Wednesday, August 5, 2009

How Good Is European/Canadian Health Care Really?

I’m convinced. We need a government-run, single-payer health care system. Why? Because our health care system is miserable -- it’s the worst in the developed world. And everybody else's is so good. Yep. The end.

What’s that? You want me to produce evidence? Fine, but it’s a waste of time. . . just like reading a bill before you vote for it.

Let’s start with life expectancy. Did you know that the United States ranks 50th out of 224 nations in life expectancy? That’s pretty bad. Of course, we live to an average age of 78.11 years, whereas the world average is only 67. So I guess that’s not so bad. And I guess I should mention that the European Union only ranks 41st, at 78.67 years. Interesting. . .

Hey, did you know that the most observable determinant of life expectancy is obesity. And if you factor out the increase in obesity in the United States between 1991 and 2004, the American life expectancy would increase by six months to 78.71, a little better than the EU. Wow, I never saw that coming!

Ok, so the life expectancy thing didn’t work, but we ALL know that the United States leads the world in infant mortality. What? That’s not true either.

The US infant mortality rate is 6.26 deaths per 1000 births, placing us 44th on the list of 224. The EU rate is 5.72 deaths per 1000, placing them 42nd. Only two spots higher. But there's more you say? Not all countries count infant mortality in the same way? In Canada, Germany and Austria, premature babies weighing less than 500 grams are not considered living children and are not counted toward mortality statistics. In Switzerland and other parts of Europe, a baby is not considered a baby unless it is at least 30 centimeters in length at the time of death. In some countries, babies that survive less than 24 hours are considered “stillborn” and are excluded as well. Hong Kong and Japan classify these as “miscarriages” and don’t count them either. Norway has one of the lowest infant mortality rates in the world until you add these exclusions back in. When you do that, the have the same rate at the US.

Who could have guessed that the two big reasons cited for switching to a single payer system are false? I wonder what else we don’t know. . .
• Breast cancer mortality is 88% higher in the UK, 52% higher in Germany, and 9% higher in Canada than in the US.

• Prostate cancer mortality is 604% higher in the UK, 457% higher in Norway, and 184% higher in Canada than in the US.

• Colorectal mortality is 40% higher in the UK and 10% higher in Canada than in the US.

• Americans have better access to treatment for chronic diseases like heart disease. For example, 56% of Americans who could benefit from statin drugs receive them. This compares to 36% of the Dutch, 29% of the Swiss, 26% of the Germans, 23% of the Britons, and 17% of the Italians.

• Canadian and British patients face waits that are twice as long as those in America.

• The US has 34 CT machines and 27 MRI machines for every million Americans, whereas Canada has only 12 CT machines and 6 MRI machines per million, and Britain has only 8 CT machines and 6 MRI machines.
Nor are foreigners all that happy with their systems. Just like Americans, more than 70% of Germans, Canadians, Australians, New Zealanders, and Britons report that their health care systems need either “fundamental change” or “complete rebuilding.” That is surprising if one is to believe that the single payer system is such a good idea?

Further, the idea that American drugs are expensive compared to the rest of the world is a myth. Recent studies have shown that while the US, on average, has higher prices for newly originated drugs, it has the lowest generic prices compared to other countries. The US also has the lowest over-the-counter costs. Moreover, while the US consumer would have spent, on average, 3% more for the same basket of drugs in Canada and 27% more than your average German, the American would have spent 30% less than the average French patient, 9% less than the average Italian, 8% less than the average Japanese, and 24% less than the average Briton.

Finally, consider that the world is piggybacking on American innovation.
• The top five US hospitals conduct more clinical trials than all the hospitals in every other developed country combined.

• Since the 1970s, the Nobel Prize in medicine or physiology has gone to US residents more than the residents of all other countries combined.

• The United States spends three times as much as the rest of the world on R&D in biotechnology.
So maybe, in the end, our system isn’t the disaster we’ve been told? Or maybe, emulating the European/Canadian single payer model just isn’t a good idea.


StanH said...

R&D is to me one of the glaring reasons to keep the mitts of the government off of our healthcare. We need some reform as stated by your excellent essay, but not a wrecking ball. The Free Market leads to innovation, statist solutions lead to stagnation.

