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US health system ranks last compared with peer nations – report

theguardian.com

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Re: US health system ranks last compared with peer nations – report

#141

Post by gregjor »

trimethylpurine wrote: post #5
naming_the_user wrote: post #2

What does the ranking look like if you compare percentiles? Naively I would assume as a non-American that if you're in the top 20% by income in the US you end up much better off than the top 20% income Brit, for example. Or is it just actually worse for everyone? It feels intuitively obvious that the average will be worse because, well, the average person is skint and the US is less socialist.

The US health care system is partly socialized. Health care is provided for the unemployed or low income and the employed are covered as employers are required to provide health coverage. The odd ones out are typically small business owners who don't insure themselves and choose to take on the risk of potentially large medical bills. In all cases treatment is required by law, regardless of payment.

Not true except for immediate emergency care.

Many employers do not provide coverage. They skirt the law by employing people part-time (Walmart, Amazon) or as gig workers.

Even if the law reads as you claim that doesn’t mean you can get care in the US.

Re: US health system ranks last compared with peer nations – report

#142

Post by vidarh »

mytailorisrich wrote: post #104
vidarh wrote: post #53

Earlier quoted context omitted.

I have had extensive rounds of tests for various things with the NHS over the last several years, and never had a problem sufficient to feel private insurance, even as cheap as it is in the UK, to be worth it. I don't doubt it's worth it for some, but there's a reason - and while costs will stop some, costs does not explain nearly all of it, given how cheap it is - that only about 10% of the UK population has private…

Private care is still quite affordable on a good salary so I can understand that you feel that private insurance is not worth it, but you were also very lucky with your NHS experience. For instance the UK have very bad outcomes for cancer because things tend to be caught late and treatment delayed thereafter. Frankly, for anything potentially serious or time-sensitive I would go straight private (and in fact the NHS…

> The NHS has much bigger problems than funding. Even the new, left-wing government has indicated that they won't increase funding without reforms.

It's always very convenient to starve something of funding for years when you want to insist something needs to be reformed before you can spend as much as it costs to provide service at an adequate quality.

Reform or no reform, outcomes won't improve without increasing the funding, as no other system in a comparable country manages to deliver more at the NHS cost level.

Re: US health system ranks last compared with peer nations – report

#143

Post by OJFord »

l5870uoo9y wrote: post #93

The UK performs better (third place) than, for example, Germany (second last place). The UK's healthcare system is often heavily criticized as being on the brink of collapse - any explanation for this?

NHS bashing is our national sport.

Throw in noisy unions, elections (despite the idea of a Conservative government actually privatising the NHS being absurd), and pay comparisons to other countries that don't account for inflation, locuming, and private work - and here we are.

Not to say it's the best and couldn't be better or anything, but I do think the discourse and perception is way out of proportion.

Re: US health system ranks last compared with peer nations – report

#144

Post by armitron »

Propelloni wrote: post #138
l5870uoo9y wrote: post #93

The UK performs better (third place) than, for example, Germany (second last place). The UK's healthcare system is often heavily criticized as being on the brink of collapse - any explanation for this?

The actual report [1] says it took five domains into account: a) access to care, b) care process, c) administrative efficiency, d) equity, and e) health outcomes. Read the linked summary. To summarize the summary: from 10 investigated countries, 9 are in the same ballpark. The US is an extreme outlier, bad in almost anything and expensive to boot. The NHS being in trouble is apparently orthogonal to these domains. It…

Are you living in the UK or just making baseless assumptions? For an ever-inceasing number of serious health issues, the NHS has been essentially non-functional for many years. I have friends with chronic conditions that are looking to emigrate becase they're dreading their health getting worse in a system that's doing nothing to help them.

"NHS would be great except for the bad politicians" is not a serious argument.

[1] https://www.independent.co.uk/news/uk/nhs-collapse-hospitals...

[2] https://edition.cnn.com/2023/01/23/uk/uk-nhs-crisis-falling-...

[3] https://www.instituteforgovernment.org.uk/comment/how-bad-nh...

Re: US health system ranks last compared with peer nations – report

#145

Post by jorvi »

evnix wrote: post #88
CaptainZapp wrote: post #76

Earlier quoted context omitted.

> The general slowness extends to simple things like x-rays and blood tests too. This is not just US but whole of the west seems to have the exact same attitude. In Switzerland I get an MRI within 48 hours if my doctor orders it. Mind you, healthcare is also very expensive comparatively but the quality is very high and coverage is extensive.

Condition is if "your doctor orders it" and how long does it take to get to that doctor if it isn't an emergency. I don't about Switzerland but it is quite bad in majority of EU countries. And Why can't you just walk in to a clinic to get x-rays and tests done like it is in done elsewhere. Have clinics compete for price. The other part no one mentions is the utter cheating that goes on in statistics to show that the…

> And Why can't you just walk in to a clinic to get x-rays and tests done like it is in done elsewhere. Have clinics compete for price.

Because false negatives are a massive problem. People get biopsies or treatments for things that never needed it, which is ultimately worse for their health (on average) than catching the rare time it is something.

