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UK has best health system in developed world, US analysis concludes

bmj.com

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Re: UK has best health system in developed world, US analysis concludes

#21

Post by guelo »

ggambetta wrote: post #15

As a resident of the UK and a former resident of Switzerland, I can't understand how they came to this conclusion. Don't get me wrong, the NHS is great and the system works much better than in the US, but health care in Switzerland is just on another level. Before you say "but in the UK it's free" - considering what I paid for (private, mandatory) insurance in Switzerland, and the National Insurance contribution that…

You could read the report.

Basically UK spends less overall, 9.9% of GDP vs SWIZ's 11.1%. While UK ranks higher than SWIZ on the report's definitions of Care Process, Access, Efficiency and Equity. SWIZ ranks higher on Health Care Outcomes.

Re: UK has best health system in developed world, US analysis concludes

#22

Post by elmalto »

IsaacL wrote: post #14

This really is a matter of what variables you choose to measure. For example, the US is by far the world leader in medical research spending - 44% of global medical research is spent in the US. (Until recently it was even higher). [1] On the same note, many nations regulate the price of prescription drugs - drugs where the initial R&D was done in the states. (Yes, drugs are sold at a huge markup, but that's to recoup…

Interesting thought regarding the r&d spending in the US versus the rest of the world and hence subsidizing global health care. I did look at some numbers in a more recent publication [1](page 21) where the latest r&d numbers for both healthcare and biotech are listed. Germany‘s spending seems to be on average a little less than 1/3 of the US which would make them equal on a per capita level. The UK seems to be a little below those levels. Do you have any data to support your claim?

[1] https://www.iriweb.org/sites/default/files/2016GlobalR%26DFu...

Re: UK has best health system in developed world, US analysis concludes

#23

Post by _delirium »

ggambetta wrote: post #15

As a resident of the UK and a former resident of Switzerland, I can't understand how they came to this conclusion. Don't get me wrong, the NHS is great and the system works much better than in the US, but health care in Switzerland is just on another level. Before you say "but in the UK it's free" - considering what I paid for (private, mandatory) insurance in Switzerland, and the National Insurance contribution that…

There's some more detail in the online summary on their own website: http://www.commonwealthfund.org/interactives/2017/july/mirro...

On cost (which is under the Access category), Swiss seem to self-report having at least somewhat more problems even with the health insurance. For example: 22% of Swiss self-report having had a "cost-related access problem to health care in the past year" (UK 7%, US 33%), and 21% of Swiss report skipping dental care or check up in the past year because of cost (UK 11%, US 32%). Also, 46% of Swiss report having paid more than US$1000 for out-of-pocket medical expenses in the past year, which was the highest of any country in the study (UK 4%, US 36%).

Re: UK has best health system in developed world, US analysis concludes

#24

Post by ramchip »

comstock wrote: post #10

This analysis of a report seems pretty bad, even with only the title and abstract available. Firstly, the report doesn't even cover the entire developed world, just 11 countries. Notably, Japan doesn't appear to be included. To be honest, I found that slightly offensive. Secondly the U.K. isn't the overall clear "best" of those 11. It's not bad, and does better on some things, worse on others. In my subjective experi…

I'm also really puzzled by the omission of Japan. It has the highest life expectancy in the world, I would expect a comparison of health systems in the developed world to include it.

Re: UK has best health system in developed world, US analysis concludes

#25

Post by mjevans »

JamesMcMinn wrote: post #16
ggambetta wrote: post #15

As a resident of the UK and a former resident of Switzerland, I can't understand how they came to this conclusion. Don't get me wrong, the NHS is great and the system works much better than in the US, but health care in Switzerland is just on another level. Before you say "but in the UK it's free" - considering what I paid for (private, mandatory) insurance in Switzerland, and the National Insurance contribution that…

I don't think anyone, in the UK at least, thinks the NHS is free. Most people in the UK who describe it as "free" really mean "free at the point of use" (i.e. no invoice after treatment), but that's a bit of a mouth full.

It removes an entire department and source of variable from a 'company' that doesn't need it.

Ultimately you aren't going to deny someone coverage based on cost*, they're going to end up in an ER and 'written off' which will then be billed in to everyone else's costs. Worse, the outcome for the individual is often less good and frequently means they will be, overall, more of a burden on society than if they had received proper treatment in an early stage.

