…except for Andorra, Iceland, Switzerland, Sweden, Norway, and 29 other countries where the health care is better than it is here. Those are the findings of a study published in Lancet of international health care systems:
National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015.
The researchers examined 32 common ailments—from measles to diarrheal disease to appendicitis—that ought to be treatable by reasonably qualified doctors in a relatively modern healthcare system. Then, based on 2015 mortality rates from those preventable causes of death, the team gave each of 195 countries and territories, what it called a “Healthcare Access and Quality†index score, ranging from a low of 0 to a high of 100.
The United States earned a score of 81—a B-minus, if you will—right on par with Estonia and Montenegro, but unfortunately much lower than most of the rich nations in America’s peer group. Sweden, Norway, and Australia received a score of 90, for instance; Iceland—that brown-nosing snot—got a 94.
But what’s most scary is how poorly the U.S.—which spends about 17% of its GDP on healthcare, and more per capita than pretty much every country in the world—did in preventing death from things like lower respiratory infections (the tiny nation of Bosnia and Herzegovina performs better than we do in this regard), neonatal disorders (Lithuania kicks our butt), Hodgkin’s lymphoma (we’re bested by Armenia, Jordan, the Northern Mariana Islands, South Korea, and Saudi Arabia), and diabetes (more deaths from this brutal disease are prevented in Cuba, Russia, and Moldova).
My point in bringing attention to this study is not to bust the chops of American health care providers. The circumstances here in the U. S. are daunting. Patients are non-compliant, have lousy lifestyles and habits, have too much information but not enough knowledge, are inundated with pharmaceutical advertisements, and are predisposed to shop for physicians who will promise the results they seek.
Rather my point is to suggest that we shouldn’t be comparing the United States with geographically tiny countries with small, homogeneous populations but with other geographically large countries with diverse populations in the hundreds of millions or even billions. By comparison with Brazil, China, India, Mexico, and Russia our health care system is very good indeed.
The big countries you cite are pretty poor. Not a good comparison. There just isn’t a perfect comparison, but I don’t think it matters all that much except at the extremes. We can certainly learn from other relatively wealthy countries, even if they are smaller. AS your articles note, this is consistent with prior studies. What we find is that for people who have insurance, our outcomes are actually pretty good. The reason we score so poorly is that we have so many people who have no insurance, or inadequate insurance.
The other things you list can be problems elsewhere. However, since our care is the most market oriented, the advertising and scamming for dollars, legitimate and illegitimate, is much more common here.
Steve
Insurance, with high out of pockets, is no help at all for any but the wealthiest Americans. Most of us have dental insurance through work, if it’s like mine, $1200 annual max which covers ONE crown @ 75%. Anything more this year, have to let it rot out.
Health, I just underwent a biopsy of my prostate, at my G P’s urging. Now I have to come up with $700.00 for nothing. Peace of mind? how many other cancers might I have, undetected? The next test she recommends I will pass on, not because I don’t trust her, but I’m still making payments on the last one, I have no choice.
Be small and homogeneous? Implement a health care system 50 or 100 years ago? Don’t have a border with a country that has a per capita income a quarter of yours?
These differences in our experience are the very reasons that single-payer or a national health service are tough sells here.
Germany adopted its system more than a century ago, the UK 60 years ago, and France 50 years ago under circumstances very different than those in the U. S. of today. Would Germany have adopted its system with costs as high as ours are now and if 30% of its population had been Turks? I don’t believe it.
Please keep in mind that I’m not defending or justifying our system. I’m just explaining it.
Actually, I’m skeptical that we’ll adopt a single-payer system in the foreseeable future let alone a national health service. You just have to listen to the belly-aching of the coastal progressives about the free-loading Red State hillbillies to think that when the green eyeshades come out and they realize that they’ll be paying for the health care of those hillbillies they’ll have second thoughts.
One reason these countries have better health habits is that it’s in the interests of the state to nag about it for reducing costs. Health info for preventive issues is everywhere.
I think that they had better health habits before they adopted their systems.
I would add to what i said above that if anyone has not sen John Oliver’s recent bit about Davita and dialysis it is worthwhile. We have bad outcomes with dialysis patients compared with the rest of the world. Of course it is mostly done by large for-profit companies.
Steve
I heard the State Dept is having trouble keeping up with passport applications from Hodgkins patients heading for the Northern Mariana Islands.
I’d suggest a first step in dealing with this issue is experiment design not so obviously tainted.