Re: US health system ranks last compared with peer nations – report

#146

Post by A_D_E_P_T »

benterix wrote: post #129
evnix wrote: post #71

Earlier quoted context omitted.

The general slowness extends to simple things like x-rays and blood tests too. This is not just US but whole of the west seems to have the exact same attitude. Most of Asia has same day or next day medical tests. In India you can order something like UberEats where in a technician comes home collects your blood samples and the results are emailed within the next 24 hours or so. Medicine seems to be commoditzed in the…

I live in Europe and if I take a blood test at 7 am I can usually check the results online by 1 pm.

Same. But in Croatia where things are a little bit... well... different. For instance, I don't need a prescription to buy (almost) any drug in the pharmacy. And I don't need a prescription or referral for any medical exams or blood tests; I can order them myself. Asia is like this, but Europe to the north and west of Croatia really isn't.

I believe that things in the UK and Germany might be a lot slower and much more restrictive.

Re: US health system ranks last compared with peer nations – report

#147

Post by InsideOutSanta »

evnix wrote: post #71
arjie wrote: post #36

One thing that's surprised me about the US is the general slowness of most things. In India, you can get MRIs and CT Scans same day. Or you could the last time I was there. And it didn't cost very much in comparison. My doctors have all been good (attested to by my parents who are surgeons themselves) but the healthcare system is wonky. One thing I didn't expect is that the Indian system where you just drag your heal…

The general slowness extends to simple things like x-rays and blood tests too. This is not just US but whole of the west seems to have the exact same attitude. Most of Asia has same day or next day medical tests. In India you can order something like UberEats where in a technician comes home collects your blood samples and the results are emailed within the next 24 hours or so. Medicine seems to be commoditzed in the…

"This is not just US but whole of the west seems to have the exact same attitude"

The slowness you describe has not been my experience in many European countries. It really depends on how the healthcare system is designed to work.

I was pretty surprised when I went to China and I could just go to a doctor's office without an appointment, stand in a queue, stick out my tongue, get a diagnosis within ten seconds, and be sent out with a handful of random colorful pills wrapped in paper. Yes, this was, in fact, a real doctor's office, and I did take the pills. I have no idea what they were or did, if anything at all.

I also did enjoy the phone-ordered house visits from nurses in Indonesia when I got Bali belly, although that is probably a result of low labor cost more than anything else. And the poop tests I received a few hours later weren't all that helpful. Oh, I have "amoebas," that's very useful, thanks.

All told, I'm happy I usually live in Western Europe. Relatively expensive, but high-quality, fast healthcare without the constant risk of going bankrupt when something unfortunate happens.

Re: US health system ranks last compared with peer nations – report

#148

Post by netsharc »

shiroiushi wrote: post #70
netsharc wrote: post #59

Earlier quoted context omitted.

Obama himself has said to that Obamacare (well ACA) is like (to use my own analogy) a "patch" on a a system that can't just be reimplemented (most of it due to political reasons). It's not terrific but it's what was able to be done. Whereas e.g. single payer was an unachievable pipe dream from where they were standing in 2008/09. And he'd rather have something a bit better rather than go for the excellent system and…

And why was it "an unachievable pipe dream"? As I remember it, the Democrats had control of both houses of Congress, as well as the White House, for about 2 years. They could have passed anything they wanted.

A others have replied, some Dems were quite red, a lot of politicians are more eager to preserve their jobs than burn political capital...

The excerpt from his book: https://archive.is/V5TVM . He also talks about "political capital" and whether it'd be more wise to spend them on e.g. recession recovery. Ctrl-F for "More than forty-three million Americans were now uninsured" to skip the introduction about how the system got to the way it got.

Re: US health system ranks last compared with peer nations – report

#149

Post by InsideOutSanta »

Propelloni wrote: post #138
l5870uoo9y wrote: post #93

The UK performs better (third place) than, for example, Germany (second last place). The UK's healthcare system is often heavily criticized as being on the brink of collapse - any explanation for this?

The actual report [1] says it took five domains into account: a) access to care, b) care process, c) administrative efficiency, d) equity, and e) health outcomes. Read the linked summary. To summarize the summary: from 10 investigated countries, 9 are in the same ballpark. The US is an extreme outlier, bad in almost anything and expensive to boot. The NHS being in trouble is apparently orthogonal to these domains. It…

"It is just unable to cover its cost with the income it has"

Which is a problem that politicians intentionally create in order to show how bad the NHS is.

Re: US health system ranks last compared with peer nations – report

#150

Post by JeromeLon »

zjp wrote: post #10
naming_the_user wrote: post #2

What does the ranking look like if you compare percentiles? Naively I would assume as a non-American that if you're in the top 20% by income in the US you end up much better off than the top 20% income Brit, for example. Or is it just actually worse for everyone? It feels intuitively obvious that the average will be worse because, well, the average person is skint and the US is less socialist.

Also: an unironic 1%-er income in France is like literally the bottom of the barrel Bay Area salary. If you're at or above the median America is great, outside of some very high cost of living cities.

Adding some numbers to this thread. 99th percentile yearly income is:

- USA: $819k (2021)

- UK: £187k = $247k (2024)

- FR: €111k = $123k (2023)

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