This capita spent less than $20 actual on healthcare last year.
Cool story bro.
Agreed.
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In what ways are our results worse? Be specific.
Or any of the other myriad of stories.
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Germany has had some form of universal healthcare for over 100 years.
It can work, and it also needs to adjust with population changes over long periods.
This needed a re-post.
Address these issues, we can afford universal healthcare.
it would take significant investment to get it going, but we spend nearly a trillion on the Defense…cut that budget in half.
True,
And those people live at or just above poverty levels.
How about we ensure people get paid a livable wage, where they can afford to pay taxes?
The “free market” is a complete failure regarding income levels.
Strong and abundant labor unions would greatly help with that.
Countries that have universal health care, are generally 70%+ union.
Or, we can just keep hoping corporations will give up their huge profits, and excessive pay for upper management, and share it their workers.
You want specifics? Comin at you hot…
Let’s first look at wait times and various barriers of care
Here is how long people waited to get an appointment to see a doctor or nurse when they needed medical attention:
| Country | Did not need to make an appointment to see doctor or nurse (%) | On the same day (%) | The next day (%) | In 2 to 5 days (%) | In 6 to 7 days (%) | In 8 to 14 days (%) | After more than 2 weeks (%) | Never able to get an appointment (%) |
|---|---|---|---|---|---|---|---|---|
| Australia | 7.1 | 40.7 | 21.1 | 20.9 | 4.5 | 1.6 | 1.3 | 0.1 |
| Canada | 8.5 | 27.3 | 11.9 | 21.7 | 7.7 | 6.1 | 10.4 | 2.8 |
| France | 0.2 | 22.7 | 32.8 | 26.1 | 12.8 | 4.2 | 1.2 | 0.1 |
| Germany | 0.1 | 24.5 | 28.3 | 20.2 | 7.8 | 11.9 | 7.3 | 0.0 |
| Netherlands | 6.6 | 47.5 | 24.5 | 12.7 | 1.3 | 1.2 | 1.0 | 1.7 |
| New Zealand | 3.7 | 47.8 | 25.3 | 17.6 | 1.8 | 1.2 | 0.7 | 0.2 |
| Norway | 4.8 | 29.2 | 12.2 | 23.0 | 9.7 | 7.4 | 7.2 | 0.0 |
| Sweden | 8.5 | 31.6 | 12.9 | 15.4 | 9.0 | 5.0 | 7.4 | 1.2 |
| Switzerland | 6.7 | 28.0 | 25.0 | 30.8 | 3.7 | 2.7 | 2.2 | 0.5 |
| U.K. | 3.5 | 39.7 | 15.4 | 22.7 | 5.5 | 4.2 | 4.8 | 2.1 |
| U.S. | 9.1 | 31.6 | 15.2 | 20.1 | 5.5 | 3.5 | 7.0 | 2.4 |
As you can see, when it comes to no appointment required or the same day, Australia, Netherlands, New Zealand, Sweden and the UK all perform better. When you include the next day, Switzerland, Norway and France also perform similarly or better. Basically, the US is in the middle of the pack. We pay double the rest of these countries to achieve median wait time for seeing a doctor.
Now, let’s look at the ease of getting medical care in the evenings, on weekends or holidays.
| Country | Very easy (%) | Somewhat easy (%) | Somewhat difficult (%) | Very difficult (%) | Never needed care in the evenings, on weekends or on holidays (%) | Not sure (%) |
|---|---|---|---|---|---|---|
| Australia | 14.8 | 26.5 | 23.5 | 12.9 | 16.4 | 5.8 |
| Canada | 8.5 | 21.4 | 23.5 | 31.8 | 11.7 | 2.8 |
| France | 2.7 | 30.7 | 44.4 | 16.2 | 5.2 | 0.9 |
| Germany | 6.8 | 29.3 | 27.9 | 35.0 | 1.0 | 0.1 |
| Netherlands | 19.0 | 31.7 | 13.4 | 4.2 | 29.3 | 1.9 |
| New Zealand | 18.1 | 25.1 | 24.8 | 11.1 | 18.2 | 2.8 |
| Norway | 13.0 | 24.7 | 18.9 | 11.9 | 22.4 | 9.1 |
| Sweden | 3.7 | 12.4 | 18.8 | 25.0 | 31.9 | 8.2 |
| Switzerland | 6.3 | 21.4 | 25.0 | 14.5 | 32.5 | 0.3 |
| U.K. | 14.0 | 17.6 | 19.1 | 17.2 | 26.8 | 5.3 |
| U.S. | 14.3 | 23.0 | 22.1 | 23.3 | 11.1 | 5.9 |
Once again, we see that the US is in the middle of the pack of those who say it’s somewhat or very easy to get medicare care on evenings, weekends or holidays.
