# Is there an objective way to determine the 'Best Healthcare System in the World'? **URL:** \ **Category:** Factual Questions\ **Created:** [January 13, 2011, 7:50pm UTC](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504 "2011-01-13T19:50:01Z")\ **Posts on this page:** 13\ **Page:** 2
**Author:** ![lazybratsche](https://avatars.discourse-cdn.com/v4/letter/l/ba8739/32.png) [@lazybratsche](https://boards.straightdope.com/u/lazybratsche)\ **Post date:** [January 14, 2011, 8:32pm UTC](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504/21 "2011-01-14T20:32:13Z")
> [@Chronos](#): > > 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. And then, even with those who do have access to their healthcare system, differences in screening and diagnosis will confound that sort of statistic. All things being equal, someone diagnosed earlier in their disease progression will have a greater survival time under this measure than someone who is diagnosed later, regardless of treatment quality. Screening will pick up asymptomatic tumors and diagnose patients with cancer, even though in many cases that tumor would remain benign for the patients entire life. There are plenty of examples in the US where aggressive screening and diagnosis don’t actually improve patient outcomes; but such efforts do increase measures of survival after diagnosis. IMO, I _might_ buy that the US has better healthcare, at least for those who can afford access. But we’re paying twice as much as other wealthy nations for outcomes that certainly aren’t twice as good. ---
**Author:** ![Lust4Life](https://avatars.discourse-cdn.com/v4/letter/l/ecc23a/32.png) [@Lust4Life](https://boards.straightdope.com/u/Lust4Life)\ **Post date:** [January 15, 2011, 11:32am UTC](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504/22 "2011-01-15T11:32:26Z")
> [@constanze](#): > > 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. Very true, here in the U.K. we also have a not inconsiderable number of wealthy foreigners coming here for treatment, though not on the National Health Service. I’ve also heard, but am happy to be corrected, that the same is true of Switzerland. ---
**Author:** ![skdo23](https://avatars.discourse-cdn.com/v4/letter/s/a5b964/32.png) [@skdo23](https://boards.straightdope.com/u/skdo23)\ **Post date:** [January 16, 2011, 7:56pm UTC](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504/23 "2011-01-16T19:56:55Z")
One thing that opponents of increasing the U.S. govt.‘s role in health care often bring up is that in other countries that offer universal health care but are otherwise economically similar to the U.S., such as the UK and Canada, there are often longer waits to receive non-essential health care services. I lived in the UK for a few years and utilized the NHS when I was there and I can say that while such delays are an issue, they really don’t result in the quality of care being any worse than in the US. Rather, such delays merely fall short of what American’s have learned to expect from our health care system and conservatives are able to twist this into meaning that these other countries’ health care systems are of a lower quality and less effective. Based on my experience with both the US system and the NHS I would say that a good example of the differences between the two systems would be this: lets say that under the NHS you are experiencing minor back pain, and, after complaining to your GP, or to a NHS representative over the phone (usually a nurse, I believe), as long as they were satisfied that the pain was not the result of anything urgent (i.e. spinal) they would refer you to a specialist, and my understanding is that a two month wait would not be uncommon. Obviously you’d rather see the specialist sooner, and in the US it would probably be more like a week or two. However, it obviously costs our health care system more to have the resources to provide this level of service. Now, to many people, that is acceptable - I’m fortunate to have a job with great benefits and, especially, with the option of having my health insurance premiums deducted from my paycheck pre-tax, I’m able to provide myself and my family with what is probably the highest quality of health care we’ll ever need. The downside is that my willingness, and the willingness of millions of other Americans to pay a bit extra, results in an economic demand for a level of health care service that is out of reach for many less fortunate Americans, without providing them with any real alternative. In other words, the fact that people like me are willing to pay extra to have their minor aches and pains treated within the next few weeks and not the next few months means that everyone who wants to utilize our health care service has to pay extra for quicker treatment, regardless of whether it’s worth it to them or not. Sorry for what, by my own admission, turned out to be a rather long and rambling post. My point is that conservatives often cite our relatively quicker access to health care as a reason why our system is superior to alternatives such as the NHS. However, this is really more an issue of convenience than health, and if anything only serves to exasperate our health care crisis. ---
