NHS in Shambles
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  • Loader2000

    The British Health Care system is notoriously bad, certainly
    worse than the US system both based on the data, and from horrifying anecdotes
    passed along from family friends to me.
    Conservatives will often generalize the NHS to all single payer health
    care systems. In fact, the French and
    German systems do considerably better than the NHS and are comparable to the US
    system. I’ve looked at cancer survival
    rates for different cancers and different nations, and the US, Japan, France
    and Germany are close together in survival rates with the US pulling slightly
    ahead for some types of cancer and lagging slightly behind in others. The real problem with the US system is not
    quality of care, at least not for most US citizens. It is inefficiency. We pay more for the same health care than
    they do in France or Germany or Japan.
    For conservatives out there who think our current system is okay, sorry,
    but it is not. For one thing, the
    litigation culture in the US dramatically alters the way doctors serve
    patients. Blue liberals like to say TARP
    reform is a red herring because they only factor the cost of malpractice
    insurance. However, the real cost is the
    way the threat of legal action in the US causes doctors to perform millions if
    not billions of unnecessary tests and scans (among other things). Every doctor I’ve ever heard or read that
    commented on the issue said that their hospital performs unnecessary tests,
    scans and even procedures because the not so remote threat of getting sued (which
    is expensive even if the patient turns out to be wrong) is more expensive in the
    long run that simply charging insurance companies for all kinds of 1 in a
    million tests. After all, the hospitals
    rarely pay for the tests and scans, the insurance companies do and the
    insurance companies have to rely on the doctors as to which tests, scans and procedures
    are necessary. As a consequence, any
    liberal who wants to talk about health care reform but is not willing to address
    TARP reform is not taking the issue seriously.

    • Corlyss

      Amen, brother! Very succinct analysis of some of the biggest cost-drivers.

      “The real problem with the US system is not quality of care, at least not for most US citizens. It is inefficiency.”

      Since the government is already responsible for so much of the system thru Medicare and Medicaid and VA, I suggest that many of the inefficiencies in it would have been naturally corrected if market forces, or even quasi-market forces had been allowed to operate. As it is, most of those programs are incapable of self-correction in part because 1) they’re run by bureaucrats whose aim is to continue doing what they were doing (rice bowl), and 2) HHS can’t monitor the programs without a hugely expanded staff. Even the VA has better fraud control and cost control than Medicare and Medicaid.

    • ColoComment

      I have read elsewhere that the statistics re: infant mortality are calculated differently in the U.S. than elsewhere. And, that the WHO study re: national comparitive health care outcomes relied to a great extent on subjective opinion and to what extent a country subsidized health care for its citizens.

      “We pay more for the same health care than they do in France or Germany or Japan. ”

      Every time I see this statement I wonder what all those calculations of the cost of health care include, and are they “apples to apples”? I have never seen an explanation of what, exactly, is measured in the claimed costs of health care.

      For example, the U.S. apparently spends a huge amount on pharmaceutical R&D & marketing: is that included in “the cost of health care”? European and Japanese tax structures impose higher costs than the U.S. on taxpayers, which costs fund their subsidized health care: is that included in “the cost of health care”?

  • Jacksonian_Libertarian

    “American hospitals are a better place to get treatment than British ones.”
    If Obamacare gets implemented they won’t be.

    • Boritz

      Those were the days my friend…

  • Corlyss

    “One piece of received wisdom in health care reporting is that the US pays more for health care than most any other country but patients receive poorer quality of care in return. While it’s indisputable that our system needs serious reform, this new data reminds us that in many ways Americans do receive comparatively good care.”

    Something that rarely occurs in journalism on health care systems is a challenge to the stats provided by governments that own the health care apparatus in their countries and who have a substantial interest in downplaying the unpleasant. Why does anyone assume they tell the truth without some form of independent verification? It’s rather like the violent crime reports from western Europe, always used to impugn America as a lawless frontier nation with low regard for the social consequences of violent crime. Until the late 90s, everyone took their government furnished stats as gospel. Then in the 90s investigators began looking behind the numbers and discovered . . . Horrors! . . . governments were cooking the books to conceal from their publics how ineffectual their police were. That’s one way to always end up looking like Socialist paradises compared to the US.

    • f1b0nacc1

      This is a crucial point, and one that is rarely discussed when debates such as this arise.
      A great example is that of infant mortality rates. In many countries (China is an excellent example), infant deaths are not actually counted as such until at least 24 hours after birth. In practice this means that a child that dies during birth is counted as a pregnancy which terminates, and not as the death of a child. Hence the infant mortality figures for China (chilling enough) are artificially low. Similar sorts of data manipulation are common throughout the world (France is notorious for this sort of thing), and healthcare in particular is often a favorite venue for these shenanigans.
      One could only imagine what the Lefties would say if a discussion of say, environmental outcomes was based upon data provided by oil companies, yet there seems to be blind trust when the government tells us that of course they are doing a great job.

  • BrianFrankie

    As someone who lived in the UK for a considerable period, the direction of these results is not surprising in the least. My UK healthcare anecdotes from top-end NHS hospitals are bone-chilling. I’ve encountered higher quality health care in most so-called “third world” countries I have lived and worked in. The only surprises I find in the post are twofold:
    1. That results are not much worse than reported. Only a 45% increase in the death rate? I am skeptical, and would have estimated it would be much higher. I suspect that if an actual neutral party, not invested in the NHS, re-ran the numbers, the results actually would be quite a bit worse.
    2. That Prof Sir Brian (isn’t that just so very British?) was surprised by the results. It takes a particularly insular sort of smug, conceited liberal to express surprise when actual real world data confirms what any reasonably observant person can see at a glance. Unfortunately, such people seem to infest the upper reaches of UK and US governments and bureaucracies. How do we get rid of them? Or at least make them use the same systems as average people in their country so that they are not quite so insular?

    The US argument, in my mind, is often divorced from reality. The obvious problems in US healthcare involve high costs and disconnection between the consumers and providers. There are solutions, but the PPACA moves the nation in precisely the wrong direction, toward a system that will start resembling the NHS. People living in the US will pay a high price. Which is why I am no longer a working US resident – as much as I’d like to return prior to retirement, I need to see some progress on important issues including healthcare and unfunded obligations before doing so.

    • Corlyss

      Within the last couple of months I’ve been lectured to by folks here who insist I was wrong about the outcomes. It took me too long to find data on the ‘net to back up my argument. However, I’m a long time reader of Economist. I was not buffaloed.

  • Boritz

    This is especially alarming in light of the British Journal of Medicine’s report of a link between playing rugby and dementia. Asked for comment the rugby players thanked God they didn’t play rugby. Lighten up. It’s only health care. It will work much better here than over there.

  • Jeff Jones

    Where is bpuharic with his entirely predictable trashing of this data, and inevitable counter-argument based upon data from such esteemed journals as Media Matters for America?

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