What criteria are conservatives using when they make the claim? Best if money is no object? Best infant mortality? Best post-diagnostic-treatment survival rates?
Or is this just one of the GOP’s talking points that they repeat ad nauseum to generate support for returning to the state of affairs prior to passage of health [del]care[/del] insurance reform legislation?
Not trying to stir debate, just want to know what objective measures exist and how they’re compiled.
No.
Man, that was short, quick, and easy!
Well, of course, there are some objective measures, like best infant mortality rate which you mentioned, but that one’s certainly not the one the GOP is pointing to as the U.S. is 33rd on this list.
List of countries by infant and under-five mortality rates - Wikipedia.
But even if you have several or many objective measures, you’d presumably have to have some subjective weighting scheme to aggregate them.
Maybe it’s the Stephen Colbert measure – whatever costs the most must be best.
Right off the bat, I would say that this could easily be a candidate for “Great Debates”.
Look down all the possible objective measures you could take:
Life expectancy. Infant mortality. Cost per patient or per capita (nationally per individual). Rates of infection. Average hospital stay. Survival rates of various afflictions.
Then look at how many ways there are to influence those numbers through behavior or analysis interpretation. Are hospital stays longer in the U.S. because doctors are afraid to let patients leave early for fear of malpractice suits? Or are they under pressure from insurance companies to shoo out the mothers of newborns earlier than they’d like? Is there a two-tier system–insured and uninsured? Do we contrast free-but-often-crappy free clinics or national health service care with private hospitals/insurance? Is there more autism/ADHD/etc. in the US, or just more diagnoses? Should we contrast the fact that a medication that costs $700 a month in the US might cost $34 a month in a European or Asian country? Why is that? If you got a skin cancer or leukemia diagnosis, what would your prospects be in the US, Canada, Chile, Sweden, Russia, Zimbabwe, China, or Thailand? Consider both the care available and the ability to pay for it, or however it’s paid for.
I think I’d rather argue for or against the existence of the Biblical God/Yahweh…
The number of “preventable” deaths is an oft quote statistic. And by that standard the US is not doing so well.
my favorite “objective” way to define a good heath system is to avoid looking at numbers, and instead look at words. The words you say when sittting around with good friends and the discussion rambles along.
A country has a good heath system if you can chat about life, love, family, etc…and NOT discuss the health system.
(rough analogy: you know a country has good freedom of speech when you dont have to discuss whether the country allows freedom of speech)
The evidence that conservatives use to claim that the US has the greatest health care is that rich foreigners will often come to the US for treatment. This is because the US is often at the cutting edge of medicine so has experimental and expensive treatments available for those who can pay. Also it’s more market based than other countries so the best doctors can be reserved for those who pay more.
Thus for a very slim proportion of society, the US heath care is the best on the planet, but for most normal people you are better off elsewhere.
I don’t think you can put countries’ healthcare systems in an order of effectiveness in any completely objective manner.
I mean, to be completely stereotypical about it, in the U.S. if you have money, or good insurance, health care is excellent, maybe as good as anywhere in the world, maybe the best in the world in some areas.
If you don’t have money and you don’t have insurance it’s terrible.
How could you put that on one location on a line?
This is probably worth a read: Online Bookstore: Books, NOOK ebooks, Music, Movies & Toys | Barnes & Noble®
I heard the author on NPR awhile back, it was a fascinating interview.
Really measures like average hospital stays, $ spent per person etc are economic measures. Are these truly the way we should determine the best? Maybe most or least efficient but how do you measure efficacy?
Life expectancy would have to be the ultimate measure…?
Thanks for reminding me about T. R. Reid. I recall seeing a television program a few years back (Frontline or Nova) on the topic of the book you reference, camera followed him around four different countries as he sought treatment for a dislocated shoulder as I recall.
I think what 'pubs refer to when they say this is the fact that the most talented surgeons and researchers in the world tend to come to America (or stay here if born here). Lured by massive amounts of pay and the “best” universities, of course.
We may have the best possible healthcare for the top 10% of our population, but the middle is languishing and the bottom is absolutely atrocious. I’d rather have a system that treated conditions instead of wallets.
