US Health Care; worth saving

In "The Business of Health" the authors address more indicative measures of quality instead of the life expectancy statistic explored here. First with cancer survivor rates, then with a menu of services. The full book is here. Below is their re-cap.


"When more specific performance metrics are used that are (at least
potentially) more sensitive to health-systems differences, in many cases the
United States does, indeed, appear to outperform other, less expensive
health systems. Table 1-6 reports age-adjusted five-year survival rates for
several types of cancers. In all cases, the survival rates for the United States
overall exceed those for European nations. Within the United States, survival
rates for whites are higher than those for African Americans. Presumably
this, at least in part, reflects race differences in average socioeconomic status
and access to health care. Even so, survival rates among African Americans
tend to be on a par with the overall survival rates in European nations." (snip)

"Similar themes are observed in a recent study by the Commonwealth
Fund International Working Group on Quality Indicators, which collected
data on twenty-one health care quality indicators from Australia, Canada,
New Zealand, England, and the United States. The measures included
survival rates for nine different diseases and conditions (such as breast cancer
and ischemic stroke), eight different avoidable events (such as suicide
and hepatitis B), and four process indicators (such as breast cancer screening
rate and influenza vaccination rate for individuals sixty-five years of age
and over). Efforts were made to ensure reasonable comparability across
countries. Among the five countries, the United States ranked either best or
second-best in just over half of the twenty-one categories. It was first or
second in three of the nine survival indicators (breast cancer, cervical cancer,
and leukemia in children ages zero to fifteen), all but one of the eight
avoidable-event indicators, and one of the four process indicators (cervical
cancer screening rate). The authors conclude that 'no country scores consistently
the best or worst overall, and each country has at least one area
where it could learn from international experience. Each country also has
an area where it could teach others.'”

Combine these outcomes with the fact that the vast majority of life-saving drugs, medical equipment (MRIs, CT scans, pacemakers, etc. ), and medical procedures are developed or manufactured in the US, and one concludes that there is much to save about medical services in the US. We have something unique. Something which adds value to us and to the rest of the world. Whatever reform we undertake should protect that, not destroy it.