Monday, November 18, 2013

But Americans don't have to wait for health care ... do we?

[Lovis Corinth, Self-portrait with skeleton, 1896]
The Commonwealth Fund's just-released annual report on health care in 14 developed countries shows that, once again, America spends more than anybody else on health care--50% more per capita than the next-most-expensive nation, Norway, and 182% more than the least expensive nation in this survey, Italy.

Well, yes, say some proud Americans, and we get what we pay for. We have the best health care in the world.

Maybe not. Other surveys regularly report that Americans die younger than people in other developed nations. Commonwealth reports that America leads the pack in avoidable deaths per 100,000 population: 96 in America compared with 55 (France) to 83 (U.K.) in the other nations surveyed. I was surprised to learn that America has fewer doctors per 1000 population than all the other countries except Japan.

OK, say defenders of America's health care, but people in those other countries have to wait much, much longer to see a doctor, and they wait nearly forever for elective surgery such as hip replacement.


Commonwealth surveyed wait times in eleven of the countries, and here's where America stands:
  • If you're sick and need a same-day or next-day appointment, you're more likely to get it in Australia, France, Germany, the Netherlands, New Zealand, Sweden, or the U.K.
  • If you need care after hours, you're more likely to find it in Australia, Germany, the Netherlands, New Zealand, Norway, Switzerland, or the U.K.
  • America has a lot of specialists, but you're still more likely to get a speedy appointment with one in Germany or Switzerland.
  • America is quick to schedule elective surgery, but not quite as quick as Germany and the Netherlands. France, New Zealand, Switzerland, and the United States are all a little slower than those two, but not by much.
Ethical question: If a nation has poor access to basic health care but good access to expensive specialized health care, what does that say about its priorities?

Practical question: If Germany, which spends about half of what the U.S. spends per capita on health care, can insure nearly everybody and still maintain speedier access to all forms of health care, why can't we?

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