Best Health Care in the The World–Our Myth

Our conservative friends have chosen the mantra that we have the best healthcare in the world as their basis for opposing reform. Facts, however, don’t support their claim.

This from the Congressional Research Service on quality:

“However, research comparing the quality of care has not found the United States to be superior overall. Nor does the U.S. population have substantially better access to health care resources, even putting aside the issue of the uninsured. Although the United States does not have long wait times for non-emergency surgeries, unlike some OECD countries, Americans found it more difficult to make same-day doctor’sappointments when sick and had the most difficulty getting care on nights and weekends. They were also most likely to delay or forgo treatment because of cost.”

We are number one (compared with other industrialized nations) in:

Bankruptcy caused by health care expenses

Excessive utilization of services and by inference inefficiency

Doctor’s salaries

Hospitalization costs

Drug costs

Insurance costs

The number of citizens who are uninsured.

The costs of emergency room services

NOT preventing preventable disease also here

Inequities of it’s health care system. It “ranks dead last on almost all measures of equity,” with the “greatest disparity in the quality of care given to richer and poorer citizens”

Perhaps because of the failures of our non-system, the World Health Organization ranked the U.S. health care system’s quality 37th in the world in 2000, if anything the situation is worse now.

Infant mortality–In 1960, the United States ranked 12th lowest in the world, by 2004, the ranking had dropped to 29th lowest.

The U.S. has been slipping for decades in international rankings of life expectancies as other countries are improving health care, nutrition and lifestyles, according to the AP/Daily Star. Countries that rank above the U.S. include Japan, most of Europe, Jordan and the Cayman Islands. A U.S. resident born in 2004 has a life expectancy of 77.9 years, placing the U.S. in 42nd place, down from 11th place two decades ago.”

“The U.S. ranks “near the bottom in healthy life expectancy at age 60” and 15th among 19 nations in deaths that would not have resulted “if treated with timely and effective care”

Outcome studies on a variety of diseases, such as coronary artery disease, and renal failure show the United States to rank not significantly better and in some cases worse than Canada and a wide variety of industrialized nations.

On the positive side however, the U.S. ranks “first in providing the ‘right care’ for a given condition” and high for preventive care but performs “poorly in coordinating the care of chronically ill patients, in protecting the safety of patients and in meeting their needs and preferences”;

Medicynical note: Our conservative friends say they want a more market oriented approach without bothering to correct the rotten “core” of our non-system. But market “competition” in health care doesn’t work. Our patent system provides a government sponsored protection to profits for drug companies and other new product developers for a generation. Such a scheme by definition is not free and open. Certainly there are benefits from patents but if the patent holders are irresponsible and abuse the privilege, the system fails, as our is in the process of doing. Drugs that cost over $10,000/month are simply not affordable by the system or individuals.

The “free market” approach to health care falls apart because the asymmetry in knowledge; the duress consumers face when utilizing the system (pay or die in some cases); and the lack of a reason for efficiency. Providers, institutions, insurers and manufacturers have operated on a cost plus basis for the past thirty years, piling on excessive costs without concern for value or for affordability.

The “free” availability of emergency room care is touted by our conservative friends as the solution to the lack of access for the uninsured. It’s at best ironic, and at worst cynical, that conservatives count on a government mandated safety-net program as an answer for our uninsured population. ER care is inefficient and expensive. As such it doesn’t answer our cost problems or the continuing care problems for 50 million of our citizens. How pathetic we are that this is a “serious” argument in the health care debate.

In summary: We have evolved into a healthcare non-system that is quite good for making money. Because of profit pressures our free wheeling approach encourages overutilization and inefficiency. Our costs are 1.5 -2 times that of other industrialized countries in the world, and approaching 16% of GDP. It’s simply not the best, but is the most expensive.

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