Wednesday, June 23, 2010

US Healthcare: First in Cost, Last in Safety and Access

An independent study has -- again -- ranked the United States dead last among the leading industrialized nations of the world in its healthcare system. Out of seven countries -- The Netherlands, Canada, Australia, New Zealand, Germany, Great Britain and the US -- the US ranked worst in coverage (as it always does, since all the other mentioned countries cover all their citizens), worst in the safety of the healthcare, worst in costs, worst in efficiency, worst in equity, and worst lifespan. Even in the best score the US got, it only ranked average in effectiveness of care and how patient-centered the care was.

As the chart below shows, The Netherlands were hugely better at almost every category, followed closely by Britain's National Health Care system -- often derided by bought-and-paid-for US insurance shills, pundits and lobbyists. They were also the second-lowest in cost, I notice.

To be fair, the study also showed that Canada has a lot of room for improvement in its own system, which came in next-to-last with scores only somewhat better than the US in most categories and worse in a few -- but on the other hand, Canadians pay half as much as Americans, and gain a full three years over the US in average lifespan (along with a significantly lower risk of catastrophic illness). Not to mention they cover everybody.

The biggest shock here is that the US comes in last on safety, as well as spending twice as much per capita than any of the studied countries for what amounts to a very mediocre health-care system. Of course, if you’re wealthy then the quality of your health care in the US improves significantly -- but what does this say about the US's values and priorities? In our opinion, nothing good.

Having lived in (now) three of the rated countries long enough to have made use of their health-care systems, the survey’s results match my own experiences pretty closely. Britain’s “socialist” NHS was by far the best experience I’ve had (not the friendliest though), followed by Canada, then the US (where misdiagnosis, insurance fights, ridiculous extra expenses, lawsuits and avoiding healthcare until things got really bad because you couldn’t afford it were the norm).

If the US wants to keep their for-profit, screw-the-poor healthcare model, that’s their business -- but even if you ignore the damning condemnation of the morality of that philosophy, this study shows clearly that even by their own standards, Americans are way overpaying for what they are getting. If nothing else, the US should focus on that.