**Author:** ![Capitaine\_Zombie](https://avatars.discourse-cdn.com/v4/letter/c/e95f7d/32.png) [@Capitaine\_Zombie](https://boards.straightdope.com/u/Capitaine_Zombie)\ **Post date:** [January 16, 2011, 9:48pm UTC](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504/24 "2011-01-16T21:48:41Z")
This two months to see a doctor sounds like a total myth. I live in France, if I want to see a common family doctor, I can see him in the day or the day after. A specialist, I can see in the week. If it’s a super busy specialist, say one that does surgery for example and so has only limited visit days, I get to see him within the month. What kind of society would accept waiting two months to see a fucking doctor? Just sounds like bullocks to me, that any system outside of the US guarantees regular access to a doctor. Most people repeating this shit have never bothered to go check if the claims they make can be countered. Why would they. They’re the Right after all. And the Right is always in the right. Hence the name. ---
**Author:** ![constanze](https://avatars.discourse-cdn.com/v4/letter/c/f9ae1b/32.png) [@constanze](https://boards.straightdope.com/u/constanze)\ **Post date:** [January 16, 2011, 10:46pm UTC](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504/25 "2011-01-16T22:46:04Z")
> [@Capitaine\_Zombie](#): > > This two months to see a doctor sounds like a total myth. I live in France, if I want to see a common family doctor, I can see him in the day or the day after. A specialist, I can see in the week. If it’s a super busy specialist, say one that does surgery for example and so has only limited visit days, I get to see him within the month. > What kind of society would accept waiting two months to see a fucking doctor? > Just sounds like bullocks to me, that any system outside of the US guarantees regular access to a doctor. Most people repeating this shit have never bothered to go check if the claims they make can be countered. Why would they. They’re the Right after all. And the Right is always in the right. Hence the name. Um, no, it’s not a total myth. When I go to see my specialist doctor for my half-yearly check-up, I have to make my appointment about 4 months in advance (used to be 2 months). But then, he and the institute he works at is one of the leading ones in the country for this type of sickness. Generally, how long I have to wait for a date depends completly on the doctor. A few doctors even have the “First come, first served, no fixed dates” system (though that could take long, too… ) One orthopedist had a date system, but used about 2 hrs. longer - evidently he had problems scheduling. Some doctors, I have to wait 10 to 14 days, others longer. All of this of course for non-emergency, the routine check-ups. In the German system, beside the offical health insurance, people can choose private insurance on individual basis and with a fixed rate instead of percentage. In a small sample test, consumer advocates found that on average, a patient with official insurance had to wait about 10-14 days for a date, but a patient with private insurance had to wait 7-10 days only. I never have understood, on the other side, how the US system works for the doctors. If you get an appointment the next day as patient, how do they manage their practice? Are the doctors sitting around waiting half the time? Are they bumping second-rate patients? But then, I never heard of that. Can the doctor Dopers explain how doctors run a practise with instant access time, without leaving gaps of idle time? ---
**Author:** ![Capitaine\_Zombie](https://avatars.discourse-cdn.com/v4/letter/c/e95f7d/32.png) [@Capitaine\_Zombie](https://boards.straightdope.com/u/Capitaine_Zombie)\ **Post date:** [January 16, 2011, 10:53pm UTC](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504/26 "2011-01-16T22:53:37Z")
I can understand a monthly wait for an ultra rare specialist (though 4 months???), but that has no link with healthcare, it is just hyper specialization on the doctor’s part. You could see a specialist in the field in less than 4 months. But you trust that specific doctor. I live in Paris, so my access to healthcare is far better than what you’d have outside of the capital. But months to wait for a doc, even a good reknowned specialist? That’s not how it works here. And so it’s kind of bullocks to say governmental healthcare means shitty medical access, both in terms of delay and skill. ---