Writer X said...

I had no idea that other countries counted infant mortality rates differently. Whether a baby is alive is determined by its weight? Unbelievable.

Also, it's interesting that the mortality rates are higher in the countries that have socialized medicine. Very telling. And depressing. No wonder why the Canadians flock to Arizona for their healthcare.

AndrewPrice said...

Writer X, That's the thing about statistics, they are very easy to manipulate (unemployment and GNP are the same thing, you can count then in many different ways).

When I researched the article, I also found that a portion of our mortality rate (though I don't know how much, which is why I didn't include it in the article) was the result of socialized countries sending their sickest people here to get better care.

Canada in particular sends a lot of terminal Canadians down here for serious treatment, and those deaths count toward our totals -- not theirs.

AndrewPrice said...

Stan, I agree completely. Without our R&D, most of modern medicine wouldn't exist. And that's something we need to protect, because the systems used by other countries just don't encourage investment in R&D.

CrispyRice said...

I totally agree with Stan - R&D alone is worth what we pay.

And I'm just shocked about the infant mortality stuff, too. Or the adult mortality rates, either. >>insert eye bugging out emoticon here<<

Thanks for the info, Andrew. Knowledge is power and we need all we can get!

AndrewPrice said...

CrispyRice, you're welcome. I agree about the R&D. People always complain that despite all the innovations, health care doesn't get cheaper.

But there are many more factors that go into cost than just the cost of innovation. Also, they never consider how the quality of care has improved. Years ago, doctors couldn't look inside you to find out what was wrong -- they had to cut you open or guess. Cancer treatment was often as fatal as the disease. Routine illnesses where much more deadly. Etc.

Innovation has been a boon to us all.

BevfromNYC said...

As per the thinking of Ezekiel Emanuel and others though, all of the medical breakthroughs in the last 100 years have just put a strain on the system. It's just making people live healthier longer and costing us more and more in health care. People with chronic illnesses who otherwise would not have lived even 20 years ago are costing some health person their wellness perks. And these same medical innovations have allowed a growing healthier elderly population which puts a strain not only on healthcare, but they can and want to work longer, so there are less jobs for the young people.

AndrewPrice said...

Bev, As implausible as that sounds, you're right. There are many people who make the argument that people live too long now and that old people take up too many resources.

And that's part of what goes on in the socialized systems, they cut old people off from treatment because it's not cost-effective to the system to pay for that care. Never mind the suffering of the individual.

It's a sick way of thinking.

LawHawkSF said...

Andrew: Two things are outstanding in American medicine above everyone's. Our medical procedures (specifically surgery) are the envy of the world. Our emergency treatment in the field and in the o.r. make the Europeans look like Neanderthals.

And the other is the ready availability of wonder drugs, almost all of which were developed right here in the good old USA. Lipitor alone will keep me from suffering the early heart attacks and strokes my parents suffered. So who are among the main targets of our single-payer socialist wannabes? The evil drug companies. Big Pharma! These clowns in Congress actually believe that governments with no incentive to do so can produce new life-saving drugs which private for-profit companies can't. Aw nuts! The last important drug invented in Europe was thalidomide, and we all know how that turned out.

BevfromNYC said...

Okay, this just in:

"There is a lot of disinformation about health insurance reform out there, spanning from control of personal finances to end of life care. These rumors often travel just below the surface via chain emails or through casual conversation. Since we can’t keep track of all of them here at the White House, we’re asking for your help. If you get an email or see something on the web about health insurance reform that seems fishy, send it to"

I am thinking of sending this statement from this blogger back to them as "something on the web...that seems fishy".

patti said...

dear lord in heaven, hear our pleas. and to everyone else: to the town hall meetings!

AndrewPrice said...

Bev, I like the idea of turning in the White House to their snitch line, that fits what they're talking about.

Patti, From the sound of it, our reps are getting an earful already! Let's hope that everyone keeps up the good work. Maybe they'll get the idea in Washington?

Writer X said...

I just turned Barack Obama into the snitch line. Is that wrong?

LawHawkSF said...

WriterX: I sent the messiah a copy of his presidential web page touting health care. I thought it seemed very fishy.

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