Comments: Why US Health Care Is the Best in the World

Fantastic misdirection in this post. When I began to read it, I really suspected that I might discover Newsweek doing actual journalism on an actual planet Earth.

Ha, ha! Good one!

Posted by Aaron Datesman at December 12, 2008 04:39 PM

Criticism of the US health care industry, while valid, has to be tempered with a recognition that comparatively Americans keep themselves in the worst physical condition. They lead the developed world in obesity, for example, as a result of poor dietary and exercise habits.
http://miscellanea.wellingtongrey.net/2007/05/06/global-obesity-fatness-by-country/

Posted by Don Bacon at December 12, 2008 04:47 PM

We also have some of the best paid lawyers in the world. The idea of tort reform is usually missing from the health care discussion.
You get a $500 EKG for a splinter in your toe, because the doctor is practicing CYA medicine. Same for all the expensive tests, Cat-scans MRI etc. No one wants to get sued

Posted by Joe at December 12, 2008 06:11 PM

Actually the Newsweek article is not bad in that it gives you all these facts. But the poor journalist would probably get fired if she questioned the altruism of the AMA, insurance companies, big pharma, and all those corporate entities that care only about our well-being.

Posted by Bernard Chazelle at December 12, 2008 08:35 PM

[T]he problem with our health-care system is that we persist in thinking like Americans.

In this context a presume "Americans" means "idiots".

“prize individual choice and resist limiting care. We believe that if doctors can treat very ill patients aggressively and keep every moment of people in the last stages of life under medical care, than they should. We choose to hold these values. Consequently, we choose to have a more expensive system than Europe or Canada”

Bull. Let's ignore things like life expectancy and ask, does our system even succeed at what it tries to do?

Does the American system give people a greater amount of choice in treatment options?
Is it easier to get long-term care in America then it is in other countries?

I don't know about people who have a nice job and really good insurance, but I can sure as hell tell you that for those of us without insurance, or with crappy insurance, our system couldn't possibly be worse at the things we're supposedly spending all that extra money on.

Posted by Christopher at December 12, 2008 10:07 PM

They always neglect to mention that most Americans want national health insurance.

Posted by cemmcs at December 12, 2008 10:12 PM

Christoper, the answer to your question is a big resounding NO those of us with that "great" health insurance have crappy medical care too and EXPENSIVE. The insurance companies talk about "maximum out of pocket expenses" first scam...somehow 99% of out of pocket expenses somehow don't count toward that, actually I've yet to figure out what that term means. To me that means if I have to pay $2000. to the hospital after my son was sick for a week, $500 or more to the doctor and another $500 or more for lab tests etc that sort of seems like out of pocket expenses but apparently to the rich insurance companies that isn't much money and I shouldn't complain....the bottom line is even those of us with what is supposed to be the greatest insurance have less and less access due to cost. I'm always paying off medical bills, I shudder to think what would happen if one of us got really sick with cancer or something...oh yeah...then the insurance company would dump us and the medical system would refuse to treat us because we had no money....yep the US system is the "best in the world"

Posted by fizzbincat at December 13, 2008 09:05 AM

I'd guess that the reason Americans think the US has the best quality medical care of any country in the world is that they KNOW we are NUMBER ONE, you suckahs! Go America! WHOOOOOOO!

Besides, how would they know anything about the relative quality of health care in different countries? Either they listen to the corporate media, or they listen to that fat commie Michael Moore, whom even other liberals have dismissed rightly as a fat communist. Did I mention that he's fat?

Posted by Duncan at December 13, 2008 12:06 PM

Not mentioned is that some so-called "third world" countries have better health care than the US. Michael Moore's "Sicko" showed Cuba's, the most famous example, but there are others. Several years ago, I talked to a woman from India who was a visiting professor at a US university and she told me that the US health care system is so bad that she regularly flew home to India for health care. Clearly, this is someone who could have afforded the finest care the US had to offer and the finest India had to offer, but she found the bureaucracy and poor care she encountered in the US intolerable. Getting more and more worked up as she talked, she finished by saying, "It doesn't even work for Americans themselves, so why do they defend it so much?!"

Posted by deang at December 13, 2008 12:18 PM

55 percent say the US has the best quality care of any country? Isn't this the same percentage who say they are in the top 10% economically?

I think I will call this, "Lake Wobegone Syndrome".

Posted by Aaron Datesman at December 13, 2008 01:31 PM

@deang: funny, the elite indians often claim to go to the USA for medical treatment.

Posted by almostinfamous at December 13, 2008 02:53 PM

The healthcare system in USA is completely broken. It is rather complicated as there are many factors responsible for this in addition all mentioned earlier. The points I am making are my person observations and they connect to explain the state of heathcare in USA.

Medical education is so expensive, when a student graduates, usually she/he is in debt of upto $300K ( YES, that is not an error).

After graduating and finishing training, to start a practice, there is an overhead of $4K/month ( including utilities, rental and staffing expenses). Add to that approximately $20K/yr for malpractice ( this is for a paeditrician ). So, before an MD earns a single penny to keep, the debit is $68K/yr ( a conservative figure).

There is marked disparity in what different specialities get paid i.e. PCP MDs ( FP, Internist and Paediatricians) get peanuts compared to what other specialities get hence more superspecialists ( not needed) and fewer PCPs ( in short supply ). Hence, more MDs prefer low risk specialities like Gastroeneterology or Pulmonary Med where they can do porcures ( makes a lot more money with fewer risks ).

