Universal healthcare's dirty little secrets

And the solution, of course, is to price healthcare out of the reach of the poor to prevent them from clogging up the system....

Using the countries listed as a comparison:

England has an infant mortality rate of 5, and an average life expectancy of 78.7. Canada has an infant mortality rate of 4.6 of 80.3.

These are both a tiny bit better than the US which as an infant mortality of 6.4 and an average life exptancy of 78.0.

However, the US spends $6,400 per capita on healthcare annually (this is the figure from 2006). This is about 15.3% of our GDP.

England spent $2,500 per capita on on healthcare in the same time, about 8% of its GDP.

Canada spent $3,100 per capita or 9.9% of their GDP.

The US is spending much more (more then twice as much by any measure) on health care, yet our public health is a bit worse.

Any subjective, rationale look at healthcare would lead one to believe that universal health care is a great idea.

Yep. Because faced with the hard overall, national data about mortality rates, the obvious retort would be a lengthy overview of anecdotal evidence.

Do you really think one could not easily gather together a comparable list of negative headlines about US health care, Miller? Or about health care in any country?What's it supposed to prove?

Ebrown's point is simple enough. You spend twice as large a proportion of your GDP on health care, yet on simple indicators like infant mortality and average life expectancy, you do worse.

Well, yeah. The US has a system oriented towards spending significant money on people who can afford insurance, offering them exceptional care (usually; like you say, there's anecdotes to the contrary) while people who are really poor don't get much more than emergency care. So of bloody -course- it has higher infant mortality and lower life expectancy, given that advanced medical care doesn't really have much of an effect on infant mortality and there's a limited return on investment for life expectancy.

The advantage of living in the US, assuming you make enough money to afford insurance, is that there are a lot of things that are likely to kill you elsewhere, but not here. People don't fly to Houston for our cancer center because they like the weather! You're much more likely to be able to get an MRI, a hip bone replacement when you get old, lasik for the eyes, what have you, without having to wait weeks or months.

The disadvantage is that there are people who don't get medical care until something terrible happens, and by that point you're usually in a lot of trouble.

So saying that the statistics which are supposed to be better in countries with universal health care... are better in countries with universal health care, is that the contention? Well, duh. Thanks for the blinding flash of the obvious. At the same time, though, there are a lot of things those health care systems don't do well; care to compare the statistics on those?

There are two separate issues here...

The first is a moral/philosophical question about what is the purpose of a public health care system. How do we balance the resources between the rich and the poor, and between the greater needs and the lesser needs. Should a rich person be able to $1 million non-life threatening knee surgery, while a poor person who needs a $500,000 operation on a critical, but curable ailment dies simply because they can't afford it.

Of course, this is one of those issues with many nuances and most of us fall between the two poles.

But I suspect that many of us will disagree about whether being wealthy or poor should effect your ability to get important but expensive medical treatment.

But the second issue seems more clear to me. The US system is clearly very inefficient. The costs to businesses, individuals and taxpayers are very high (and rising) where other systems get comparable results with a fraction of the cost.

Clearly having millions of people who are uninsured is stupid, since they end of costing much more to treat (and this cost for largly poor people is paid by both higher costs to employers and individuals and by taxes).

People with insurance go for checkups where diseases can be caught and treated early and cheaply. People without insurance end up in the Emergency rooms with fullblown critical diseases in advanced stages.

This simply doesn't make any sense no matter what position you take on the first question.

It's not the first item I'd like to do away with, it's the second.

Drew, it's not an a la carte menu. You get one or the other. Spreading the US system of care universally will -necessarily- mean that we're spending less on advanced care. Yes, yes, you can cut a bit of fat in the way of unnecessary tests and the like, right up until you don't test for something and someone drops dead of it two years later; which is more or less precisely what I'm talking about. Some of the fat in the system is doctors being careful with people's lives, so cut too deep and people actually die.

Even worse, unlike other Western nations that have instituted socialized care, there's nobody else to keep up the standard of care; we can't just bop over to Britain for the best care money can buy. I suppose we can always export THOSE jobs to India too...

Many individuals, who do have health insurance, don't take care of themselves and thus fail to be screened for diseases such as breast cancer and prostate cancer.

Too many women, who do have insurance, fail to recogonize the importance of yearly mammograms or the importance of breast self-examination. Yes, they pay the premiums for insurance, but they fail to do their own part by utilizing the healthcare system to screen for disease.