With all this hype about health care, I find myself asking: Is the American health-care system really worse than other countries? Here are some points to consider:1. America’s mortality rates need work.
American health care basically doesn’t get the same bang for its buck compared to other countries. Actually, it seems like we pay more for less. The major indicators (mortality rates) show that America is at a disadvantage compared to other developed countries. The Organization for Economic Co-operation and Development released a report last year with these findings:
"Notwithstanding very high health spending (about 15% of GDP) and the use of cutting edge technology, the health status of the US population does not appear to fare well by international comparison. The United States ranks poorly in terms of life expectancy at birth, infant mortality and ‘amenable mortality’ (i.e. mortality that can be averted by good health care). While there are factors beyond the health care system itself that contribute to this below average health outcome and/or higher health expenditures such as the relatively high risk of death or injury from violence or accidents, the higher prevalence of obesity and of low birth weight babies, and the cost of the medical liability litigation system and the associated practice of defensive medicine, these factors do not appear to explain all of the gap in performance between the United States and other countries."
2. We have less coverage than other developed nations. That's a fact probably most familiar to us.
The OECD estimates that 46 million persons were not insured at all in 2007 (16% of the population), with a larger share of the population underinsured.
And yes, if you are wondering if the coverage problem has something to do with our mortality rates, you might be right. The report notes:
"It is therefore plausible that the significant and growing proportion of the population that is uninsured or underinsured is one of several factors that help to explain the growing gap in life expectancy between the United States and other countries."
3. We get less value.
So, we pay more than other countries and yet don’t have a lot to show for it. Another fascinating study is straight from an association of U.S. CEOs, who want to get the most out all the money they shell out for insurance. The study found that on a weighted scale, U.S. workers and employers receive 23% less value from the American health-care system than the average of five leading competitors: Canada, Japan, Germany, the U.K. and France, and 46% less value than the average of emerging competitors Brazil, India and China.
The CEOs concluded that “the costs and performance of the U.S. health care system have put America’s companies and workers at a significant competitive disadvantage in the global marketplace.”
4. The price of health care is going up.
Skyrocketing costs are another widely reported symptom of the ailing health system; it has been a large impetus behind reform (on both sides of the aisle). Just today a study was released by consulting firm Mercer that found that if employers kept their medical coverage as is, they would see a 9% cost hike. More than half of the surveyed employers plan to shift some of that cost onto employees by asking them to pay more.
5. Americans like their insurance...So something is right? Right?
Despite all of the above considerations, the majority Americans are not exactly protesting in the streets for reform. We are happy with our $20 copays to whatever doctor we want. Many Americans are scared by the horror stories of long lines and less choice in other countries with more socialized systems. The U.S. seems to promise bigger and better opportunity. (T.R. Reid recently wrote an interesting piece arguing that some of our perception of services in other countries is myth.)
Of course, many Americans do not have health insurance at all. And many Americans aren’t aware of how much that health insurance costs. Maybe it won't always be so available.
There seems to be a poll to prove everything about how Americans feel about health care. Even if we can’t rely on polls, it’s still pretty fascinating to see what people say. One poll last year by Harris Interactive found that America’s health system is the least popular compared to other countries. (One-third of respondents said it should be completely overhauled.)
And another survey by Harris Interactive and Harvard University is pretty amusing: Republicans are more likely than Democrats to think America’s health-care system is the best in the world.
So is America’s health system worse off than other countries? I guess it depends on who you ask.
Posts
2 comments:
The reality is that most Americans have no idea how their healthcare compares to other countries. But, having experienced some of it first-hand, I would say that most Americans (certainly those with insurance coverage) would not be happy to trade in what they have for what they would find in other countries. They would not like the lack of choice, they would not like the dearth of doctors, and they would not like the higher taxes that they would inevitably have to pay to provide that kind of healthcare system. Unless, of course, you're currently without health care coverage or unable to afford it - or worried about losing your job (and your coverage). Those that trumpet the advantages of other systems tend to gloss over the fact that mortality rates are a function of more than health care - we drive more/farther/more often - we eat more (though not "better") - and, frankly, we keep better statistics than some of the "competition." Some of it is simple economics - we spend more because we, as a nation have more to spend. And - frankly - much of the spend is because we are keeping older Americans alive longer (the "death panel" concern is that a big way to save costs would simply be to deny care in situations when that seems economically inappropriate).
There is a reason why the world still comes HERE.
I think we would all like to see healthcare costs level off - and I think for most Americans, that's the reform they'd most like to see (it's also the reform I think least likely to be achieved by the proposals currently on the table). Much of the cost in the current system is imbedded by regulations in the various states that impose requirements on what kinds of treatments MUST be covered - HAIR PLUGS? Via.gara? THAT'S why, as the President noted this week, there is effectively one provider in Alabama. It's not the lack of government involvement - it's BECAUSE of it.
I think most Americans would like everyone to be able to acquire - and keep - insurance coverage. But a third of those "uninsured" are just choosing not to buy it. Something like a quarter are not even in this country legally. The actual number legitimately unable to acquire coverage is "millions", but do we need scrap the program that covers hundreds of millions to deal with that?
The real question (IMO) is - would you be willing to give up the system/coverage you have - would you be willing to pay more (albeit perhaps in different ways) - to build a system where everyone has SOME level of coverage? And, even if you are, do you believe the government has the ability to build that better system?
Or would you rather go for what's behind door #3?
Thanks for your points. I think the conflict really comes down to quality verse quantity. Are we willing to risk losing some of the perks of our health coverage to get everyone else in the system?
Post a Comment