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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

#31

Post by comstock »

ramchip wrote: post #24
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.

The original report is better. This report is really about saying "the US system could be a lot better" rather than an overall ranking of healthcare.

The way it's being used here, to say the NHS is wonderful, doesn't work very well in my opinion.

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

#32

Post by the_watcher »

dv_dt wrote: post #29
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.…

What he's saying is that drugs are marked up more in the US than other countries that regulate their prices. That necessarily implies that Americans paying for the drug are contributing more to pharma revenues than those in countries that are regulating prescription drug prices.

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

#33

Post by robocat »

elmalto wrote: post #22
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 lit…

The UK could easily be more efficient/effective on how they spend their R&D dollars (like for healthcare).

And R&D is very hard to compare due to different incentives to categorize R&D depending upon taxation laws and charity institutions.

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

#34

Post by geomark »

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…

Expat American here now living in Thailand for many years and have been treated numerous time to the outstanding medical care at both private and public hospitals here.

Question: As far as you know, do the private hospitals here in Thailand receive any government money? Because it sure seems like a real market here with private hospitals competing on services and prices. And they advertise those services and prices in the media regularly.

I plan to never return to my home country and one of the main reasons is the health care debacle in the U.S. It's so much better and affordable here.

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

#36

Post by scythe »

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…

It's true that America's higher drug prices ultimately subsidize the world. But this certainly isn't the only thing driving up costs. Administration costs in healthcare are significantly higher in the US than other countries, and heroic end-of-life care is a sort of religion that sucks money down a black hole. Some chronic health issues like obesity are more common in the US. And there's this:

http://johnhcochrane.blogspot.com/2017/04/the-second-origina...

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

#37

Post by jseliger »

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…

In my subjective experience (as a Brit) British people often think the NHS is the best health service in the world

Having experienced it, I'm surprised that Brits feel that way. When I was studying abroad a while ago (which was not a great experience for other reasons... https://jakeseliger.com/2012/11/18/about-the-university-of-e...), I needed an x-ray and then a CT scan for what appeared to be a minor issue. So I went to the clinic and signed up for one, only to discover a week later that an x-ray typically takes 6 - 8 weeks to be done! I asked around and was told to go to Bupa facility (https://en.wikipedia.org/wiki/Bupa). To the Brits this seemed like an obvious solution, and paying in cash is in fact a good way to get things done quickly. It turns out that when people have something really wrong with them, the solution is often to just pay out of pocket!

This disabused me of any notion that publicly-provided healthcare is automatically superior.

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

#38

Post by jseliger »

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…

the NHS is great and the system works much better than in the US,

I'm not so sure about that: https://news.ycombinator.com/item?id=14774718

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

#39

Post by mikeash »

jseliger wrote: post #37
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…

In my subjective experience (as a Brit) British people often think the NHS is the best health service in the world Having experienced it, I'm surprised that Brits feel that way. When I was studying abroad a while ago (which was not a great experience for other reasons... https://jakeseliger.com/2012/11/18/about-the-university-of-e... ), I needed an x-ray and then a CT scan for what appeared to be a minor issue. So I…

Is it really a big deal to wait 6-8 weeks to get an x-ray for a minor issue? Obviously this is not ideal, but it seems pretty minor compared to the ridiculous stuff we deal with in the US system, especially if you compare to the pre-ACA US system.

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

#40

Post by mikeash »

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.

Nothing is truly free. TANSTAAFL and all that. We all know this, and we use the word anyway because it gets the point across.

But for some reason any time it's used in the context of health care, people just have to point out that it's not really free.

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