One of the President’s core assertions, oft repeated, about health care is that the status quo is unacceptable. He regularly assails opponents of his (nebulous) plan for lacking one of their own, coming very near to that fine old line of reasoning:
Something must be done!
This is something.
Therefore. . . .
Fred Barnes has penned an excellent column assembling the case for the health care system we have now. It’s worth pondering before we rush to make massive fixes to something that isn’t all that badly broken.
One major reason for satisfaction is that American medicine has been astoundingly successful in lessening mortality from the two most feared killers, cancer and heart disease.
Two major studies (EUROCARE-4 and a study by the National Center for Epidemiology, Health Surveillance, and Promotion, in Rome, both published in the September 2007 issue of Lancet Oncology) [compared] five-year survival rates for Americans and Europeans diagnosed with cancer.
For all cancers, 66.3 percent of American men and 63.9 percent of women survived [for five at least five years]. In Europe, 47.3 percent of men and 55.8 percent of women survived five years. Those are statistically important gaps.
And the survival rates were higher in the United States for the most common cancers as well. More than 99 percent of men with prostate cancer had survived in the United States after five years, 77.5 percent in Europe. Those with colon or rectal cancer survived at a 65.5 percent rate here and 56.2 percent in Europe. The rates for breast cancer showed a similar difference, 90.1 percent for Americans, 79 percent for Europeans.
The U.S. does more than other countries to prevent heart disease. Barnes quotes Dr. Scott Atlas, chief of neuroradiology at Stanford University Medical School:
“Some 56 percent of Americans who could benefit from statindrugs . . . are taking them,” Dr. Atlas wrote. “Bycomparison . . . 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.”
When Americans do suffer heart attacks, their prospects for survival have improved vastly compared to just a few years ago.
“Wildly successful” is the way David Brown of the Washington Post has characterized the transformation of heart treatment. “Today, someone having a heart attack who gets to a hospital in time is likely to get cardiac catheterization, angioplasty, the placement of a medicated stent, therapy with four anticoagulant drugs and, on discharge, a handful of lifetime prescriptions,” he wrote. These are innovations over the past half-century.
The results are in. “In the 1960s, the chance of dying in the days immediately after a heart attack was 30 to 40 percent,” Brown wrote. “In 1975, it was 27 percent. In 1984, it was 19 percent. In 1994, it was about 10 percent. Today, it’s about 6 percent.”
These results are matched by the success in dealing with all heart disease. “In 1970, the death rate from coronary heart disease was 448 per 100,000 people,” according to Brown. “In 1980, it was 345. In 1990, it was 250. In 2000, it was 187. In 2006, it was 135.”
In other, less life-and-death areas, the United States leads the world by a large margin. For example,
The two most significant innovations for patient care in the past decade are magnetic resonance imaging (MRI) and computerized tomography(CT) . . . . The United States has 27 MRI machines per million Americans. Canada and Britain have 6 per million. The United States has 34 CT scanners per million. Canada has 12 per million, Britain 8.
Surprisingly (at least if one has listened only to lamentations about excessive costs), Americans pay less directly for this care than people in other countries.
Out-of-pocket expenses by American patients amounted to 12.6 percent of total national health spending ($2.24 trillion) in 2007.
That’s one of the lowest percentages of private out-of-pocket spending among the world's advanced countries – lower than Germany, Japan, Canada, and most countries in Europe, including those with government-run health care systems. Why do Americans get more and pay less? Because their insurance policies provide broader coverage than most government plans, says Tom Miller of the American Enterprise Institute.
That breadth of coverage is, in fact, a major cause of one of our system’s perceived problems: “[B]reakthroughs and discoveries are enormously expensive, so much so that America spends far more on health care (now 17 percent of GDP) than any other country.”
That statistic is, however, the aggregate product of individual decisions. Someone who wants to minimize his own personal medical expenditures can do so by purchasing only catastrophic coverage, forgoing tests and treatments that are not strictly necessary to deal with current health problems, and accepting the risk of a shorter life span. Is it, for instance, cost-effective to take statins in order to reduce a one-in-five chance of developing heart disease during the next ten years to a one-in-ten chance? The figures quoted above indicate that Americans making their own choices think so, while central medical planners in other countries are more skeptical. Ultimately, the debate about health care reform is a debate about who should decide.
Overall, the status quo gives Americans high quality medical care, for which they pay a great deal, albeit through insurance company conduits. It isn’t the only possible trade-off, but many worse ones are imaginable.
Eighty-nine percent of Americans in a June 2008 ABC News/USA Today/Kaiser Family Foundation survey said they were satisfied with their health care. Put another way, more than 270 million Americans (I’m including kids) are reasonably happy with the system of medical care in this country. Other polls have found the same level of satisfaction.
President Obama and other liberals are sure that their countrymen are the victims of false consciousness and that only massive government intrusion can remedy the status quo’s intolerable defects. Maybe the difficulties that they’re facing in selling hope-and-change are evidence that their certainties are at fault.
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