I think Hans Rosling a professor of statistics has a way, but he is discouraged by the fact that even old Republican heal care plans (The current Obama/democratic plan is actually based on the Republican counter plan offered in the past against the Clinton health care plan) are denounced as communist or socialist, ignoring that the rest of the world gets better results using less money while giving health care to all their citizens.
You only need to watch question #6 and the reply.
The USA is the big red bubble spending 15% of GDP in health spending per person and yet countries like Switzerland spend 11% and get a higher life expectancy than the USA.
But at the same time, how much of life expectancy is impacted by, among other things: local diet, local customs, amount of sunshine (Eskimos versus people on the equator), presence or lack thereof of guns/crime, tribal warfare, genetics/the gene pool, wealth, leisure time availability, stress factors, etc.?
My argument is that for every presumably “objective” measure to judge “best health care,” there’s a “subjective” rationale to reject same. For example, you can say “more people come here to get better care than they can get at home,” but that demonstrates that it’s available for those who have the means to pay their way around a waiting line, or maybe that we allow doctors to do things (liposuction, lasik eye surgery, experimental cancer/AIDS treatment protocols, or even pure quackery) that other places don’t/won’t let doctors do. Is that “better”? Certainly, to a libertarian. Certainly not, to a “health care is a right, not a choice” activist.
This is lousy evidence because (as usual?) the consies either ignore or don’t know that other first-world countries besides the US exist. In Munich, we also get a lot of tourist from Middle-Eastern (Arab) countries, both for shopping and for medical operations (and often combined) - so much that the city has now opened a branch city information in one Mid-Eastern state (Dubai or nearby) to attract more. (The visitors like the liberal atmosphere and relaxed, no-trouble city compared to the bigger ones.)
The Berliner Charite is not only a very big hospital, but also has top surgeons and patients from all over Europe coming there. Another doku was about a children’s hospital (I’ve forgotten where it is) - one of the surgeons there has developed a new technique to deal with sunken ribcages in boys and so kids from far away go there.
Generally, whenever a rare disease or a very specialized treatment is discussed, it depends completly on the circumstance where the hospital specalizing in treatment or where the top surgon for that case is located, so people travel from Germany all over and from all over to Germany.
With elective surgeries like eyes or dental, there is a strong tendency to go to Eastern Europe, where people are well-trained, but have lower cost of living, and thus, lower wages for the procedures. An aquaintance of mine (to get into anecdote territory) went to Turkey for a holiday combined with eye surgery, because it was a cheap combined package, and she compared quality before.
The US has a bigger PR, though, so rich people from other countries go there because of glamour, or what they see on TV and Hollywood (or because they want to spend a nice holiday shopping in NY), not because they researched the issue and found objectivly that the US is top.
It seems to me that you ought to look for actual conservatives making this claim and read what they say.
The best measure would be to look at prognosis of similar individuals with similar diagnoses. Infant mortality and life expectancy are very bad measures but since they are easily collected they are used most often. For example, in America a baby that is 4 months premature may die after being in intensive care for a few days and count against the infant mortality whereas in a poor country a similar infant would be classified as a miscarriage and not be included. The town I live in has a much higher life expectancy than Baltimore, but that is because it has much fewer drug dealers shooting each other, not because my local hospital is better than Johns Hopkins.
Also is it very hard to compare systems because of demographic differences. Latinos in America have longer life expectancy than Anglos. Does this mean they get better health care or is it because of other factors not related to health care?
Wait times, iatrogenic diseases and cost would also be valid measurements but tell only part of the story.
The US does well in comparisons of years lived after a cancer diagnosis and life expectancy adjusted for demographics and these are better statistics than life expectancy and infant mortality, but they are stilled flawed. The amount of data needed to produce a meaningful comparison between countries of total health care systems would be incredibly huge. Therefore the notion of best comes down to a value judgement which is not objective.
The evidence I hear most often from conservatives is cancer survival rate.
Diet is a huge factor. It’s no secret that Americans eat way too much. In all likelyhood, this explains most or all of the difference in life expectancy.
That doesn’t work either, since under our current system, a poor person with some condition might have a terrible prognosis, but never be diagnosed in the first place. Just by restricting it to people who get diagnosed, you’re skewing the statistic towards the portion of the population that has decent healthcare, but the biggest criticism of our current system is that that portion is too small.