Which country has the best Health Care System?

[phk]

Our private-sector healthcare-spending hasn't paid off. Were well down in the charts for the industrialized world, when it comes to every measure of health comparative to the first world, life expectancy, morbidity, infant mortality.

There is no need to spend 12% of your GNP on healthcare, more than the 2nd highest-paying country if it isn't paying off.

We might be the top-dogs in research, no doubt, but we cannot evenly distribute the fruits of the research, so it goes back to ground one.

Were going to have to learn to control our run-away healthcare costs, while still being able to provide adequate healthcare for all..

Were going to be hearing from the ghost of Paul Tsongas once again.

[David S]

Your points are very good, but fail to note the cause of the problem.

Fundamentally the problems with health care delivery in the US is that it became entrenched as an employer-based program. 50 years ago when the majority of working families could expect a wage earner to stay with a single employers for their career an employer-based system provided a useful connection for the country. 40 years ago patches to the system were added because the retired and poor populations had no connection to the employers. As the 80's showed, the workforce was far more mobile than a half century before, and insurance portability was a problem resulting in higher costs to cover those at risk who changed jobs. The HMO system came into being, but it too has failed to live up its promise to hold down cost increases for employers.

There really is no basis for a connection between the employer and health care, and it hurts business as much as the healthcare consumer. Unfortunately the US population over the last three generations has come to expect a health insurance benefit. In a thread a few months ago I drew the comparison to police services, and I do believe that the  wider public now has an expectation of critical services from the health care system the same way.

I think that some of your fears about the effect of the political system on health care are justified. However, when such a large fraction of society expects the benefit, poiltical forces are going to reflect the desire of the public.

If government must be involved, I think we should utilize smaller jurisdictions. Like the police, critical health care services can be delivered at a scale far below that of the whole nation. Security uses a mix of public and private options - but at a local level. Health care could use some of that same model with critical services provided by localities (eg. county hospitals and clinics), and a wide range of other services left to consumer choice.

Muon I disagree on the cause of our healthcare woes.  I am a firm believer in competitive free market captialism. Healthcare is the portion of our economy that seems to be in crisis now and it is a part of our economy which does not operate as a competitive free market.

If I want a house I don't expect the insurance company or government to buy it for me. If I want a car I don't expect government to give me one free. If I need groceries I don't need the insurance company to buy them for me. When I want any of those things I just go buy them myself. Same is true for you and anyone else. And yet even though houses, cars and groceries are expensive we don't have a crisis in those things. Only in healthcare do we have a crisis.

As you point out people have come to expect someone else to provide their healthcare. That, in my estimation, creates a disconnect in the free market forces that would normally keep costs under control.

Insurance should be used to cover very expensive and rare occurrences which would be unmanageable otherwise. It should be used to spread out the risk as Richius said earlier. But we expect it to cover all medical expenses, from routine office visits to prescription drugs. That won't work in a free market. 

[muon2]

Your points are very good, but fail to note the cause of the problem.

Fundamentally the problems with health care delivery in the US is that it became entrenched as an employer-based program. 50 years ago when the majority of working families could expect a wage earner to stay with a single employers for their career an employer-based system provided a useful connection for the country. 40 years ago patches to the system were added because the retired and poor populations had no connection to the employers. As the 80's showed, the workforce was far more mobile than a half century before, and insurance portability was a problem resulting in higher costs to cover those at risk who changed jobs. The HMO system came into being, but it too has failed to live up its promise to hold down cost increases for employers.

There really is no basis for a connection between the employer and health care, and it hurts business as much as the healthcare consumer. Unfortunately the US population over the last three generations has come to expect a health insurance benefit. In a thread a few months ago I drew the comparison to police services, and I do believe that the  wider public now has an expectation of critical services from the health care system the same way.

I think that some of your fears about the effect of the political system on health care are justified. However, when such a large fraction of society expects the benefit, poiltical forces are going to reflect the desire of the public.

If government must be involved, I think we should utilize smaller jurisdictions. Like the police, critical health care services can be delivered at a scale far below that of the whole nation. Security uses a mix of public and private options - but at a local level. Health care could use some of that same model with critical services provided by localities (eg. county hospitals and clinics), and a wide range of other services left to consumer choice.

Muon I disagree on the cause of our healthcare woes.  I am a firm believer in competitive free market captialism. Healthcare is the portion of our economy that seems to be in crisis now and it is a part of our economy which does not operate as a competitive free market.

If I want a house I don't expect the insurance company or government to buy it for me. If I want a car I don't expect government to give me one free. If I need groceries I don't need the insurance company to buy them for me. When I want any of those things I just go buy them myself. Same is true for you and anyone else. And yet even though houses, cars and groceries are expensive we don't have a crisis in those things. Only in healthcare do we have a crisis.

As you point out people have come to expect someone else to provide their healthcare. That, in my estimation, creates a disconnect in the free market forces that would normally keep costs under control.

Insurance should be used to cover very expensive and rare occurrences which would be unmanageable otherwise. It should be used to spread out the risk as Richius said earlier. But we expect it to cover all medical expenses, from routine office visits to prescription drugs. That won't work in a free market. 

