Comparisons between healthcare systems are difficult for, erm, systemic reasons, but comparisons in costs and outcomes are easier as they have a more objective footing. The US delivers excellent standards of care with outcomes in the same ball park as the rest of the developed world. Nonetheless, that solid set of averages in terms of delivery and outcome come at a significantly higher price to the public purse, and to the patient individually.
The problem here is that if we engage in a discussion about healthcare which mainly focuses on one-or-other of those aspects, on delivery/outcomes vs cost, then we're only having half a debate, and it's at this point where I'd like to raise a third important factor in any healthcare system: access. Delivery and outcomes are directly linked to access to healthcare service -- if you don't have access to a Dr. for example nothing is delivered and outcomes go the wrong way. Similarly, access is also tied to cost -- if you can't afford the cost of a consultation or treatment then it doesn't matter how good or plentifull your local services are, and outcomes go the wrong way again.
And here I think one can make a valuable comparison between the US healthcare system and the standard universal model implemented (albeit differently) in, for example, the EU. In the US cost, specifically cost to the patient, is a significant factor in limiting access to healthcare services, and in that limitation delivery and outcomes inevitably fall short. Some might argue that cost to the patient is not a significant limiting factor, and in absolute terms there may be a point to be had here, but the fact remains that medical indebtedness and bankruptcies run high in the US whereas it is so rare in the EU as to be almost non-existent (and I qualify that such only because I can't find any data on people losing their houses or failing to complete a treatment etc because they can't meet their medical bills in Europe).
In short, this is where I think one can say, objectively, that the US healthcare system falls short - and I don't think it's particularly controversial to do so. When we align this access-limited shortfall with the fact that the US spends significantly more public money on healthcare than almost any other nation then we can also say that that the US system is also falling short in terms of overall delivery and outcomes even as individual delivery and outcomes stand firmly in the middle ground.
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"It isn't necessary to imagine the world ending in fire or ice.
There are two other possibilities: one is paperwork, and the other is nostalgia."
"This is how humanity ends; bickering over the irrelevant."
Clinton Huxley » 21 Jun 2012 » 14:10:36 GMT