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U.S. health is lousy compared with peer nations, report says

latimes.com

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Re: U.S. health is lousy compared with peer nations, report says

#51

And yet people from around the world fly here every day to have critical surgeries performed by the world's top doctors in state of the art facilities. News Flash: The U.S. isn't a welfare state. To benefit from everything this country has to offer, you need to pay for it. Yes, it would be better if that didn't apply to healthcare, but there needs to be some method of exclusion when demand is high and supply is low.…

> "And yet people from around the world fly here every day to have critical surgeries performed by the world's top doctors in state of the art facilities."

Citation sorely needed. This claim is regularly trot around, but nobody has been able to point to data that would suggest that this is anything but extreme outlier behavior.

As a Canadian who lives in the US it's often shocking how different the perception of the Canadian health care system is between the US and Canada. Canadians by and large are quite satisfied with the system, while even reasonably liberal Americans I've met seem to believe it's some kind of waitlist-filled hellhole.

I've had more than one American express incredulity when I pointed out going to the US for major medical procedures isn't really a thing in Canada, where they thought it was widespread and relatively common.

By my own observation, there are a few isolated cases of this happening (mostly among the extremely wealthy), and is not at all widespread.

> "but there needs to be some method of exclusion when demand is high and supply is low."

The supply of medical capacity is not fixed or subject to a real physical limitation (like, say, rare earth metals). In Canada the response to constricted supply has been expanding the supply, as well as reducing per-use costs to make this possible. The supply is not infinite, but is high enough that people who need it, get it, and at a cost affordable to them (amortized across the entire population).

[edit] It's worth mentioning that, due to the economic incentive of single-payer health care, Canada invests a tremendous amount of money in preventative care and screening, which serves to dramatically reduce demand for the most expensive, most supply-constrained treatments. In fact I have a friend who works for the Canadian government right now doing computational screening for early cancer detection. It's interesting stuff, saves lives, and saves money, but requires a dramatic economic incentive to build out that simply doesn't exist in privatized care.

> "Would you rather wait 2 months just to see a specialist and another 2 months for treatment like patients in nationalized healthcare systems frequently do? (I'm looking at you, Canada and Europe)"

Citation, again, sorely needed. I grew up in Canada and have never waited 2 months to see a specialist, nor 2 months for treatment. The longest I've waited for a specialist was a few days. I've also (unfortunately) been to both Canadian ERs and American ERs, and the wait times are not substantially different (immediate (Can), 4 hours (Can), 7 hours (Can), and 6 hours (US)).

Re: U.S. health is lousy compared with peer nations, report says

#52
post #31

The US is at or very near the worst among OECD countries in: infant mortality, child poverty, child health and safety, life expectancy at birth, healthy life expectancy, rate of obesity, disability-adjusted life years, doctors per 1000 people, deaths from treatable conditions, rate of mental health disorders, rate of drug abuse, rate of prescription drug use, incarceration rate, rate of assaults, rate of homicides, i…

Dig a bit deeper and you'll see that those statistics don't tell you the whole story. In the US, premature births occur at a much higher rate than other country and account for a large portion of the higher infant mortality rate. Those stats also don't tell you that if you have a premature baby, it's most likely to survive if treated in the US.

I've heard that and am not sure whether the comparative statistics control for this. However, even if it's true, that still leaves child poverty, child health and safety, life expectancy at birth, healthy life expectancy, rate of obesity, disability-adjusted life years, doctors per 1000 people, deaths from treatable conditions, rate of mental health disorders, rate of drug abuse, rate of prescription drug use, incarceration rate, rate of assaults, rate of homicides, income inequality, wealth inequality, and economic mobility.

Re: U.S. health is lousy compared with peer nations, report says

#53
post #43

Worth remembering some things here: * The US is thought by some economists to have an artificially high infant mortality because the US is more rigorous about reporting live births than other countries which might write up the same events as stillbirths. * Outcomes in the US for chronic serious illnesses are at or near the top of the rankings. * Life expectancy figures in the US are anchored down by suicides and, mor…

I think quality of life is a much more important factor to include.

Re: U.S. health is lousy compared with peer nations, report says

#54

The US is at or very near the worst among OECD countries in: infant mortality, child poverty, child health and safety, life expectancy at birth, healthy life expectancy, rate of obesity, disability-adjusted life years, doctors per 1000 people, deaths from treatable conditions, rate of mental health disorders, rate of drug abuse, rate of prescription drug use, incarceration rate, rate of assaults, rate of homicides, i…

What's your point? For instance, what improvement to us healthcare would cure obesity?

