How Good Is European/Canadian Health Care Really?

I’m convinced. We need a government-run, single-payer health care system. Why? Because our health care system is miserable -- it’s the worst in the developed world. And everybody else's is so good. Yep. The end.

What’s that? You want me to produce evidence? Fine, but it’s a waste of time. . . just like reading a bill before you vote for it.

Let’s start with life expectancy. Did you know that the United States ranks 50th out of 224 nations in life expectancy? That’s pretty bad. Of course, we live to an average age of 78.11 years, whereas the world average is only 67. So I guess that’s not so bad. And I guess I should mention that the European Union only ranks 41st, at 78.67 years. Interesting. . .

Hey, did you know that the most observable determinant of life expectancy is obesity. And if you factor out the increase in obesity in the United States between 1991 and 2004, the American life expectancy would increase by six months to 78.71, a little better than the EU. Wow, I never saw that coming!

Ok, so the life expectancy thing didn’t work, but we ALL know that the United States leads the world in infant mortality. What? That’s not true either.

The US infant mortality rate is 6.26 deaths per 1000 births, placing us 44th on the list of 224. The EU rate is 5.72 deaths per 1000, placing them 42nd. Only two spots higher. But there's more you say? Not all countries count infant mortality in the same way? In Canada, Germany and Austria, premature babies weighing less than 500 grams are not considered living children and are not counted toward mortality statistics. In Switzerland and other parts of Europe, a baby is not considered a baby unless it is at least 30 centimeters in length at the time of death. In some countries, babies that survive less than 24 hours are considered “stillborn” and are excluded as well. Hong Kong and Japan classify these as “miscarriages” and don’t count them either. Norway has one of the lowest infant mortality rates in the world until you add these exclusions back in. When you do that, the have the same rate at the US.

Who could have guessed that the two big reasons cited for switching to a single payer system are false? I wonder what else we don’t know. . .

• Breast cancer mortality is 88% higher in the UK, 52% higher in Germany, and 9% higher in Canada than in the US.

• Prostate cancer mortality is 604% higher in the UK, 457% higher in Norway, and 184% higher in Canada than in the US.

• Colorectal mortality is 40% higher in the UK and 10% higher in Canada than in the US.

• Americans have better access to treatment for chronic diseases like heart disease. For example, 56% of Americans who could benefit from statin drugs receive them. This compares to 36% of the Dutch, 29% of the Swiss, 26% of the Germans, 23% of the Britons, and 17% of the Italians.

• Canadian and British patients face waits that are twice as long as those in America.

• The US has 34 CT machines and 27 MRI machines for every million Americans, whereas Canada has only 12 CT machines and 6 MRI machines per million, and Britain has only 8 CT machines and 6 MRI machines.

Nor are foreigners all that happy with their systems. Just like Americans, more than 70% of Germans, Canadians, Australians, New Zealanders, and Britons report that their health care systems need either “fundamental change” or “complete rebuilding.” That is surprising if one is to believe that the single payer system is such a good idea?

Further, the idea that American drugs are expensive compared to the rest of the world is a myth. Recent studies have shown that while the US, on average, has higher prices for newly originated drugs, it has the lowest generic prices compared to other countries. The US also has the lowest over-the-counter costs. Moreover, while the US consumer would have spent, on average, 3% more for the same basket of drugs in Canada and 27% more than your average German, the American would have spent 30% less than the average French patient, 9% less than the average Italian, 8% less than the average Japanese, and 24% less than the average Briton.

Finally, consider that the world is piggybacking on American innovation.

• The top five US hospitals conduct more clinical trials than all the hospitals in every other developed country combined.

• Since the 1970s, the Nobel Prize in medicine or physiology has gone to US residents more than the residents of all other countries combined.

• The United States spends three times as much as the rest of the world on R&D in biotechnology.

So maybe, in the end, our system isn’t the disaster we’ve been told? Or maybe, emulating the European/Canadian single payer model just isn’t a good idea.