Map of life expectancy at birth from Global Education Project.

Tuesday, December 15, 2009

We're Number One!

Not! You'll hear a lot of people say that the United States has the best health care system in the world. There must be other reasons why we don't match up well on life expectancy and other indicators of population health. Some will go so far as to say that universal coverage does have something to do with it, and maybe we should try to achieve that, but not at the cost of "rationing" or putting government bureaucrats in charge who will ruin the magnificent edifice created by our private system.

I really don't think so. Here you can see that according to an international survey done just last year, we appear to have the worst health care of all the wealthy countries (there were more countries in the survey but I’ve just showed you a sample). People with chronic illnesses in the U.S. often can’t afford their medications, don’t get appropriate treatments, are least likely to have a regular doctor, and have their time wasted by our disorganized, fragmented system.

Not only that, but we spend more out of pocket. 41% of U.S. respondents had out-of-pocket costs of more than $1,000. Lowest was UK with 4%; Canada was second-highest with 20%. Okay, well even if the patient's experience isn't great, we're still delivering the best technical quality medicine, right? Err. . .

We get bad results from our health care system. These investigators just looked at certain causes of death which can be prevented or delayed by health care, and looked at age-adjusted death rates from these causes alone. As usual, we’re number last.

So what exactly is it that the Republicans in the Senate and Joe Lieberman are determined to preserve? I have even more bad news on that tomorrow.


robin andrea said...

Somebody is making money and lots of it.

stickyfingers said...

Thanks for this -- do you have a link to the Commonwealth Fund report?

Cervantes said...

Commonwealth Fund report. (Check out the site, they have a lot of stuff.)

Anonymous said...

I wondered, C, what you think of the counter-argument that the US DA BEST crowd brings up, namely that the poor US stats on standard measures (and they often pick life expectancy so I’ll stick with that here as this is just a short post) are partly explained by various cultural and/or life-style, and sometimes even political characteristics, such as massive car driving (with accidents), gun ownership (with murder etc.), sport is another they forget, etc.? They often go on to mention immigrants, but that is another can of beans.

Suicide stats. are low in the US as compared to other OECD. On the other hand, labor accidents/death are high. Maybe even extremely high.

This issue is not important, for health care as a whole, by any means, and the numbers are not shattering. Nevertheless, I found myself wondering about the weight of this factor - premature death by accident / crime - from the public health pov.

Or is it something one should simply ignore? Or should one have a counter argument to hand?


Cervantes said...

Ana -- Yes. Patience. This is going to be a long story.