Next, let’s look at how long people waited in the emergency room:
| Country | Never treated/left without being treated (%) | <1 hour (%) | 1 hour to <4 hours (%) | 4 or more hours (%) | Not sure/decline to answer (%) |
|---|---|---|---|---|---|
| Australia | 0.4 | 54.4 | 32.7 | 9.8 | 2.7 |
| Canada | 1.1 | 34.9 | 33.6 | 29.5 | 0.9 |
| France | 0.0 | 58.2 | 40.3 | 1.5 | 0.0 |
| Germany | 0.0 | 42.5 | 53.7 | 3.3 | 0.5 |
| Netherlands | 1.8 | 64.9 | 27.8 | 4.0 | 1.5 |
| New Zealand | 0.7 | 58.8 | 30.4 | 9.7 | 0.4 |
| Norway | 0.6 | 48.8 | 33.7 | 13.0 | 3.9 |
| Sweden | 1.8 | 46.1 | 29.3 | 20.0 | 2.8 |
| Switzerland | 0.6 | 57.0 | 29.1 | 7.4 | 5.9 |
| U.K. | 0.5 | 47.9 | 40.6 | 7.9 | 3.1 |
| U.S. | 0.5 | 55.2 | 32.4 | 11.2 | 0.8 |
Once again, we’re the median. I’m really starting to sense a pattern here.
Now, let’s look at how long—after being advised that surgery was needed—people waited for non-emergency or elective surgery:
| Country | <1 month (%) | 1 to <4 months (%) | 4 or more months (%) | Not sure/decline to answer (%) |
|---|---|---|---|---|
| Australia | 56.8 | 28.3 | 8.4 | 6.6 |
| Canada | 34.8 | 44.0 | 18.2 | 3.0 |
| France | 51.4 | 47.0 | 1.6 | 0.0 |
| Germany | 39.0 | 58.1 | 0.0 | 2.9 |
| Netherlands | 48.9 | 39.8 | 4.5 | 6.9 |
| New Zealand | 43.3 | 38.6 | 14.9 | 3.2 |
| Norway | 37.0 | 41.9 | 15.3 | 5.8 |
| Sweden | 37.3 | 46.8 | 11.8 | 4.1 |
| Switzerland | 59.3 | 32.8 | 6.5 | 1.5 |
| U.K. | 43.4 | 31.8 | 12.0 | 12.8 |
| U.S. | 61.0 | 31.7 | 3.6 | 3.7 |
The US leads the pack for waiting less than a month, although Switzerland and Australia are right on our heels. When looking at four months or less, France and Germany edge out the US with Switzerland, Netherlands and Australia following closely.
Next, we’re going to look at how long it takes to get an appointment with a specialist:
| Country | <4 weeks (%) | At least 4 weeks (%) | Don’t know/decline to answer (%) |
|---|---|---|---|
| Australia | 54.7 | 39.3 | 6.1 |
| Canada | 38.0 | 58.5 | 3.5 |
| France | 60.2 | 39.8 | 0.0 |
| Germany | 71.2 | 27.4 | 1.4 |
| Netherlands | 64.0 | 28.9 | 7.1 |
| New Zealand | 49.3 | 47.3 | 3.3 |
| Norway | 36.9 | 55.5 | 7.7 |
| Sweden | 48.1 | 44.7 | 7.2 |
| Switzerland | 73.2 | 25.9 | 0.9 |
| U.K. | 48.6 | 42.5 | 8.9 |
| U.S. | 69.9 | 25.3 | 4.8 |
Switzerland performs the best, with Germany coming in 2nd and the US in third. Netherlands and France aren’t too far behind, either.
