During the GOP rebuttal following the State of the Union, Virginia Governor Bob McDonnell said “most Americans do not want to turn over the best medical care system in the world to the federal government,” a theme Republicans have repeated many times.
Is US health care the best in the world? No, it isn’t.
US vs. the World
A cross-country analysis conducted by the Commonwealth Fund compared the US’s health care program to those of eight other countries, looking at tangibles such as life expectancy, infant mortality and the amount spent on health care by the respective governments.
Of the nine countries surveyed, the US had the lowest life expectancy rate and the highest infant mortality rate. Moreover, the US spent almost twice as much on health care per capita as the other countries while the government spent less than half that spent by the foreign governments for health care.
| US | Australia | Canada | France | Germany | Japan | Norway | Sweden | UK | |
| Life expectancy | 78.1 | 81.4 | 80.7 | 81.0 | 79.8 | 82.6 | 80.0 | 81.0 | 79.1 |
| Infant mortality | 6.7 | 4.2 | 5.0 | 4.0 | 3.8 | 2.6 | 3.0 | 2.5 | 4.8 |
| Per capita health spending | 7,290 | 3,137 | 3,895 | 3,601 | 3,588 | 2,581 | 5,910 | 3,323 | 2,992 |
| % paid by government | 45.4 | 67.7 | 69.8 | 79.0 | 76.9 | 81.3 | 83.6 | 81.7 | 81.7 |
US is the only industrialized nation without public health care
Of the 38 industrialized nations, the US is the only one that does not offer public health care, with 71 nations offering some form of public care, including:
- Mexico
- China
- India
- United Arab Emirates
- Saudi Arabia
- Israel
- Pakistan
- Russia
Quality of care in other countries
Those who oppose a public option cite poor quality of care — long waiting lists, etc. — in countries that offer it as a reason for not adopting a similar system in the US. A colleague of mine who lived in London for a couple of years described her experience with the UK’s National Health Service:
“The doctors were always very capable, facilities were excellent, and the wait time was no more than I would have waited in the US for a routine appointment — about two weeks. The UK’s system offers good coverage and if you want extras, such as a shorter wait time to see a physician for a non-emergency or a private hospital room, you can purchase supplemental private insurance. But I didn’t find it necessary.”
She added: “Sixty-two percent of Americans who file bankruptcy do so because of medical bills. Of those 62 percent, 78 percent had health insurance. In England there’s peace of mind knowing you won’t be in financial jeopardy if you become seriously ill. You can’t be dropped because of pre-existing conditions or because you couldn’t afford the cost of premiums.”
Your ratings on health cares systems are very misleading. The US has lower life expectancy figures than the other countries shown for two major reasons – automobile accidents and homicides. Neither of those issues will be changed by nationalizing health care. Infant mortality is higher in the US because the US records every live birth as an infant. Other nations leave out babies born below certain weights. That means our mortality rates will be higher by definintion. Finally, our infant mortality is negatively influenced by women using drugs while pregnant. In conclusion, your measures tell nothing about the effectiveness of our health care system.But I am sure that fairness and accuracy have nothing to do with your efforts.
Jim,
Those are good points. But even conceding that the US provides excellent health care, how does that help the 46 million Americans who don’t have insurance and, therefore, can’t pay for it?
Phil,
With all due respect you just changed the entire point of your original op ed with this answer. Are you saying that our healthcare system is inferior (as your original writing suggest) or are you saying that we should simply provide free healtcare to 46 million people (many of that number being illegal aliens) on the backs of those of us who pay our share? Can you help me explain to my daughter why her healthcare will become inferior to what it is now so that illegal aliens can get free?
When you adjust Life Expectancy statistics by deaths from homicides and car accidents, to get down to what is more about health, U.S. Life Expectancy shoots up, in some estimates, to the top.
Moreover, when talking about healthcare and life expectancy, we ought to separate other factors that affect health and life expectancy but are not functions of healthcare:
1. U.S. takes in large numbers of immigrants from the 3rd world, whose life expectancy is lower because of poor childhood nutrition and medical care.
2. Eating and exercise habits. U.S. lifestyle is more sedentary.
As to the supposed fact that we spend much more per capita on health care, expenditures expressed in currency per capita are meaningless when countries with government run healthcare use price controls and rationing. The question that should be asked is whether U.S. healthcare industry is less productive than healthcare industries in other countries. That is, if to achieve exactly the same end result (the same improvement in health from the same starting point), it takes more real resources – human labor, energy, amortization of equipment and facilities. Do you have any facts to show that to be true?
Boris,
I just researched the most accepted comparative studies that have been done. It is true that I didn’t dissect those studies and question their assumptions. But as I told Jim above, even if the quality of care for those who can afford it is excellent, how can we justify 46 million people not being able to afford it?
Dear Phil,
Thank you for sharing data about this important issue. The absence of a public option and government support to help families during our lifetimes enjoy a healthy life is embarrassing and tragic. Isn’t it remarkable that Medicare is offered to people to help with their end of life care….and no comparable offering available to help people care for their children from infancy on? I appreciate your being a voice to reach out to our citizens to take some of the political rhetoric out of the debate. Warm regards, Janet
Dear Phil,
Thank you for sharing data about this important issue. The absence of a public option with government support to help families obtain the care they need to have a healthy life is embarrassing and tragic. If find it remarkable that Medicare is offered to people to help with their end of life care….yet no comparable offering is available to help people care for their children from infancy and throughout their lives. Other Western nations are so far ahead of the U.S. in healthcare policies. I appreciate your being a voice of reason reaching out beyond partisan politics. Warm regards, Janet
Thanks, Janet. I’m not saying we can afford to provide cradle to grave coverage. But let’s get rid of misleading rhetoric about the US having the greatest health care in the world.
Wow Phil! This is a great study, but does this mean you support a public health care option? Maybe I missed something.
Delores
Delores,
It doesn’t necessarily mean I support a public option, but I’m tired of phoney rhetoric that suggests the US has the best health care in the world. The facts say it’s not true.
Quality of healthcare & paying for healthcare are 2 different things. The public option is kinda strange. “Forcing” people to buy insurance sounds strange. Single Payer makes the most sense for paying for healthare. You pay into it from day one & it’s there as you need it when you get older. You don’t lose what you earned when you get laid off. You don’t have people weaseling out of paying you back your money.
Real story…last year a friend of mine, a tri-athlete who competes worldwide, went to have ankle/foot surgery in Austria where her surgery cost less than 50% of what it would have cost in the US where she would have paid over $26,000 just for the surgery, not counting the post-operative expenses. She went to an Austrian hospital that specialized in sports injuries and post-operative care. She is now in training to compete again and can’t stop singing praises of the hospitals in Austria. Also, I understand that India also offers medical procedures at way way below what the same procedure costs here. The U.S. does not have the best health care in the world; it has the most expensive health care in the world (no data to back that statement up, but I think that assumption is correct). Best and most expensive are not always the same thing.