I understand your position, but it doesn't take into account the reality of our situation. The root problem is that health insurance is provided as an employment benefit for all full-time, and many part-time workers. Given as a benefit there is no pressure from the health care consumer to make the market respond with appropriate costs for health care services. It is fine to talk about going to a full free market, but you can't there from here.

I don't know that whta I'm saying any more realisic, but I think it at leats recognizes some of the real structural problems. If we can separate the unusual high-cost items due to acute or chronic illness (I'll these the critical healthcare services) from the rest of health care, I think that the market can be made to function for the non-critical items. Routine care and medicine, minor illnesses might be accepted by the public as a reasonable cost as long as the fear of catastrophic covereage is out of the picture. I think these are equivalent  to your examples of cars and groceries.

For the critical expenses, I think they are not the same as cars and groceries. They are much more like robberies and fires. We do pay for insurance to protect ourselves from these losses, but we also expect the government to provide emergency response in the form of police and fire services. And we pay taxes to support those services.

[scorpiogurl]

To the original question - 'best' is relative. My best and your best could easily be different. In terms of quality and advancement, the U.S. is the best. In terms of availability and affordability to the public, the U.S. is likely not the best.

However, I think this needs to be said - other countries around the world, socialist or not in their healthcare systems, rely on the U.S. for much of their medical advancements. Socialist countries do sometimes advance their medicine, but there is little motivation compared to the motivation of profit that is present in the U.S. system. We have quite a number of private companies working constantly to advance medicine - are they altruistic? Probably not, but they want to get the job done so they can make money. These companies also want to sell their products in other markets, so they sell to other countries, socialist or not. Unfortunately for the socialist countries, their systems sometime set price caps too low, so they don't end up getting these new products until they become cheaper(generic) which can end up costing lives.

Sometimes I wonder whether many of you have even visited the UK!!! The UK is NOT a socialist country in the accepted dogma of Marx et al. The UK is a social democracy, like most Western European countries, and has matured to this point over many many centuries. We do not have "mass state ownerships of our industries". We have a healthy regard for the social welfare of our fellow citizens.
I also think your premise that the US is the prime mover for the advancement of medicine is also somewhat misleading. Sure the US is the world's major market for healthcare products, but much R&D is done outside the USA. Companies such as Novartis, AstraZeneca, Roche, Aventis and GlaxoSmithKline are not American and yet all feature in the world's top 10 drug companies. If you want specifics of their contribution to cancer medicine then I can surely give these.

If we compare the US and UK Health Care systems........they both have advantages and disadvantages. The US system is undoubtedly excellent in terms of having the latest technology and treatments........but unfortunately the latest medicine is not available to all its citizens.......health care is based on the ability to pay!!!

The UK is somewhat less technologically advanced (although the training of the personnel is excellent), but the most sophisticated medicine the service has to offer is available to all citizens regardless of the ability to pay.

It is a difference in philosophy.......born out of different experiences. I think it is better to take what is good from both systems rather than "point score" one system over the other!!!

[scorpiogurl]

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The people of Britian are stupid, and their country is going down the toilet.  The immigration lines to the United States are full.

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Richius, do you usually use such juvenile arguments "the people of Britain are stupid".  That is offensive!!!

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[DanielX]

My opinion, nobody.

Every system i have heard of has problems. I'd say the US is the least bad, but that isn't saying much- first off, lawsuits have driven insurance costs sky-high. It also depends on what state you're in.

Canada stinks. More people die from diseases caught in-hospital in Quebec alone than all of the Northeastern US.

Plus, I think there are certain moral standards in healthcare. For example, I would take Mississippi over Oregon, even though Mississippi has atrocious care. Why? I am strongly suspicious of any assisted-suicide program - the temptation for using it as a bed-emptying procedure is too rampant.

[??????????]

Tory is just another example of a tea swirling, crumpet munching bad toothed brit.

[Math]

Dick Cheney, during the Republican Convention: "Our nation has the best care in the world".
Did it really speak about this extremely uneven system, with tens of million American without social security cover, and its inflation of the costs? In 2000 WHO classified the best systems. The United States arrives at... the 37eme row (France first). The United States are first ... only on the amount of the expenditure of health per capita (France is fourth). A statistic that Cheney could meditate: the childhood mortality is in the United States of 7 per 1000 (against 4,5 in France): not better than in Cuba!

[??????????]

So says the socialist.

[minionofmidas]

Tory is just another example of a tea swirling, crumpet munching bad toothed brit.

I hope you're trying to be offensive just for the hell of it...I hope you meant swilling...I hope you notice you're confusing classes here...Tory munches crumpets, Al has bad teeth. Both swill tea. Of course that would be theory, reality might be different.

[??????????]

Tory is just another example of a tea swirling, crumpet munching bad toothed brit.

I hope you're trying to be offensive just for the hell of it...I hope you meant swilling...I hope you notice you're confusing classes here...Tory munches crumpets, Al has bad teeth. Both swill tea. Of course that would be theory, reality might be different.

[phk]

He's a Southerner, his culture supports offensive bigotry.

