Tuesday, July 21, 2009

Is national health care hazardous to your health?

Various websites and e-mails are reporting that cancer survival rates are much higher in the U.S. than in various European countries. Some quote Mark Tapscott in the Washington Examiner, who quotes Jim Hoft in the American Issue Project, who quotes Michael D. Tanner of the Cato Institute, who quotes ... well, quite a group of conservative pundits and politicians are involved. They appear to be using the same set of statistics to argue that national health care results in dramatically increased mortality rates from breast, prostate, and other cancers.

To check the facts, I went to the World Health Organization and made myself a chart. Using the most recent statistics available, I compared the health outcomes of six Western nations. No nation's health-care program is totally private, and no program is totally nationalized. Government funds pay for a percentage of health-care expenses in all six countries: the United States (45.8%), Germany (76.6%), Italy (77.1%), France (79.7%), the Netherlands (81.8%), and the United Kingdom (87.4%).

Do mortality rates increase with a higher percentage of government funding? Here's what I found:
  • The United States ties with Italy for the lowest cancer mortality rate of all six countries. Interestingly, the U.S. and Italy also have the lowest smoking rates. The Netherlands and the U.K. have the highest smoking rates and also the highest death rates from cancer. The cancer mortality rate in the Netherlands is 15% higher than that of the United States and Italy.
  • However, cancer accounts for fewer than a quarter of all deaths in the United States. Heart disease is an even bigger killer, and statistics on cardiovascular mortality are not so good in America. Of the six countries, the U.S. has the second highest mortality rate, with 59% more heart-related deaths than France.
  • The U.S. also has the second highest death rate from injuries. American mortality in this category is more than 100% higher than that of the Netherlands.
  • In the largest category, non-communicable diseases, the United States has the highest mortality rate of all six countries, with 25% more deaths than France.
  • The adult mortality rate--that is, the probability of dying between the ages of 15 and 60--is highest in the United States. The next runner-up, France, is 20% lower, and Italy is 70% lower.
Personally, I don't want to die from cancer. I don't want to die from heart disease or other non-communicable diseases either, and I'd rather not be smashed to death in an accident. In fact, I'd just as soon stay healthy as long as possible, so I'd be very happy if the United States had the best health care in the world. Alas, we have a long way to go.

Of the six countries I compared, the United States is at the bottom in terms of healthy life expectancy: 69 years here compared to 71 in the Netherlands and the U.K., 72 in France and Germany, and 73 in Italy.

The U.S. is also at the bottom in terms of total life expectancy: 78 years here compared to 79 in the U.K., 80 in Germany and the Netherlands, and 81 in France and Italy.

Please, when you get an e-mail or see a web page giving statistics to argue that the United States already has excellent health care and doesn't need to revamp the system, stop and ponder. We currently spend roughly twice as much per capita on health care (counting both public and private sources) as these European countries.

What lots of Americans don't realize is this: the U.S. government already spends more per capita on health care than do the governments of these other countries--over 50% more than the Italian government spends, for example. And yet the Italians manage cancer just as well as we do, and their health-care outcomes are better than ours in every other category.


Jay Cunningham said...


In the interest of fair fact-checking you might read this article from the AP:


Jay C :)

LaVonne Neff said...

Thanks for the article, Jay. For the most part, it was dealing with different topics from the ones I cover above, but we both noted that the U.S. government is already paying for a lot of health care. I appreciate Obama's wish to cut out waste. I fear that Congress never met waste it didn't like. And we have whole industries that live on unnecessary spending. It will be interesting to see how it plays out. It can't keep on the way it's going...

Jay Cunningham said...

Agreed. There is so much temptation to overspend when the dollars in hand belong other people. The same principle applies when a group of people go to dinner and decide to split the check - some will order more expensive dishes knowing that their cost will be less overall since so many are paying for their overindulgence. And those who choose modestly are forced to overpay. I just wish that Congress would spend more time in their districts with real people who are suffering at the hands of their policies. They are so entirely out of touch with anybody living west of the Potomac.

Andrew said...

I came to here from sojourners.net (through the more recent vegetarian post). I am curious to know what you think of the NHS, in the light of much recent US criticism of it. (Needless to say, everyone here is quite proud of it, all the more so now we feel somewhat under attack!).

The reason I ask is that the tone of your comments is suggestive and yet you don't appear - unless I've missed it - to come out and endorse a national health, um, service.

LaVonne Neff said...

Andrew, I think a single-payer health service like the NHS would be a great boon for the US--if we ran it well (and we might not). I suspect it would be easier to persuade most Americans of the advantages of a not-for-profit yet competitive private insurance funding scheme like Germany's, but it doesn't look like we'll get that, either. Until we change our mentality from frontier individualism to concern for the common good, I am not sure we'll be able to make any health-care system work.