I don’t think we should be too dismissive of the recent New York Times article comparing the health care systems of other major developed countries with that of the U. S. It’s to be expected that the U. S. will excel in some things e.g. the prescribing of tests while not doing so in other areas e.g. the perception of fairness. I note two areas not mentioned in the article in which the U. S. excels and does not excel, respectively. The U. S. has far higher physician salaries than any other country—three times that of physicians in France, for example. The other area is physician job satisfaction. I’ve had some difficulty locating direct comparisons between countries on this. Perhaps someone can direct me to a study?
However, the article (and the WHO World Health Report on which it is based) does mention that patient satisfaction is lower in the United States than in many other countries. There is a demonstrated relationship between patient satisfaction and physician job satisfaction so you can draw your own conclusions.
Our present system is unsustainable. Some major changes in the way health care is funded in the United States are on the horizon and at the very minimum we should expect that government spending for senior health care won’t maintain its present course. That in turn is quite likely to result in lower availability of health care for seniors and significantly higher health care costs for all of us. Consequently, I don’t think we should waste too much breath defending the honor of the U. S. health care system. That system will be unrecognizeable in the near future, undoubtedly within my lifetime.
Our energies would be much better devoted to considering the nature of the reforms that will be adopted before they’re adopted in haste, winnowing the effective and desireable reforms from the politically impossible ones. Because there is health care system reform in our future.
Stop making sense, Dave! I’ve never seen it said better– American cocksureness is no substitute for a cold, heart look at the actual facts on the ground– in healthcare, or anything else. And in the healthcare field, the facts on the ground may not be as ugly as some (Michael cough cough More) suggest, but the “we have the best healthcare system in the world so f*** off” canard just rings hollower and hollower.
We certainly have the most expensive healthcare system in the world, and there’s no question whatsoever that other countries are getting a lot more bang for their buck (or euro). Figuring out how to improve on that is a national imperative.
Is there any particular reason why trained surgeons get five times as much (at least) as for example airline pilots?
Just as much experience required, just as much training and just as much intelligence and technical knowledge – with the difference that a pilot has three hundred lives in his care and the surgeon has one.
The answer is that the medical profession is the new priesthood, aided and abetted by the drug industry.
Socialised medicine a la UK is not the answer either – all that achieves is people at the sharp end of medical care being starved of resources while hordes of bureaucrats (many of whom get more money than highly-skilled nurses) who produce nothing stick their noses in the trough. Also hospitals that send out over 30% of their patients with diseases they didn’t have when they went in – because the bureaucrats are the ones who control where the money goes, and Pournelle’s Iron Law of Bureaucracy kicks in.
I don’t know where the answer is. Possibly a mixed system like that of France or Germany, along with a change of rules in the medical profession, so that anyone who takes kickbacks for unnecessary tests is struck off.
The legal profession also has something to do with it – medical tests of dubious usefulness can head off malpractise suits. Making “no-win, no-fee” arrangements illegal or against legal professional rules would help immensely here.
Fat chance of either.