So, as we can see, it’s not true that the US has the best results when it comes to wait times. Additionally, we can’t just look at wait times to measure how readily care is available. We also have to look at accessibility in terms of cost barriers and how that affects people’s decisions to seek care. Here’s how people answered when asked if in the last 12 months, they needed to seek medical care but didn’t because of the cost:
| Country | Yes (%) | No (%) | Not applicable (%) | Not sure (%) | Decline to answer/blank (%) |
|---|---|---|---|---|---|
| Australia | 8.6 | 88.8 | 2.4 | 0.2 | 0.0 |
| Canada | 6.3 | 92.7 | 0.8 | 0.1 | 0.1 |
| France | 8.6 | 89.9 | 1.2 | 0.2 | 0.1 |
| Germany | 2.8 | 96.8 | 0.3 | 0.2 | 0.0 |
| Netherlands | 3.3 | 93.1 | 3.5 | 0.1 | 0.0 |
| New Zealand | 14.2 | 85.3 | 0.5 | 0.0 | 0.0 |
| Norway | 5.3 | 92.6 | 1.0 | 0.5 | 0.7 |
| Sweden | 3.3 | 88.7 | 7.8 | 0.2 | 0.0 |
| Switzerland | 16.2 | 66.3 | 17.4 | 0.1 | 0.0 |
| U.K. | 3.7 | 93.5 | 2.6 | 0.1 | 0.1 |
| U.S. | 21.5 | 77.1 | 0.7 | 0.5 | 0.1 |
Holy crap. Over 21% of Americans who had a medical problem in the past 12 months did not visit a doctor because of the cost. This is over THREE TIMES the median. We don’t even have the best wait times, but who the hell cares about wait times when you don’t even bother to get care because it’ll cost too much? This is absolutely damning. But it’s not just visiting a doctor. Here’s the results for people who didn’t get a medical test, treatment or follow-up that was recommended by a doctor because of the cost:
| Country | Yes (%) | No (%) | Not applicable (%) | Not sure (%) | Decline to answer/blank (%) |
|---|---|---|---|---|---|
| Australia | 7.4 | 89.4 | 3.0 | 0.2 | 0.0 |
| Canada | 5.7 | 92.7 | 1.3 | 0.2 | 0.1 |
| France | 12.5 | 86.0 | 1.2 | 0.2 | 0.1 |
| Germany | 4.7 | 95.0 | 0.3 | 0.0 | 0.0 |
| Netherlands | 3.6 | 91.2 | 5.0 | 0.2 | 0.0 |
| New Zealand | 9.7 | 89.8 | 0.5 | 0.0 | 0.0 |
| Norway | 3.8 | 94.4 | 1.6 | 0.1 | 0.2 |
| Sweden | 3.0 | 88.0 | 8.7 | 0.3 | 0.0 |
| Switzerland | 9.9 | 68.8 | 21.2 | 0.0 | 0.2 |
| U.K. | 2.7 | 94.4 | 2.5 | 0.3 | 0.1 |
| U.S. | 19.2 | 79.3 | 1.2 | 0.2 | 0.0 |
Once again, we are the worst performing country and this time we’re almost four times worse than the median. It doesn’t stop there. Of those who didn’t fill a prescription or had to skip doses of their medicine due to cost, the US is the worst at 17.7% compared to a median of 5.7%. Of those who skipped dental care or checkups because of the cost, the US is the worst at 32.5% compared to the median of 20.9%. The only other country where more people said they had serious problems paying their medical bills was France, coming in at 23% compared to the US’s 19.5% (of the people who could actually get care in the first place) and the median of 6.4%. Only 1.4% of people in the UK said they had serious problems paying their bills.
When it comes to the quality of care, we have one of the highest infant mortality rates, lowest life expectancies at age 60, and highest mortality rates amenable to health care. We literally have the worst maternal mortality rate in the developed world. While the maternal mortality rate is decreasing in all over developed nations, we are unique in that ours is on the rise. Our mothers are dying at a rate almost five times greater than the median of other developed nations. Our system is failing them.