And then the maldistribution of MDs ( more in urban areas and hardly any in rural areas-- Federal Govt allows IMGs( internationa medical graduates ) to serve in underserved areas so they do not have to return to their home country and become eligible for green card if they so wish.

A commeter mentioned, everyone wants universal healthcare. However, when an advocate of that system is given a voice, there is an alleged expert on Canadian healthcare system who talks about the horrors of how patients are denied necessary tests and operations and they have to wait for 6 months, completely forgetting to mention that in the USA, they may NEVER SEE AN MD, so question of a test or procedure does not even arise.

American society is very mobile, in good and bad economic times. A person will quit a job with addtion of $10-15K and move to another town. When a person loses a job, has to move where job is available. Because the health insurance is related to employment, everytime a person moves, has to find a new medical professional which is a big problem in delivering quality healthcare as then it takes a while to develope a rapport with an MD and continuity of care is not maintained ( absolutely the most important factor in giving best healthcare).

Trying to reduce the cost of giving healthcare, HMOs were formed and the basic funtion was supposed to be wellness i.e. preventive medicine and eduction of public about how to remain healthy. For the HMOs, it is the bottom line and the administrators decide for how long ( 10-15 minutes appt for a patient) an MD will see a patient and how many return visits per illness!! will be permitted( this is no exaggeration--this is personal experience--when HMO would refused to give an appt, patient came to our public institution for care ). And if a particular doctor gave more time to the patients and gave frequent return visits appoinments, was reprimanded and even threatened with termination. In contrast, the free standing clinics that have sprouted all over where people go who have insurance, they do every possible test and at the end of the day they tally the total and MDs generating maximum income, are given a bonus. I know this is shocking and people may not believe it ( like I did not ) but these are facts.

Cosidering this is litigenous society, MDs claim, they have to practise defensive medicine. This is not true. If MDs were to spend more time talking to patients and explaining their illness instead of "going in and out", patients would not be prone to sue. Yes, malpractice premiums are very high for certain specialties like Neurosurgery( some have given up practising in some states causing severe shortage of neurosurgeons). In reality, most of the suits are frivolous and thrown out of court. If there is real negligence, MD should be treated as any other criminal and punished accordingly. If it is a genuine judgemental error, independent peers ( medical professionals ) should judge the case and decide on the compensation. Malpractise insurancee would certainly come down.

And in spite of USA being way behind in life expectancy, more and more people are living longer and longer and hence a new field of Geriatrics. And inspite of being aware of this, I am not pesonally aware of any specific programme ( state or federal) that pays for permanent long term care ( which is going to be another major problem in terms of providing healthcare and its cost ). People who can afford, probably buy 'long term care' insurance but I do not know what percentage is able to.

To go back to the beginning, 55% said they thought, USA had the best healthcare sysyem. Perception and reality are not in sync. Having worked in a public institution for 25+ years, I have seen everything one can see, the best ( trauma unit, burn unit, neonatology unit) and the worst and things I should not have seen considering I was in the USA ( patient dumping, transfer of allegedly living patients from hospitals that did not accept them because of lack of insurance and they were DOAs ).

SO, unless there is a total overhaul of a system that claims to provide the best healthcare, things will remain the same.

ps One can not emphasise enough the role of pharmaceutical companies that spend more money on advertising than research which makes patients demand of their doctors the latest and most expensive drug when an old, true and tried drug is eaually effective and relatively costs nothing. It is all about PATENT and control of markets. Also ONLY 30% of doctors belong to the AMA. Majority choose to belong to associations of their own specialty. And just like other institutions which get taken over, hospitals get taken over by the giants of so called Healthcare Industry which shamelessly really care only about profits.




Posted by Rupa Shah at December 13, 2008 04:25 PM

If Newsweek put Jennifer Aniston on the cover I might take a look at it.

Posted by par4 at December 13, 2008 05:10 PM

Don Bacon at December 12, 2008 04:47 PM:
"...as a result of poor dietary and exercise habits..."
And habits are a result of choices, and those choices are the personal responsibility of those who made them and we must all take persoanl responsibility for the choices we make so it's their fault they're fat and unhealthy.
It's not that they're being raised like veal calves in tight little pens.
They're choosing choosing choosing choosing, just like they chose Bush and now Obama and sub-prime mortgages and back when they chose smoking.
Chose chose chose chose.
Not that they were seduced into it, coerced inveigled and tricked. No it's a personal choice and we have to take responsibility for our personal choices so too bad for Mr and Mrs Tubby.

Posted by roy belmont at December 14, 2008 03:54 PM

roy belmont:
Some people do want to have healthy diet but they can not afford it. An unemployed person can not afford to buy fresh produce and fruits which are very expensive compared with fast food at McDonald's or Burger King's which is filling and cheap. Even diabetic patients are not able to eat ADA recommended diet because of lack of money.
And they are the same ones who can not join health clubs or gyms.

Posted by Rupa Shah at December 14, 2008 08:52 PM

roy belmont:
I guess, I have the "tubelight has gone on" syndrome! Go figure.

Posted by Rupa Shah at December 15, 2008 02:10 PM