[Bono]

Dick Cheney, during the Republican Convention: "Our nation has the best care in the world".
Did it really speak about this extremely uneven system, with tens of million American without social security cover, and its inflation of the costs? In 2000 WHO classified the best systems. The United States arrives at... the 37eme row (France first). The United States are first ... only on the amount of the expenditure of health per capita (France is fourth). A statistic that Cheney could meditate: the childhood mortality is in the United States of 7 per 1000 (against 4,5 in France): not better than in Cuba!

That is because helthcare is not a right, adn the US still understand that. You don't have a right to take other people's money and use it to your health. Public health care i the moral equivalent of going around mugging people on the street to pay for a surgery on you.

[David S]

He's a Southerner, his culture supports offensive bigotry.

That would make Jimmy Carter and Bill Clinton Bigots? 
Come on guys lighten up. This is a discussion forum.

[Math]

you're too individualist. I don't think that one can be happy whereas people die for lack of care.

[minionofmidas]

He's a Southerner, his culture supports offensive bigotry.

That would make Jimmy Carter and Bill Clinton Bigots? 
Come on guys lighten up. This is a discussion forum.

From what I see of Rocket, I think lightening up is not what he needs...more like taking his own posts more seriously. THat comment was obviously spoken in the same, offensive-for-the-hell-of-it spirit as States'.

[A18]

you're too individualist. I do not think that one can be happy whereas people die for lack of care.

It is individualism that makes this country great.

[Bono]

you're too individualist. I do not think that one can be happy whereas people die for lack of care.

If one would feel trully unhappy, he himself would help those people. I ask you, what virtue is there in doing good with other people's money?

[Math]

I am sorry but I cannot understand that... A great country it's a country which each one of you have built, rich and poors. Why only the rich person benefit from it ?

[scorpiogurl]

One interesting point is that there is a direct correlation between ill health and low(er) socio-economic status.

Consequently there is an argument that if you tackle the causes of much ill health (eg. poor housing, poor diet and lack of health education....say smoking) you will lower your health costs in the long run.

I know to many this will seem like a "socialist" philosophy, but I think it is an interesting debating point ie. if a government spends money on improving housing and health education etc, whether the overall burden of spending by governments on health would fall.

 

[Filuwaúrdjan]

Tory is just another example of a tea swirling, crumpet munching bad toothed brit.

I hope you're trying to be offensive just for the hell of it...I hope you meant swilling...I hope you notice you're confusing classes here...Tory munches crumpets, Al has bad teeth. Both swill tea. Of course that would be theory, reality might be different.

My teeth are fine, but I do drink a lot of tea. Strong tea. In a mug.

[A18]

If government is responsible for our health, what will stop them from banning cigarettes or alcohol, or whatever else they consider unhealthy? People need to be responsible for themselves, actions and body.

And unconditional insurance is a bad idea.

[scorpiogurl]

If government is responsible for our health, what will stop them from banning cigarettes or alcohol, or whatever else they consider unhealthy? People need to be responsible for themselves, actions and body.

And unconditional insurance is a bad idea.

I agree that people need to be responsible for themselves, but surely the government has a duty to educate? I guess it all comes down to your philosophy.
The Western European philosophy is based on social responsibility....(an individual is a member of a society and has a responsibility to that society and the society has a responisbility to the individual).
The American philosophy is individualism........the individual is supreme.
It seems to me, that the well being of the society is not the guiding principle. It is a "winner takes all" culture.

Vive la difference

[Bono]

If government is responsible for our health, what will stop them from banning cigarettes or alcohol, or whatever else they consider unhealthy? People need to be responsible for themselves, actions and body.

And unconditional insurance is a bad idea.

I agree that people need to be responsible for themselves, but surely the government has a duty to educate? I guess it all comes down to your philosophy.
The Western European philosophy is based on social responsibility....(an individual is a member of a society and has a responsibility to that society and the society has a responisbility to the individual).
The American philosophy is individualism........the individual is supreme.
It seems to me, that the well being of the society is not the guiding principle. It is a "winner takes all" culture.

Vive la difference

That is becuse they well-being of the society is impossible to measure, since the society is made of individuals, and those individuals have subjective notions of what is best for them.

[scorpiogurl]

If government is responsible for our health, what will stop them from banning cigarettes or alcohol, or whatever else they consider unhealthy? People need to be responsible for themselves, actions and body.

And unconditional insurance is a bad idea.

I agree that people need to be responsible for themselves, but surely the government has a duty to educate? I guess it all comes down to your philosophy.
The Western European philosophy is based on social responsibility....(an individual is a member of a society and has a responsibility to that society and the society has a responisbility to the individual).
The American philosophy is individualism........the individual is supreme.
It seems to me, that the well being of the society is not the guiding principle. It is a "winner takes all" culture.

Vive la difference

That is becuse they well-being of the society is impossible to measure, since the society is made of individuals, and those individuals have subjective notions of what is best for them.

Indications of the well-being of society are lowered crime rates, decreased levels of sickness, increased availability of leisure pursuits, increased time to spend with family etc. They are quality of life issues and I would agree that they are somewhat intangible.

In my opinion a more equitable society usually leads to the above.