One area I thought we’d be better is one that hits pretty close to home—cancer. One of my brothers first battled non-Hodgkins lymphoma when he was 19 and then again when he was 23. My dad was diagnosed with prostate cancer at the end of 2010. Despite my initial instincts, the United States does not lead the pack in terms of cancer survival rates. As I dug into the data, I came to realize that even in this area we lag behind other nations. The gold standard when it comes to research on cancer survival rates is the CONCORD Programme. It is endorsed by over 40 national and international agencies and its studies have spanned multiple decades. The latest study is the CONCORD-3 that covered 5-year survival rates over 18 cancer and cancer groups (what they call “index cancers”) that represent over 75% of all worldwide cancer cases from 2000-2014. This study covers almost 40 million patients across 71 countries. I did a deep dive into the data from this study and the findings were not what I expected.
Before I delved into the CONCORD-3 data, I thought it was going to just reinforce my preconceived notions—the United States was indisputably the best when it came to cancer survival outcomes. However, when looking at the outcomes, this was sadly not the truth despite us paying over twice as much per capita as other developed nations. I narrowed my analysis to OECD countries and when looking at the rankings for all 18 index cancers, we average 9th place. The only two cancers where we rank #1 are breast cancer and prostate cancer. Even then, at 90.2%, our net 5-year survival rate for breast cancer is only 0.7 percentage points above Australia’s 89.5%. Our prostate cancer survival rate of 97.4% is only 1.8 percentage points above Israel’s 95.6%. The next 10 countries after the US average a 5-year survival rate for prostate cancer of 93.5%.
Furthermore, we are only ranked in the top 5 for 6 of the 18 index cancers. Out of all childhood cancers, we rank 13th. When weighted by the prevalence of the index cancers, we have an overall net 5-year survival rate of 61.2%. This puts us in fourth place behind Japan, Israel and Australia. Canada—a country that conservatives love to use as a whipping boy when it comes to cherry-picked wait time stats—is less than 1 percentage point behind us. These other four countries achieve these results with a per capita spending of $4,717, $2,833, $4,543, and $4,826 respectively. Again, we spend over $10,700 per capita. According to so many outcome metrics, we are not even close to being the best.
Following up on that disparity, perhaps the biggest counter-argument to other countries providing worse care is the fact that about 8.8% of our population doesn’t have health care coverage. This simply can’t be ignored. You can’t get much worse in terms of quality of care than that of no care. That plays a significant role in affecting health care outcomes because when someone doesn’t have health care coverage, they are less inclined to seek out preventative measures or treatment when symptoms aren’t as severe. This results in seeking emergency care once symptoms are much worse which in turn develops into higher mortality and higher costs. Depending on the study, the number of people that are uninsured results in an increase of between 20,000 and 40,000 extra deaths each year. Ultimately, we’re paying more than twice, and sometimes three times, as much as other developed nations and our outcomes simply don’t justify that cost.
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Wow! It will be very interesting what sort of replies you get from conservatives. Will they attempt to refute with any data?
I recall being surprised myself when I did similar research on cancer outcomes. Very much a mixed bag on which cancers we did better andcdhuch we did worse for survival rates.
It’s because we have a lot of non-whites in our country or something…
Way to being facts to a hyperbole fight.
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Pick a state with a high population and try it there first. See how it works out. California comes to mind.
Yeah, typical response from conservatives. No explanation of that logic.
I can pick a number of countries with populations similar or greater than California where it works: France, UK, Germany, Japan and Canada.
Actually by results I was trying to get at more the quality of care and outcomes. In other words comparing two people getting a knee replacement, one in the US vs someone in Canada or Denmark for example. Something like wait times is function of the quantity of healthcare providers in a given location to the number of people, which I’m sure varies throughout communities in all countries. Also by no means was debating how the US compares regarding costs. I’ve seen firsthand how the whole cost structure is abused. I had a child in the hospital for example and literally had their blood pressure checked about 5 times a day for no reason other than to bill the insurance company for all these tests.
The better example regarding that argument would involve a discussion on China and how they supply healthcare for a population of 1.3 billion people.
Then there should be no problem. My point was to do this to determine how much it costs in taxes. Can you use those four countries you’ve mentioned to determine tax rates in California? If not then bringing them up is pointless. My suggestion was to determine how much it costs here in the US, not those 4 countries.
One would need to also take into account the pay scales of the workers in each country.
less people = less tax money shocking I know.
you can easily fix this by doing the America method of importing new tax payers.
