Comparing Health Care Across the Pond
Although Laura Wilson Porter ’83 wrote from Scotland to testify “personally and professionally that health and social care is better than in the USA,” data from the Organisation for Economic Co-operation and Development on health care show otherwise. Women’s mortality rates from strokes are 29 per 100,000 in the United States, 39 per 100,000 in the United Kingdom. Men’s rates are 32 per 100,000 in the U.S., 42 per 100,000 in the U.K. Cancer mortality rates are lower in the U.S. than the U.K. (for women, 130 per 100,000 in the U.S. versus 141 per 100,000 in the U.K.; for men, 185 per 100,000 versus 199 per 100,000). The U.S. has more MRI units, MRI exams, CT scanners, and CT exams, and higher rates of coronary angioplasty, knee replacement, and vaccinations for measles. Waiting times for specialist appointments and elective surgery are shorter in the U.S. than in the U.K.
Yes, infant mortality rates are higher in the U.S. One reason is the rate of preterm births is 65 percent higher than in the U.K., and more premature babies are born here alive that would be declared stillborn in the U.K. The U.S. has more technology to serve preterm babies, such as miniature suction devices, catheters, and emergency incubators, but not all survive. Those who die raise the overall U.S. infant mortality rate.
Yes, life expectancy is higher in the U.K., but that’s due to violence in American society, not quality of American health care. When you remove deaths from car accidents, guns, and other fatal injuries, Americans have a higher life expectancy than the British.
Americans are already discovering the disadvantages of the Affordable Care Act. Their health-insurance premiums are rising. Employers are limiting hiring and putting workers on part time to reduce taxes. And, despite the president’s promise, even if people like their plans, they can’t necessarily keep them.
Diana Furchtgott-Roth ’79
Chevy Chase, Md.
April 30th, 2013 6:18 pm
Ms. Furchtgott-Roth recently wrote the Bulletin to assert that
healthcare is better in the United States than in the U.K.
.
As a trained economist working for the conservative Manhattan
Institute, she and her staff are skilled at cherry picking the
data to reinforce a political agenda. But the readers of this
publication know about “lies, damn lies and statistics.”
There is not enough room in this forum to be debating statistical
significance. Simply put, the overall picture shows the US spends
50% more on healthcare than other industrialized countries for
no better results. And the other countries do it while insuring
all citizens and not putting the burden on employers.
.
Contrary to conservative ideology, the solution to all ills is
not free markets, deregulation, slashing taxes, slashing government
spending and putting the onus on “personal responsibility”.
As an economist, she certainly should know that consuming health
care services in the US is far from being free market where an
individual can “shop around for a better price.” As much
as she might wish it, healthcare in the US is not like buying
orange juice or a car.
.
The right continues to demonize the Affordable Care Act in the
hope they can just make it go away. Of course premiums are continuing
to rise faster than inflation. One reason (among several) is
because the medical industrial lobby is so successful in opposing
cost controls that would serve the greater good.
.
Our illness-based, fee for service, for-profit model for healthcare
will continue to deliver more and more services at ever increasing
cost. Because it can. The first step (of many) toward controlling
this is to get everyone in the insurance pool. This is what the
ACA does. Can the ACA be improved? Of course.
.
Jonathan Caldwell ‘75
May 3rd, 2013 3:37 pm
Thanks for a great lesson in "How to Lie with Statistics," if I may cite
book I enjoyed in my years on the Crum. And also for a lesson in
fallacious "More is Better" logic. The letter by Diana Furchtgott-Roth
'79 in the April issue provides two wonderful examples.
In defending the US healthcare system and attacking the Affordable Care
Act, she cites disease incidence and mortality rates differences between
the US and the UK and concludes that the lesson is that the US system is
superior. The differences in rates per 100,000 range from 10 to 14, and
so may be statistically insignificant on their face. Ms. Furchtgott-Roth
then acknowledges the greater life expectancy of UK residents. She thus
is comparing two populations with different age profiles — which could
more than explain the higher stroke and mortality rates in the US.
We are then treated to an example of the "superiority" of the US
healthcare system: MORE.
Ms. Furchtgott-Roth cites more nedical equipment and procedures in the
US than the UK. (We can be generous and assume she means more per
capita, can't we?) But that abundance shows minimal difference in
outcomes despite roughly twice the cost per capita, and we seem to see
monthly news about the overutilization or overprescription of the
abundance offered by US medicine.
Might one inquire what content in her letter seemed to warrant publication?
Peter B. Meyer ' 65
May 28th, 2013 5:09 pm
The debate over medical care in the USA and other places is easily misdirected. I don't doubt for a moment that Diana Furchtgott-Roth's statistics are correct, that there are more and better of whatever in the United States than in many parts of Europe. If I looked I could certainly find statistics to show that care in Europe (in my case, Spain) has its own statistical advantages. But that is not, to my mind, the major issue in the debate. I ask, who has access to the medical care? Here in Spain, until recently, health care was universal and free. Any Spaniard had access to high quality health care, including transport to hospitals in other cities if local facilities could not offer the necessary treatment. Is the same true in the US? From talking to friends and family, I would say not.
Whether this system will withstand the attack of the present Sapnish government, I don't know, but up to now the Spanish health system has been excellent.
Dan Cohen '79