also explains things like the grossly lower numbers of scanners, treatments, surgeries, etc. So yes the cost is lower, but we pay the price in other ways, most of which are probably not measured.