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Saturday, November 19, 2005

US Healthcare: Simply The Best

Just as headlines often do not tell us the full story (even in the very article it trumpets), David Henderson at TCS explains how data alone tells us nothing. It needs to be interpreted. So a Commonwealth Fund press release screams how US medical patients report "experiencing medical, medication, or test errors, the highest rate of any nation in a new Commonwealth Fund international survey."

Are we really that bad?

No, explains Henderson. But you have to interpret the data.

First, it is a comparison with only 5 other health systems surveyed: Australia, Canada, Germany, New Zealand, and Britain. Before going further, understand that except for Germany, the others are all socialized medicine.

Now the truth:

The press release points out that 30% or fewer of American and Canadian patients were able to get needed medical care the same day, whereas for New Zealand, Germany, Australia, and Britain, the numbers were much higher: 58%, 56%, 49%, and 45%. What the 6-page-long Commonwealth press release does not report are the data on longer waits. Asked whether they had to wait more than 4 weeks for an appointment with a specialist doctor, only 23% of the Americans surveyed said yes, virtually a tie with Germany's 22%, whereas 40% of New Zealand patients, 46% of Australian, 57% of Canadian, and 60% of British patients said yes. Asked whether they had to wait more than 4 months for elective surgery, only 8% of Americans and 6% of Germans said yes, contrasted with 19% for Australia, 20% for New Zealand, 33% for Canada, and a whopping 41% for Britain.

Henderson mentions an economic axiom: He who pays the piper calls the tune. Americans pay more out of pocket but that direct payment of cash gets the doctors' attention.

I want my doctor to depend on me for his livelihood rather than to know that there are many more like me lined up, none of whom can affect what he is paid: I'll get better service that way. Interestingly, U.S. managed care organizations are currently adjusting their plans so that patients pay higher out-of-pocket costs because they've found that this effectively keeps overall costs down and quality up.

We constantly talk about incentives, conservation, choice and advancement. All of these are enhanced by the patient paying in this context. And so far at least we have the best health care system on the planet.

BTW, for those of you who can handle more positive stats about American healthcare:

The press release points out that 30% or fewer of American and Canadian patients were able to get needed medical care the same day, whereas for New Zealand, Germany, Australia, and Britain, the numbers were much higher: 58%, 56%, 49%, and 45%. What the 6-page-long Commonwealth press release does not report are the data on longer waits. Asked whether they had to wait more than 4 weeks for an appointment with a specialist doctor, only 23% of the Americans surveyed said yes, virtually a tie with Germany's 22%, whereas 40% of New Zealand patients, 46% of Australian, 57% of Canadian, and 60% of British patients said yes. Asked whether they had to wait more than 4 months for elective surgery, only 8% of Americans and 6% of Germans said yes, contrasted with 19% for Australia, 20% for New Zealand, 33% for Canada, and a whopping 41% for Britain.

1 Comments:

At 4:34 PM, Anonymous Blue Cross of California said...

I don't completely agree on the US healthcare being simply the best. We have a major healthcare crisis and million which lack health coverage. We have a lot of work to do on our health care system.

 

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