Posted on 08/29/2007 1:03:13 AM PDT by Angel
In May, the Commonwealth Fund issued its latest comparison of the U.S. medical system with five other wealthy nations' systems: Australia, Canada, Germany, New Zealand and Great Britain.
Predictably, the study begins: "Despite having the most costly health system in the world, the United States consistently underperforms."
I was immediately suspicious, considering the loaded study by the World Health Organization seven years ago. (I wrote about it last week.)
My suspicion was justified. It turns out the new study is almost as biased as the WHO's. The authors write, "The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes."
I see. America "underperforms" because we don't have enough government intervention.
But while the U.S. lost points for not having national health insurance, the authors added, "[I]f insured, patients in the U.S. have rapid access to specialized health care services."
That's an understatement. Insured Americans have almost immediate access to cutting-edge procedures performed by some of the best-trained doctors. It's why our outcomes for such diseases as prostate and breast cancer are markedly better than in Canada's and Britain's socialized systems. The Commonwealth Fund doesn't mention that.
The United States is the center of medical innovation for the world. When internists ranked the world's top 10 medical innovations, eight were developed thanks to American innovations. The Commonwealth Fund ignores all that and focuses almost exclusively on the problems of our uninsured population.
As I've noted previously, the problem of the 45 million uninsured is exaggerated. The statistics represent a snapshot, and many uninsured people are reinsured in less than a year. The same people are not uninsured year in and year out.
The Commonwealth Fund study divides "quality" into right (effective) care, safe care, coordinated care and patient-centered care. The U.S. placed fifth or sixth in the last three.
But where did the U.S. place in "right care"?
First.
"Right care" is the most important criterion because it includes things like how often women have mammograms and whether diabetics get proper treatment.
The Commonwealth Fund ranked the U.S. last in "equity": "Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick, not getting a recommended test, treatment or follow-up care ... because of costs."
But how much of that is due to the government's increasing the cost of care and insurance through mandates, a tax code that encourages reliance on expensive insurance and bureaucratic red tape?
The Commonwealth Fund's study has other problems. It was based on telephone interviews with patients and doctors. So it grades nations on people's perceptions without controlling for their expectations. Yet patients who live in a country with long waits for medical care and bureaucratic inefficiency may have low expectations.
More ridiculous is the arbitrary way the Commonwealth Fund assigns weight to each of its measures. The proportion of patients who say they got infected at a hospital counts about the same in the "quality" measure as the proportion of doctors who use automated computer systems to remind them to tell patients their test results. Those things aren't equal in my book.
The study's authors also consider having high administrative costs and spending the largest share of GDP on health care worse than having the highest share of patients who wait four months or more for surgery. This seems designed to make the U.S. look bad.
Finally, the study penalizes nations for having large numbers of patients who spent more than $1,000 on medical care out of pocket, as if third-party payment is somehow superior.
Michael Cannon, the Cato Institute's director of health policy studies, summed up what's wrong with the study: "The report does nothing more than reveal which nation does the worst job of satisfying the subjective preferences of the people who conducted this study."
Fans of the Canadian system should note that Canada ranked fifth out of six and did worse than the U.S. in many ways.
Are you listening, Michael Moore?
What the report fails to mention (realize) is that every person in the United States will recieve medical care at the Emergency Room of their choice, should an emergency situation arise.
Effectively, there isn’t a single uninsurged individual in the United States, if this is taken into consideration.
Game, set, match...
As noted on Fox News the other night:
45% of the 45 million are not US citizens!!!!
Of the remaining 55%, 8.5% are those earning more than $75,000/year (presumably self-insured) and about 54% are in the age group of 18-35, young, healthy, invincible, don't care, don't want to spend a fortune on insurance ...
In other words, the 45 million figure is just so totally BOGUS!!!
-—and what Republidum politician (up to and including the President) is willing to speak out about this——or even say it out loud????
Last week I toured a hospital in Sweden. It was clean, well-run, etc. But the taxes on income of 40% at the national and county levels to provide these services were glossed over. They don't have huge pockets of...well, of potential Katrina victims that are cared for out of our funds.
High level business execs have private insurance, justified by the loss of "value" if they are sick and have to wait for care. The government still pays the medical bills, but the hospital gets the insurance payments also as a purchased ticket to immediate care. So, if you want timely care, you pay for it.
My response wasn't popular: (1) I don't want to pay that high an income tax for my care; (2) being non-insured or under insured in the US is a non-issue, since no one is denied care; and (3) the bottom line is that if I get seriously ill, I want to be in the U.S. rather than any other country in the world, including Sweden.
I guess this is an example of universal health care...
“TOKYO (AP) - A pregnant woman miscarried in western Japan on Wednesday after nine hospitals refused to admit her and the ambulance transporting her crashed on its way to a tenth...”
also:
“In a similar incident last year, a pregnant woman died in Nara after being refused admission by about 20 hospitals that said they were full.”
http://apnews.excite.com/article/20070829/D8RAPFU80.html
Without naming names, this is exactly the problem when you elect a Republican Democrat. What comes to you and I instinctively, just doesn’t occur to a guy that isn’t well grounded. Now if he gets wound up on a subject and gets up to speed, he may agree with you. But that’s after he’s been sat down and talked to about what the conservative option should be.
I’m tired of watching folks get caught flat-footed, when they are asked questions that a conservative should know the answers to, but they don’t.
When our guys go public, they should speak on these issues pre-emptively. Nip the topics in the bud.
Thanks for the response.
Wow, those would be great to have when the debate over national healthcare goes into overdrive.
Our system isn’t perfect. It’s far from it, but it sure as hell beats anything else out there by a wide margin.
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