Monday, February 14, 2005

Die in Britain, Survive in the US

Click here for AmazonThe Spectator's James Bartholomew provides a UK perspective on the divergent approaches to healthcare in his country and the US. In short, while our healthcare system is an expensive mess, it delivers far superior results for all involved when constrasted with the UK's National Heathcare System (NHS).

His lengthy treatise is worth reading in its entirety. For the time-impaired, here are the highlights.

Which is better - American or British medical care? If a defender of the National Health Service wants to win the argument against a free market alternative, he declares, ‘You wouldn’t want healthcare like they have in America, would you?’

...the American system is so bad that even Americans - plenty of them anyway, if not all - want to give it up. They want something more like the Canadian system or our own National Health Service. That is what Hillary Clinton wanted and there are still plenty of people like her around.

... [How do we judge the two systems?] Let’s try the simple way first. Suppose you come down with one of the big killer illnesses like cancer. Where do you want to be - London or New York? In Lincoln, Nebraska or Lincoln, Lincolnshire? Forget the money - we will come back to that - where do you have the best chance of staying alive?

The answer is clear. If you are a woman with breast cancer in Britain, you have (or at least a few years ago you had, since all medical statistics are a few years old) a 46 per cent chance of dying from it. In America, your chances of dying are far lower - only 25 per cent. Britain has one of the worst survival rates in the advanced world and America has the best.

If you are a man and you are diagnosed as having cancer of the prostate in Britain, you are more likely to die of it than not. You have a 57 per cent chance of departing this life. But in America you are likely to live. Your chances of dying from the disease are only 19 per cent. Once again, Britain is at the bottom of the class and America at the top.

...The more one looks at the figures for survival, the more obvious it is that if you have a medical problem your chances are dramatically better in America than in Britain. That is why those who are rich enough often go to America, leaving behind even private British healthcare. One reason is wonderfully simple. In America, you are more likely to be treated. And going back a stage further, you are more likely to get the diagnostic tests which lead to treatment...

...[Diagnostic tests] are underperformed in Britain: first, because there is a shortage of equipment and second, because the equipment is underused. Britain has half the CT scanners per million of population that America has (6.5 compared with 13.6). It also has half the MRI scanners (3.9 per million of population versus 8.1). In Britain these machines are generally used during business hours only, regardless of the fact that some are extremely expensive. At the Mayo Clinic in America, by contrast, an MRI scanner is in use around the clock.

...In Britain 36 per cent of patients have to wait more than four months for non-emergency surgery. In the US a mere 5 per cent do...

...The [Americans] who face major problems [with the system] are somewhere between middle-income and poor. They are the ones who are not earning enough to take out an insurance policy, or not one with a high limit on medical expenditure. So if they come down with an illness which requires a long - and therefore ruinously expensive - stay in hospital, their insurance may run out and they may have to sell their homes or even go bankrupt. Those who are temporarily unemployed, between jobs, are similarly vulnerable.

The numbers are not large in relation to the whole population. We are talking about a minority of the American population - figures of 35-45 million are mentioned - which is not insured and which is not covered by Medicare or Medicaid. Of that minority only a small proportion will need fairly long-term hospital treatment. But financial disaster can happen and sometimes does. People lose their homes, their savings, everything. Half the bankruptcies in America are people who had previously been ill. In Britain the system might kill you. In America the system will keep you alive but might bankrupt you.

...the curious thing is that the new, improved, simple state system of Britain does not work as well as the American muddle. You have a better chance of living to see another day in the American mishmash non-system... than in the British system where the state does everything. It is not that America is good at running healthcare. It is just that British state-run healthcare is so amazingly, achingly, miserably and mortally incompetent.

A monolithic government bureacracy bloated and inefficient? Who'da thunk it?

Spectator: Die in Britain, Survive in the U.S.

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