Re: U.S. health is lousy compared with peer nations, report says

#55

I found the following blurb from the article interesting as it tries to make the information relevant the gun control debate: Gun use emerged as a factor: Americans were seven times more likely to die in a homicide and 20 times more likely to die in a shooting than their peers. In all, two-thirds of the mortality disadvantage for American men was attributable to people under the age of 50 -- and slightly over half of…

Why is health interesting to anyone? Viewed in a more hackish light: here's a problem; how can we fix it?

(1) Help Medicare track cost-effectiveness of tests/procedures involving really expensive technology (development of which will only get more & more expensive); (2) Teach Medicare patients how to become actual consumers of health care (how to shop for price/compare treatment options) -- i.e. help transfer some of the burden of reducing cost from payers to patients w/out causing mass hysteria

Re: U.S. health is lousy compared with peer nations, report says

#56
post #41

My first thought was "what the hell does health have to do with accidents?", which I learned was justified by the first article I found after googling for "life expectancy without accidents": http://www.forbes.com/sites/aroy/2011/11/23/the-myth-of-amer... >A few years back, Robert Ohsfeldt of Texas A&M and John Schneider of the University of Iowa asked the obvious question: what happens if you remove deaths from fata…

Perhaps I'm tired, but how can the Japanese life expectancy figure be higher when considering fatal injuries?

Re: U.S. health is lousy compared with peer nations, report says

#57
post #43

Worth remembering some things here: * The US is thought by some economists to have an artificially high infant mortality because the US is more rigorous about reporting live births than other countries which might write up the same events as stillbirths. * Outcomes in the US for chronic serious illnesses are at or near the top of the rankings. * Life expectancy figures in the US are anchored down by suicides and, mor…

This report[1] claims that the difference in reporting child mortality isn't the chief cause of the difference in infant mortality between the U.S and similarly developed countries. Instead the claim that most of this difference is due to the high percentage of pre-term births in the US compared to other developed countries.

[1] http://www.cdc.gov/nchs/data/databriefs/db23.pdf

Re: U.S. health is lousy compared with peer nations, report says

#58
post #41

My first thought was "what the hell does health have to do with accidents?", which I learned was justified by the first article I found after googling for "life expectancy without accidents": http://www.forbes.com/sites/aroy/2011/11/23/the-myth-of-amer... >A few years back, Robert Ohsfeldt of Texas A&M and John Schneider of the University of Iowa asked the obvious question: what happens if you remove deaths from fata…

Perhaps I'm tired, but how can the Japanese life expectancy figure be higher when considering fatal injuries?

The figure doesn't go up, the ranking goes up. (Meaning all the other figures go down.)

Re: U.S. health is lousy compared with peer nations, report says

#59

And yet people from around the world fly here every day to have critical surgeries performed by the world's top doctors in state of the art facilities. News Flash: The U.S. isn't a welfare state. To benefit from everything this country has to offer, you need to pay for it. Yes, it would be better if that didn't apply to healthcare, but there needs to be some method of exclusion when demand is high and supply is low.…

This kind of argument probably worked better in the 90s or something, but it does not hold as much water today.

First, the exorbitant rate of medical inflation in our "market" healthcare system is a fiscal menace not only to the public sector, but to the private sector as well.

Secondly, the deteriorating health of the American workforce is an increasing threat to global competitiveness. An overweight employee pool with high prevalence of unmanaged diabetes is not an attractive one for global capital.

Expanding access, controlling costs and emphasizing preventive care are things we need to get better at out of naked self-interest. Saudi sheiks who want to fly in for a quadruple bypass may continue to do so, but if we lose them to somewhere that bows and scrapes to the mega-rich more than we do, good riddance.

Re: U.S. health is lousy compared with peer nations, report says

#60
post #41

My first thought was "what the hell does health have to do with accidents?", which I learned was justified by the first article I found after googling for "life expectancy without accidents": http://www.forbes.com/sites/aroy/2011/11/23/the-myth-of-amer... >A few years back, Robert Ohsfeldt of Texas A&M and John Schneider of the University of Iowa asked the obvious question: what happens if you remove deaths from fata…

Perhaps I'm tired, but how can the Japanese life expectancy figure be higher when considering fatal injuries?

The article has an updated section on that question.

>I asked Robert Ohsfeldt about this, who responded that the adjustment factor was based on fatal injury rates relative to the average. Hence, the adjusted numbers shouldn’t be seen as hard numerical estimates of life expectancy, but rather as a way of understanding the true relative ranking of the various countries on life expectancy excluding fatal injuries.

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