Friday, July 10, 2009

Health Care Here And There

With data current as of July, 2008, NPR contrasts health care in seven industrialized nations- France, Germany, Great Britain, the Netherlands, Switzerland, Japan, and the U.S.A. Among the indices listed are coverage, health spending per capita and as portion of gross domestic product, and life expectancy at birth. It finds that health spending per person ranges from $2358 annually in Japan to $6402 annually in the U.S.A.- and as portion of gdp from 8.4% in Japan to 15.35 in the United States. Coverage is indicated as 100% in Japan and France, "all citizens and legal residents" in Germany, Great Britain, Holland, and Switzerland, and in the U.S.A., 82% of people under age 65, 100% (thank you, Medicare) of people 65 and over.

The comparison indicates that life expectancy at birth in the United States is lower, at 78.1%, than in those of the other six nations. In an article explaining the lessons our nation might learn from the relative success of health care in France (11th) and the Netherlands (5th), Jonathan Cohn includes a similar, yet different, index. Referring to a 2003 ranking of 20 advanced countries, he notes

....the U.S. finished 16th when it came to "mortality amenable to healthcare," another statistic that strives to capture the impact of a health system.

Cohn knocks down a few myths propagated about health care by conservatives, who particularly delight in pointing to longer waiting periods for elective operations in Canada (a nation not included in the NPR study) than in the United States. Usually left unexplored is a major reason for the longer rate, suggested in Cohn's remark about the two countries he studied (emphasis mine):

Dutch and French patients do wait longer than Americans for specialty care; around a quarter of respondents to the Commonwealth Fund survey reported waiting more than two months to see a specialist, compared to virtually no Americans. But Dutch and French patients were far less likely to avoid seeing a specialist altogether - or forgoing other sorts of medical care - because they couldn’t afford it. And there’s precious little evidence that the waits for specialty care led to less effective care.

Frightened away by cost, Americans frequently avoid the treatment they need. And still health care is way more expensive here than in other comparable, or remotely comparable, nations. But if consumers and doctors are unsatisfied with the system as it is, the health insurance industry is quite pleased, thank you. And to too many Repubs and centrist Democrats, shielding private insurers from competition is all that really matters.

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