The Good, The Bad and The Ugly–Sicko

There’s a lot in the media, here too, here, about health care thanks to the upcoming presidential campaign, the movie Sicko, and a dawning realization that we pay more and get less for our health care than many similar nations.


“As early as 2000, the World Health Organization made the first attempt at ranking all the world’s health-care systems. The United States came in 37th out of 190 nations in the provision of health care. (France, according to the report, was first.) The report was criticized for using inconsistent comparison measures and for failing to note that some countries deny expensive care to very sick patients. Americans could still reasonably cling to their long-held pride.”

“But in 2006, the Organization for Economic Cooperation and Development, an international organization that aims to lift living standards by promoting economic development, compared health spending and health statistics in its 30 member nations. Its report was more detailed than the WHO rankings, and had more controlled and consistent measures. The data, taken more seriously than the WHO rankings, left Americans with little to brag about.”

“another report released by the Commonwealth Fund, which supports independent research into health-care issues, found the United States at the bottom among six industrialized nations on measures of safe and coordinated care.”

“the United States had fewer practicing physicians, or 2.4 per 1,000 people, than the average of 3 per 1,000 people. Infant mortality rates have been falling in the United States, but are still higher, at 6.9 deaths per 1,000 live births, compared with less than 3.5 deaths per 1,000 live births in Japan, Iceland, Sweden, Norway and Finland.”

“The health-care picture is certainly not all bad. Emanuel knows, for example, that as an NIH employee, he works for the premier medical research institution in the world. Americans’ penchant for raising awareness, consciousness and money have helped the country shine in breast cancer treatment, preventive measures such as colonoscopies and world-class institutions such as the Joslin Diabetes Center. And America leads the world in the development of new drugs, in part, the pharmaceutical industry says, because there are no constraints here on what the industry can charge for patented medications.” (medicynical note: But unlimited pricing and aggressive marketing of drugs, most mediocre, are factors that contribute to our costs–see below.)

“the United States spends an annual $6,102 per person – more than any other country and more than twice the average of $2,571. Yet Americans have the 22nd highest life expectancy among those nations, at 77.2 years compared with the analysis’ average of 77.8 years. People in Japan, the world leader in longevity, live an average of 81.8 years.”

Despite the discussion I’m not at all sure anything will happen. Legislative inertia, financial insolvency, powerful lobbies and lack of leadership beyond political posturing, make significant change of our dysfunctional system unlikely. More bandaids when major surgery is required. The question is whether the patient will survive or whether we will eventually have to do surgery on a dead man.

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