
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.