Health care reform: We got it bad (and that ain’t good)

The media keeps telling us that the US medical system delivers poor quality care. Examples abound: our infant mortality rates are higher than many other countries, and our life expectancies are no better. These perceptions are driving the current “health care crisis” reform initiatives, and providing public support for a government solution, or at least a government “something.” But are things really that bad here, compared to everywhere else?

Take infant mortality as an example. The CIA’s data of estimated 2009 infant mortality ranks the US down at #45, well behind France, Israel, Australia, and Wallis and Futuna. But a closer look at these statistics reveals that we’re not really making a fair comparison. In the United States, any baby born with any signs of movement, breathing, or a beating heart is considered a live birth, but many other countries do not count these babies in their infant mortality figures. Some countries use a minimum length or weight to consider a baby “alive,” or a minimum gestational age. Since prematurity (and therefore small birth size) is by far the leading cause of infant mortality in the developed world, by not counting these babies as “living” in the first place many countries shift statistics from “infant mortality” to “stillbirths.” Looking at infant mortality rates between countries that collect this data differently is not a reasonable or fair judgment.

What about the effectiveness of medical treatments? In a detailed, well-referenced report by The National Center for Policy Analysis, cancer survival comparison statistics make us look pretty good. Men in the United States have a five-year survival rate of 66%, compared to 47% for Europeans. In Canada, women have a 25% higher mortality rate from breast cancer. How about the treatment of chronic health problems, which contribute to most elderly mortality? High blood pressure is well-controlled in 36% of US diabetics compared to 9% in Canada.

Will a socialized system lead to rationing of services and waiting lists? In 2000, Norwegians waited 160 days for a knee replacement and 2 months for cataract repairs. In some provinces of Canada, waiting times for orthopedic procedures can be over a year (though this varies very much by province and local availability.) You think the wait won’t be as long for something more urgent? 46 days was the average wait time for coronary bypass surgery in Norway, after it was decided that surgery was medically necessary.

There are some big problems with health care system in the USA. Health care access for the poor and uninsured is unreliable and inefficient; an astronomical amount of money is being wasted on defensive and unnecessary medicine; and a great big chunk of the health care expenditure pie is sucked up by insurance companies and pharmacy benefit managers, diverting resources away from actual health care. Despite this, there is still good health care being performed in the United States. Let’s not let exaggerations and over-simplifications back us into a system that may be much worse than what we’ve got. To paraphrase Duke Ellington, thinking we’ve got it so bad may not do us any good.

Explore posts in the same categories: In the news, Pediatric Insider information

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One Comment on “Health care reform: We got it bad (and that ain’t good)”

  1. Shannon Says:

    We can only hope and pray that our system does not come under the government control. Otherwise, only the rich (possibly very rich) will be able to circumvent the system to receive the quality of care many/most of us currently receive. The rest of us will be waiting in long lines for our by-pass surgeries and biopsies. Thanks for providing more accurate, less-sensational (at least to the media) information on the state of our health care system!


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