Obamacare supporters throw out numbers that try to show that the US Health care system is on the lousy side. For example the World Health Organization (WHO) rated U.S. health care 37th in the world in 2000, behind Andorra, Malta, Colombia, Cyprus, and Morocco and just ahead of Slovenia and Cuba. This is absolutely true. Of course included in the WHO methodology are ideological socialist type of ratings such as "fairness of pricing" and "responsiveness distribution"
When you look at pure survival statistics, what happens to people who get Ill, American Health Care is the best system in the world, despite what you will hear from the ruling party:
An Unnecessary Operation
Obamacare threatens what's right with American health care.
by Fred Barnes
This is the poll number that drives supporters of Obamacare crazy: Eighty-nine percent of Americans in a June 2008 ABC News/USA Today/Kaiser Family Foundation survey said they were satisfied with their health care. Put another way, more than 270 million Americans (I'm including kids) are reasonably happy with the system of medical care in this country. Other polls have found the same level of satisfaction.
One reason is the availability of first-rate care almost everywhere, day or night. But there's a more important reason: If you have a serious ailment, your chances of survival are better when treated in America than anywhere else in the world. Sure, the system has flaws, shortcomings, and inefficiencies. It probably costs too much. But if your goal is to live longer, then American doctors and American hospitals are your best bet.
Americans appear to understand this. So do the 400,000 foreign patients who come here every year for medical care. "Not too many people get on a plane and fly to Cuba or to France" to see a doctor, says Dr. Stanley Goldfarb, associate dean of clinical education at the University of Pennsylvania School of Medicine and an expert on worldwide health care systems.
Why would they go anywhere but here? America provides timely access--and not just for the wealthy--to the latest and most innovative technology, a full array of breakthrough drugs, and the top medical specialists. "If you have an acute illness, this is the country to get your care," Goldfarb says. "If you're not that ill, other countries are great."
Even if you're not seriously ill, American doctors have more to offer. The two most significant innovations for patient care in the past decade are magnetic resonance imaging (MRI) and computerized tomography (CT), according to Dr. Scott Atlas, chief of neuroradiology at Stanford University Medical School. The United States has 27 MRI machines per million Americans. Canada and Britain have 6 per million. The United States has 34 CT scanners per million. Canada has 12 per million, Britain 8.
And utilization of MRI and CT technology has become routine in America. My wife had an X-ray after injuring her ankle last spring and the diagnosis was she'd broken a bone. When it was slow to heal, she had an MRI, which revealed she'd actually torn a tendon. Now her ankle is healing.
Our share of the cost was minimal. Health insurance pays for tests, and you don't need a Cadillac policy to be covered. A little-known fact: Out-of-pocket expenses by American patients amounted to 12.6 percent of total national health spending ($2.24 trillion) in 2007.
That's one of the lowest percentages of private out-of-pocket spending among the world's advanced countries--lower than Germany, Japan, Canada, and most countries in Europe, including those with government-run health care systems. Why do Americans get more and pay less? Because their insurance policies provide broader coverage than most government plans, says Tom Miller of the American Enterprise Institute.
Private insurance, Medicare, and Medicaid cover most of the high cost of treating critical illnesses such as cancer and heart disease. And those are the ones in which the survival rates in the United States are significantly higher than in Europe or other countries. There are clinical data substantiating this. Two major studies (EUROCARE-4 and a study by the National Center for Epidemiology, Health Surveillance, and Promotion, in Rome, both published in the September 2007 issue of Lancet Oncology) were used to compare five-year survival rates for Americans and Europeans diagnosed with cancer.
For all cancers, 66.3 percent of American men and 63.9 percent of women survived. In Europe, 47.3 percent of men and 55.8 percent of women survived five years. Those are statistically important gaps.
And the survival rates were higher in the United States for the most common cancers as well. More than 99 percent of men with prostate cancer had survived in the United States after five years, 77.5 percent in Europe. Those with colon or rectal cancer survived at a 65.5 percent rate here and 56.2 percent in Europe. The rates for breast cancer showed a similar difference, 90.1 percent for Americans, 79 percent for Europeans.
Dr. Atlas cites a different set of results that underscore the same point: Your chances of living longer are better with treatment here. "Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom," he reports (see "Here's a Second Opinion," Hoover Digest online). "Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher."
Canada, whose single-payer health system is admired by many liberals, fared better but still trailed the United States. "Breast cancer mortality in Canada is 9 percent higher than in the United States, prostate cancer is 184 percent higher, and colon cancer among men is about 10 percent higher," according to Dr. Atlas.
Gary Becker, the Nobel Prize-winning economics professor at the University of Chicago, has cited still another study, this one on the mortality rates for the second leading cause of male cancer deaths (prostate) and the deadliest cancer for women (breast). This study, by Samuel Preston and Jessica Ho of the University of Pennsylvania, Becker wrote in his blog, found that "death rates from breast and prostate cancer declined during the past 20 years by much more in the U.S. than in 15 comparison countries of Europe and Japan."
