Scientific American, that paragon of science writing, has an article on health care. It reports the results of a study done by a bunch of Canadians. They compare the health care systems in the USA and Canada and discover that We're Number Two: Canada Has as Good or Better Health Care than the U.S..
According to Woolhandler, by looking at already ill patients, the researchers eliminated any Canadian lifestyle advantage and just examined the degree to which the two systems affected patient deaths. (Mortality was the one kind of data they could extract from a disparate pool of 38 papers examining everything from kidney failure to rheumatoid arthritis.)These studies are never conclusive. There will always be people who quibble about this or that and just as you might expect there is the obligatory complaint about wait times in Canada.
Overall, the results favored Canadians, who were 5 percent less likely than Americans to die in the course of treatment. Some disorders, such as kidney failure, favored Canadians more strongly than Americans, whereas others, such as hip fracture, had slightly better outcomes in the U.S. than in Canada. Of the 38 studies the authors surveyed, which were winnowed down from a pool of thousands, 14 favored Canada, five the U.S., and 19 yielded mixed results.
The point isn't so much whether Canada is better—although it is—the point is that Americans have just got to stop pretending that they have the best health care system in the world. At the very least it's time to admit that it's "one of the best." One thing is very clear, the American system may not be the best in the world but it's sure the most expensive.
The study's authors highlight the fact that per capita spending on health care is 89 percent higher in the U.S. than in Canada. "One thing that people generally know is that the administration costs are much higher in the U.S.," Groome notes. Indeed, one study by Woolhandler published in The New England Journal of Medicine in 2003 found that 31 percent of spending on health care in the U.S. went to administrative costs, whereas Canada spent only 17 percent on the same functions.I suspect there are many European countries with health care systems that are just as good as the one in America. I suspect that Japan, New Zealand, and Australia have good health care as well. I've never seen any data that shows that the quality of health care in America is better than everywhere else in the world. It seems to be one of those myths of American superiority that has no basis in fact. The myth prevents Americans from joining the rest of the civilized world and adopting socialized medicine.
I obviously haven't looked at the same numbers as the Scientific American, but on all parametres I've looked at, the US is among the worst in the Western world.
ReplyDeleteI wrote about that here (if you find the post interesting, check out the others under the "universal health care" label).
It reports the results of a study done by a bunch of Canadians.
ReplyDeleteWow, a study on a political question by a bunch of Canadians gives a boost to the Canadian policy solution. Amazing. I wouldn't believe a study by "a bunch of Americans" that lauded the American approach to a political issue like health-care funding -- why should I believe it from any other nationality?
"Americans have just got to stop pretending that they have the best health care system in the world."
ReplyDeleteActually, what's all over the papers, airwaves, Web, etc., here is how *broken* the U.S. health care system is, using descriptions much like yours, i.e., not the best results but sure as heck the most expensive. These sorts of comments are now starting to come from heads of major corporations (including health insurance companies) as well as more traditional sources like consumer advocates.
In a display of Americans' remarkable talent for logical inconsistency, the most popular alternative to a federal health care system being discussed at the moment is *state*-run health care.
Every study I've seen seems to conclude that the French have the best health care in the world. And they ought to- it's the second most expensive system in the world, though a considerable distance behind the good ol' pay-more-get-less USA.
ReplyDeleteas someone who has lived in both, i much prefer the treatment i get here (in the usa), than to canada. its easier to find a doctor, there is less waiting and the quality of care seems much better. granted i have a job which subsidizes it, and i guess i have a pretty good hmo. Plus even excluding income tax differences, its cheaper down here
ReplyDeletewolfwalker asks,
ReplyDeleteWow, a study on a political question by a bunch of Canadians gives a boost to the Canadian policy solution. Amazing. I wouldn't believe a study by "a bunch of Americans" that lauded the American approach to a political issue like health-care funding -- why should I believe it from any other nationality?
I specificaly mentioned that the study was done by a bunch of Canadians in order to emphasize the potential bias. The point isn't that you should believe Canadians more than Americans. The point is that you should be skeptical of every claim, including that of Americans, who say they have the best system in the world.
As a matter of fact, your bullshit detectors should almost always go off whenever anyone claims to have the "best" thing in the entire world.