**Author:** ![skdo23](https://avatars.discourse-cdn.com/v4/letter/s/a5b964/32.png) [@skdo23](https://boards.straightdope.com/u/skdo23)\ **Post date:** [January 16, 2011, 11:13pm UTC](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504/27 "2011-01-16T23:13:41Z")
“I never have understood, on the other side, how the US system works for the doctors. If you get an appointment the next day as patient, how do they manage their practice? Are the doctors sitting around waiting half the time? Are they bumping second-rate patients? But then, I never heard of that. Can the doctor Dopers explain how doctors run a practise with instant access time, without leaving gaps of idle time?” Doctor’s often end up with empty time slots due to canceled appointments, extra time that they allocated for unforeseen circumstances that they end up not needing, etc. Also, many medical practices consist of several physicians who don’t all work every day, but agree to be on call on some days that they don’t work or to work additional days if needed to accommodate overflow. It’s a given in a medical practice that they will need to accommodate patients at the last minute, and they plan their schedules accordingly. ---
**Author:** ![fumster](https://avatars.discourse-cdn.com/v4/letter/f/e9c0ed/32.png) [@fumster](https://boards.straightdope.com/u/fumster)\ **Post date:** [January 16, 2011, 11:22pm UTC](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504/28 "2011-01-16T23:22:35Z")
Usa, usa, usa!! ---
**Author:** ![Baron\_Greenback](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/baron_greenback/32/48_2.png) [@Baron\_Greenback](https://boards.straightdope.com/u/Baron_Greenback)\ **Post date:** [January 16, 2011, 11:30pm UTC](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504/29 "2011-01-16T23:30:28Z")
> [@Capitaine\_Zombie](#): > > bullocks It’s “bollocks” . A bollock is a testicle, a bullock is a male bovine that has been de-bollocked. ---
**Author:** ![Capitaine\_Zombie](https://avatars.discourse-cdn.com/v4/letter/c/e95f7d/32.png) [@Capitaine\_Zombie](https://boards.straightdope.com/u/Capitaine_Zombie)\ **Post date:** [January 16, 2011, 11:33pm UTC](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504/30 "2011-01-16T23:33:07Z")
> [@Baron\_Greenback](#): > > It’s “bollocks” . A bollock is a testicle, a bullock is a male bovine that has been de-bollocked. Raight. ---
**Author:** ![Baron\_Greenback](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/baron_greenback/32/48_2.png) [@Baron\_Greenback](https://boards.straightdope.com/u/Baron_Greenback)\ **Post date:** [January 16, 2011, 11:45pm UTC](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504/31 "2011-01-16T23:45:40Z")
> [@Capitaine\_Zombie](#): > > Raight. Happy to help, wish my French was as good as your English. It’s “Right”, btw. ☹ ---
**Author:** ![Capitaine\_Zombie](https://avatars.discourse-cdn.com/v4/letter/c/e95f7d/32.png) [@Capitaine\_Zombie](https://boards.straightdope.com/u/Capitaine_Zombie)\ **Post date:** [January 16, 2011, 11:48pm UTC](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504/32 "2011-01-16T23:48:07Z")
> [@Baron\_Greenback](#): > > Happy to help, wish my French was as good as your English. It’s “Right”, btw. ☹ I know, was being facetious. Nothing makes you look more stupid than constantly using the same word, but in a wrong sense. ---
**Author:** ![sisu](https://avatars.discourse-cdn.com/v4/letter/s/df705f/32.png) [@sisu](https://boards.straightdope.com/u/sisu)\ **Post date:** [January 17, 2011, 4:13am UTC](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504/33 "2011-01-17T04:13:52Z")
> [@skdo23](#): > > Doctor’s often end up with empty time slots due to canceled appointments, extra time that they allocated for unforeseen circumstances that they end up not needing, etc. Also, many medical practices consist of several physicians who don’t all work every day, but agree to be on call on some days that they don’t work or to work additional days if needed to accommodate overflow. It’s a given in a medical practice that they will need to accommodate patients at the last minute, and they plan their schedules accordingly. That’s the same down under. Hyper specialists are harder to get onto, but that would be the same everywhere. [Previous page](https://boards.straightdope.com/t/is-there-an-objective-way-to-determine-the-best-healthcare-system-in-the-world/567504.md?page=1)