Thursday, March 26, 2009

10 Surprising and positive facts about American health care

Beware of organizations with agendas when they display statistics about the US health-care system. They bend things around to find a few negative aspects in the corners that they put in the spotlight, but in displaying the dark corners they hide what's in plain sight. We get excellent health care. We pay more, but we get more. We get the new drugs and new methods. Scott W. Atlas, M.D., a senior fellow at the Hoover Institution and a professor at the Stanford University Medical Center, covers it. National Center for Policy Analysis Fact No. 1: Americans have better survival rates than Europeans for common cancers. Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher. Fact No. 2: Americans have lower cancer mortality rates than Canadians. Breast cancer mortality is 9 percent higher, prostate cancer is 184 percent higher and colon cancer mortality among men is about 10 percent higher than in the United States. Fact No. 3: Americans have better access to treatment for chronic diseases than patients in other developed countries. Some 56 percent of Americans who could benefit are taking statins, which reduce cholesterol and protect against heart disease. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons and 17 percent of Italians receive them. Fact No. 4: Americans have better access to preventive cancer screening than Canadians. Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate and colon cancer:
  • Nine of 10 middle-aged American women (89 percent) have had a mammogram, compared to less than three-fourths of Canadians (72 percent).
  • Nearly all American women (96 percent) have had a pap smear, compared to less than 90 percent of Canadians.
  • More than half of American men (54 percent) have had a PSA test, compared to less than 1 in 6 Canadians (16 percent).
  • Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with less than 1 in 20 Canadians (5 percent).
Fact No. 5: Lower income Americans are in better health than comparable Canadians. Twice as many American seniors with below-median incomes self-report "excellent" health compared to Canadian seniors (11.7 percent versus 5.8 percent). Conversely, white Canadian young adults with below-median incomes are 20 percent more likely than lower income Americans to describe their health as "fair or poor." Fact No. 6: Americans spend less time waiting for care than patients in Canada and the U.K. Canadian and British patients wait about twice as long - sometimes more than a year - to see a specialist, to have elective surgery like hip replacements or to get radiation treatment for cancer.[6] All told, 827,429 people are waiting for some type of procedure in Canada.[7] In England, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.[8] Fact No. 7: People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand and British adults say their health system needs either "fundamental change" or "complete rebuilding."[9] Fact No. 8: Americans are more satisfied with the care they receive than Canadians. When asked about their own health care instead of the "health care system," more than half of Americans (51.3 percent) are very satisfied with their health care services, compared to only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).[10] Fact No. 9: Americans have much better access to important new technologies like medical imaging than patients in Canada or the U.K. Maligned as a waste by economists and policymakers naïve to actual medical practice, an overwhelming majority of leading American physicians identified computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade. The United States has 34 CT scanners per million Americans, compared to 12 in Canada and eight in Britain. The United States has nearly 27 MRI machines per million compared to about 6 per million in Canada and Britain. Fact No. 10: Americans are responsible for the vast majority of all health care innovations. The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other single developed country.[14] Since the mid-1970s, the Nobel Prize in medicine or physiology has gone to American residents more often than recipients from all other countries combined.[15] In only five of the past 34 years did a scientist living in America not win or share in the prize. Most important recent medical innovations were developed in the United States. Conclusion: Despite serious challenges, such as escalating costs and the uninsured, the U.S. health care system compares favorably to those in other developed countries. [The original has an table about fact number 10.] Via Prof. M.J. Perry at U Michigan Flint CARPE DIEM: 10 Surprising Facts About American Health Care.

11 comments:

Anonymous said...

I suppose a few things should be pointed out:

1) Three of the 10 points refers to US cancer treatment. An area in which the US is commonly known to lead the world. That is good, but apparently it was impossible to find a full 10 areas where the US did well?

2) A reprint has recently been published. This one did not include the references included in the original (http://www.hoover.org/publications/digest/49525427.html.)
This is perhaps not surprising, as it turns out that they were from suspect sources, or did not actually have anything to do with the subject, or concludes the exact opposite of what the author claims. I am still a tad shocked that the response to critisism was just to delete the references when it was next published.
(The author interned in 1982, I personally would speculate that he was not quite onboard with the notion that when writing for the internet, his references can be googled in a minute.)

3) The report was originally produced for the NCPA. It can be found here (With the actual references):

http://www.ncpa.org/pub/ba649

The NCPA is a "classic liberalist" think tank, whose board includes representatives from health insurance and medical malpractice lawfirms. Their latest quarterly can be found here:
http://www.ncpa.org/files/activities_2qrt09.pdf

There are a number of other problems with the report that the average student should be able to spot. Such as the deliberate selection of Canada for comparisons in waiting times. Canada is known to be the only country in the first world with longer waiting times than the US.
Thus "second worst in the first world" becomes something good.

Finding the rest of the issues this report has is left as an excercise for the students. (Hint: How relevant is the authors background?)

Ron said...

Anonymous thinks its biased to mention that the US has the best cancer survival rates, because "everyone already knows that." And only 3 types are mentioned, not 10. It is a problem "for the student" to find 7 more.

And "everyone knows" that Canada has the worst waiting lines in the world. How do we know who is second? No source? No source.

Anonymous said...

It is not biased to mention that the US does well in cancer survival. And it would make a good point number one on a honest list. However, the fact that the author of the original essay needs to use several points on that indicates that he could not find a lot of other good points.

And the "rest of the issues" refers to the many glaring inaccuracies and downright falsehoods of the original essay. Such as the references that conclude the exact opposite of what the author claims, the way the author needs to compare the US to shifting individual countries without ever mentioning what the international standards are...its only about the ability to find a single country that is beatable. Etc, etc, etc.

The fact is, any study that needs to pick individual countries and stats for comparisons, rather than comparing the US to standard international performances...well, it is trying to hide something.

As for waiting lists,that the US has nearly the longest waiting lists in the world is as well known as the fact that the US has good cancer survival. A reference can be produced in 5 sec:

Lets have an essay, since that seems to be the thing at the moment:

http://www.businessweek.com/magazine/content/07_28/b4042072.htm

somaie said...
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henrylow said...
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dissertation writing services said...

I think active debate about health care reform in the United States concerns questions of a right to health care, access, fairness, efficiency, cost, choice, value, and quality

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