Instead, the 'cost' of billing that is 'outsourced' to the government's tax collectors, which are going to be the /very/ last thing removed if ever.

Re: UK has best health system in developed world, US analysis concludes

#26

Post by hackerboos »

mboto wrote: post #12
comstock wrote: post #10

This analysis of a report seems pretty bad, even with only the title and abstract available. Firstly, the report doesn't even cover the entire developed world, just 11 countries. Notably, Japan doesn't appear to be included. To be honest, I found that slightly offensive. Secondly the U.K. isn't the overall clear "best" of those 11. It's not bad, and does better on some things, worse on others. In my subjective experi…

As a fellow Brit I'd agree we're proud of the NHS but I don't think people believe it's the best in the world. We complain too much for that.

France ranks higher in some studies. I did a lot of personal research after "Sicko" the movie was released.

Re: UK has best health system in developed world, US analysis concludes

#27

Post by [deleted] »

cmurf wrote: post #11

Unsurprising. We pay more money per capita, to get worse results, BUT at least we get to, in one way or another, exclude people who aren't paying their own way. And that's what red states in this country appear to want, because they keep voting for Republican governors who campaign on sabotaging health care and then succeeding. http://www.latimes.com/opinion/op-ed/la-oe-baker-obamacare-r... Today on NPR I listened to…

[deleted]

Re: UK has best health system in developed world, US analysis concludes

#28

Post by HarryHirsch »

mjevans wrote: post #25
JamesMcMinn wrote: post #16

Earlier quoted context omitted.

I don't think anyone, in the UK at least, thinks the NHS is free. Most people in the UK who describe it as "free" really mean "free at the point of use" (i.e. no invoice after treatment), but that's a bit of a mouth full.

It removes an entire department and source of variable from a 'company' that doesn't need it. Ultimately you aren't going to deny someone coverage based on cost*, they're going to end up in an ER and 'written off' which will then be billed in to everyone else's costs. Worse, the outcome for the individual is often less good and frequently means they will be, overall, more of a burden on society than if they had recei…

Ultimately you aren't going to deny someone coverage based on cost

For acute conditions, yes, but in the American ER they do not treat chronic conditions, like cancer, depression and substance addiction. That's a public health issue.

Re: UK has best health system in developed world, US analysis concludes

#29

Post by dv_dt »

IsaacL wrote: post #14

This really is a matter of what variables you choose to measure. For example, the US is by far the world leader in medical research spending - 44% of global medical research is spent in the US. (Until recently it was even higher). [1] On the same note, many nations regulate the price of prescription drugs - drugs where the initial R&D was done in the states. (Yes, drugs are sold at a huge markup, but that's to recoup…

> In other words, Americans are taking it in the chin to invest in pharmaceutical innovations, which other countries then treat as a public good.

I completely reject this line of argument. Just because the spending is here, and that a huge profit center is in Ameriica, you can't conclude anything about R&D. A large portion of the marketing spend is also in America too.

All the large drug companies are multi-national. Once the income arrives from various nations, that money is fungible within the accounting of the company. One really can't say a pound coming in from the UK isn't funding R&D in America, any more than you could say a dollar is.

Re: UK has best health system in developed world, US analysis concludes

#30

Post by porterrobertson »

IsaacL wrote: post #14

This really is a matter of what variables you choose to measure. For example, the US is by far the world leader in medical research spending - 44% of global medical research is spent in the US. (Until recently it was even higher). [1] On the same note, many nations regulate the price of prescription drugs - drugs where the initial R&D was done in the states. (Yes, drugs are sold at a huge markup, but that's to recoup…

I like how you mentioned there's no purely capitalistic healthcare system in the world, even in the U.S. there is massive government involvement in Health Care (120 millions Americans are on medicare/medicaid for instance which is twice the population of the UK if i'm not mistaken), additionally Switzerland which seems to have the best healthcare in the world also has very strict government regulation. When it comes to drug pricing there's another caveat which is a lot of the incredible R&D breakthroughs aren't even done in the states but rather they are done by British and Canadian companies that then markup the prices in the US because it's the only place they can charge people lots of $ (and even in the US they have to sell at a reduced cost to the third of the population that is on medicare/medicaid as stated earlier). So in short the U.S. healthcare system isn't entirely capitalist and the pharmaceutical companies in countries with national health insurance are very capitalist when it comes to selling their drugs in the U.S...basically nothing is what it seems.
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