Becker draws the obvious conclusion: "These results suggest that the U.S. health care system does deliver better control over serious diseases than systems in other advanced countries."
What gives American medicine its advantage? Success in treating cancer is largely determined by early detection and treatment and the use of the best drugs. "The United States does very well on all three criteria," Becker wrote. It helps that medical care for cancer and other deadly disease is more intensive here.
Tests for colon, breast, cervical, and prostate cancer have become an integral part of American health care, far more than in other countries. Nine out of 10 middle-aged women have had a mammogram, 96 percent of all women a Pap smear. As for men, 54 percent have had the PSA test for prostate cancer, 30 percent a colonoscopy for detecting colon cancer.
Since most advances in medical care are developed here, Americans benefit from them sooner, often many years sooner. Senator Edward Kennedy received proton beam therapy, which spares other tissue while attacking cancer. It may have prolonged his life. "You don't have a chance of being exposed to that in other countries," Dr. Goldfarb says.
In treating heart disease, Americans have far more access to statin drugs that reduce cholesterol. "Some 56 percent of Americans who could benefit from statin drugs . . . are taking them," Dr. Atlas wrote. "By comparison . . . only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians receive them."
But breakthroughs and discoveries are enormously expensive, so much so that America spends far more on health care (now 17 percent of GDP) than any other country. Incremental advances have driven up the cost of treating heart patients especially, but their effect in saving lives is indisputable.
"Wildly successful" is the way David Brown of the Washington Post has characterized the transformation of heart treatment. "Today, someone having a heart attack who gets to a hospital in time is likely to get cardiac catheterization, angioplasty, the placement of a medicated stent, therapy with four anticoagulant drugs and, on discharge, a handful of lifetime prescriptions," he wrote. These are innovations over the past half-century.
The results are in. "In the 1960s, the chance of dying in the days immediately after a heart attack was 30 to 40 percent," Brown wrote. "In 1975, it was 27 percent. In 1984, it was 19 percent. In 1994, it was about 10 percent. Today, it's about 6 percent."
These results are matched by the success in dealing with all heart disease. "In 1970, the death rate from coronary heart disease was 448 per 100,000 people," according to Brown. "In 1980, it was 345. In 1990, it was 250. In 2000, it was 187. In 2006, it was 135."
Cold numbers don't capture the breathtaking drama of what's happened. The transformation of heart care "has saved the lives of millions of Americans," Brown wrote. ". . . It is safe to say that almost everybody who has a heart attack wants the best treatment available. Nobody wants to turn back the clock." Nor should they, despite higher costs.
Critics of American health care, including advocates of overhauling the system and enlarging the government's role, harp on the rankings by the World Health Organization and other health organizations. These rankings are out of date, discredited, or misleading.
The WHO rated U.S. health care 37th in the world in 2000, behind Andorra, Malta, Colombia, Cyprus, and Morocco and just ahead of Slovenia and Cuba. This is not credible. To reach this ranking, the WHO used ideological assumptions--about such things as "financial fairness" and "responsiveness distribution"--heavily biased in favor of socialist countries or those with government-run health systems and against those relying on market incentives.
"It is entirely possible to have a health care system characterized by both extensive inequality and good care for everyone," Glen Whitman, an economics professor at California State University at Northridge, concluded. Indeed, that comes close to describing the U.S. system and explains why it gets a low WHO ranking.
America's relatively high rate of infant mortality is more complicated. In 2004, the United States ranked 29th in the world, based on government reports (not the WHO) from the countries ranked. Some of these statistics may be unreliable, and the standards for measuring infant deaths vary.
All babies that show signs of life at birth are counted as alive in the United States, even if they die within hours. Some countries don't count infants who die within 24 hours, others register babies below a certain weight as stillborn. So comparisons among countries are unreliable.
But we do have an infant mortality problem. The chief source is preterm births, babies born at 6 or 7 months. Non-health care factors play a role. "Lower infant mortality tracks with fewer teen pregnancies, married as opposed to single mothers, less obesity and smoking, more education, and moms pregnant with babies that they are utterly intent on having," Dr. Bernadine Healey explained in U.S. News & World Report. But biological reasons for so many preterm births remain something of a mystery.
The average life expectancy of Americans (78 years) is affected by infant mortality. The WHO ranked the United States 24th in life expectancy a decade ago. But "it's not about health care," Dr. Goldfarb says. "The mortality statistics are a social phenomenon, not a health care phenomenon." Diet, lifestyle, obesity, lack of exercise, a relatively high crime rate--all play a part.
But here's the good news. If you reach 80 in America, when most people are highly dependent on health care, your chances of reaching 90 are at least as good and probably better than anyone else's in the world. And of getting to 100 as well. The older you get in America, the better your prospects for living longer--thanks to American health care. Let's hope it stays that way.
No comments:
Post a Comment