In other news, Canada also has the biggest coin:
ReplyDeleteOTTAWA (Reuters) - The Royal Canadian Mint unveiled a welcome addition to any piggy bank on Thursday -- a monster gold coin with a face value of C$1 million (455,000 pounds) that it says is the world's biggest, purest and highest denomination coin.
Weighing in at 100 kilograms (220.5 pounds)...
The Canadian mint introduced the mega-coin, which is the size of an extra-large pizza, alongside the one-ounce gold bullion coins it is mass producing at its Ottawa plant.
Amazing! A typical extra-large pizza in Canada weighs 100 kilograms.
Not a comment on the study itself, but it struck me as funny that the article said "We're Number Two" when there are only two in the comparison. Wow! I'm so proud of being 2 out of 2! Is that called framing?
ReplyDeleteLarry,
ReplyDeleteMy thought is that both country's health care systems have similar capabilities. The apparently small differences between the two countries would be small if compared to the best and worse health care regions in the US itself.
For the twenty percent or so of US population that has limited or no access to the health care system, the quality of care is irrelevant. To them a health care system does not exist.
As a matter of fact, your bullshit detectors should almost always go off whenever anyone claims to have the "best" thing in the entire world.
ReplyDeleteAgreed. And mine does.
Of course, it also goes off whenever anyone else claims that "X has the worst Y in the entire world." Especially when Y is a political issue or arrangement. There ain't no such thing as a free lunch, and there ain't no such thing as a good solution to a political issue. There are only bad ones and worse ones.
The US health care system is a dreadful one. You know it, I know it, anyone who knows the facts knows it. But so are all the others. It's up to you to decide which one you like better: a system that can deliver quality care but makes you pay through the nose, or a system that costs a lot less but can't deliver quality care when it's needed.
(Please don't anyone try to claim that anyplace has free health care. Ain't no such critter. Some places you pay at the door, other places you pay through taxes ... but either way, you do pay.)
A layperson's view point here, I must admit before I go any further:
ReplyDeleteThe ranking of health care, as conducted by this study, is based upon "the degree to which the two systems affected patient deaths".
Is the results of this, what makes a good health institute? Who can determine what exactly "good health care" is? Doesn't it vary from person to person? While I can understand that these figures and data observed from the "outsiders eye" are important and useful in their own way, I do not like to think that we should go by these results on which country provides better health care.
Health care is so much more than how much the system has affected patient deaths (although, yes, that is an important factor to think about, too) - everything in a hospital, when observed, happens at the simplest of levels. The doctor-patient interactions, the way the patients are treated by the nurses, the hospital food, the environment in the hospital, the way many different people (of all different 'statuses' within the hospital) work together to make a human being as comfortable as possible whilst in a building dealing with their body and its health. It's all these things that add to health care, too. Why is the fact that, even though one country might have had a more intense degree of affecting on the death of its patients, the patient might have received compassionate and competent care ignored?
On top of that, why are there such studies in the first place? I do not get the point of them. OK, while I understand that, overall, some countries will on average provide better health care than others, I do not understand the need for such surveys to be conducted.
What difference does it actually make to the society? There will always be squabbles about the reliablity of the results of the study conducted, questions on the method of the conduction of the study, disagreements on what the studies show, and how seriously they should be taken. Besides, there is no fixed standard, like a scale, upon which to compare all the countries in the world. So what is the point?
It serves no purpose to the patients, who might want to know specifically which place is better for a specific area of medicine. Or those who want a certain kind of doctor. And so what if one country is better overall at providing health care than another - is that actually going to affect the patient in the hospital bed, waiting for a hop replacement? No, not really.
Perhaps it is an interesting study to do, and might be of interest to those for professional reasons, I don't know. But, based on what I have seen only, these issues rarely find their way through to the public, and even if they do - it does not make a difference to their lives. They will carry on visiting their regular GP and going to their regular hospital.
I don't know... these are just my thoughts... I hope I made sense.
ordinarygirl: "it struck me as funny that the article said 'We're Number Two' when there are only two in the comparison."
ReplyDeleteIndeed. When I saw the title "USA Is Number 2 in Health Care," I thought, "Wait a minute, isn't that a bit high?" AFAIK, my country is doing much worse than Number 2, unless one is making a scatological reference.