Also, fwiw, what I’m reading (e.g. https://www.npr.org/sections/goatsandsoda/2018/01/30/5819148...) suggests that US cancer survival is better than the rest of the developed world, but not significantly so.
All derived from figures that don't account for how much more you pay in taxes for that "free or cheap" healthcare.
[1] https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...
[2] http://thehill.com/policy/finance/238735-average-us-worker-p...
Someone is paying for this in tax.
What I was referencing was the per capita or per household total cost of healthcare. The comparisons that say western countries with universal healthcare have "lower costs" generally omit the increased tax burden.
If I make $100k a year, for example, and pay ~30% in taxes, but also pay ~$15k a year for total family medical expenses, including premiums, I'm still making out better than if I pay ~60% in taxes, but get "free" healthcare.
https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...
If you include private insurance:
> As a percentage of GDP, the UK spent less on healthcare than USA, Japan, France and Germany and a similar percentage to Canada. The USA spent the most on healthcare as a percentage of GDP at 16.6%.
If you exclude private insurance the US still pays a lot, at about 8.2%
The US has by far the largest spend per capita, yet has average life expectancy.
I could take those same numbers and say, "The United States does a better job of assisting it's poorer citizens into the highest quality healthcare in the world, all while allowing all its people the complete freedom to control their own health outcomes."
For the record, I'm not a health libertarian, but I'd sure as hell take it over health authoritarianism, and the UK government proved that's what they have last week.
Yes, that's the point. The US government spends more on healthcare, but that huge spend doesn't cover the whole population.
> "The United States does a better job of assisting it's poorer citizens into the highest quality healthcare in the world,
Why does the US have such poor mortality figures if health care is so good and if everyone can access it?
> but I'd sure as hell take it over health authoritarianism, and the UK government proved that's what they have last week.
In the US cases of medical futility the doctors announce their plan to remove life support and if the parents disagree they have to go to court to stop it happening.
In the UK the doctors need to get the agreement of the parents, and if the parents don't agree the doctors have to go to court. In that court process the family can get legal aid (if they meet the financial test) - Alfie Evan's parents went through 7 legal firms, and they had expert counsel of a well respected silk and two juniors. But also Alfie had his own legal representation.
Alfie Evans had 16 months of excellent health care, followed by robust legal protection to make sure his best interests were looked after. His family are poor. He wouldn't have got anything like this in the US.
What?! How does an infant/toddler receive legal representation arguing for the plug to be pulled, outside of the wishes of his parents?! That is the very definition of authoritarianism.
> He wouldn't have got anything like this in the US.
Absolute nonsense spread by someone who has no knowledge of the American system. A child like Alfie is given free medical care from one of many charity hospitals with some of the best doctors in the world, and other charities house the family, for no cost, during treatment. You know, like the Vatican offered, and the parents accepted, but apparently you're government decided it was time for Alfie to die.
The child is not property. The child is a human, and has human rights. Those rights are protected. The child has his own independent legal representation to look after its best interests.
This system has been tested by international courts -in Europe- and they've found it works to protect the rights of the child.
> You know, like the Vatican offered,
No. The vatican offered the same end of life care he was getting, with the additional burden of a long difficult journey.
> A child like Alfie is given free medical care from one of many charity hospitals
I've already linked a page in this thread that shows this to be false.
You keep saying "government", but the UK government wasn't involved in any of the cases (apart from the EU ones).
How humane of your government to decide that a toddler must starve to death.
Also, it's far better that the hospital has to go to the courts to get permission to do this than the situation in the US: the doctors announce their plan and the parents then have to go to court to stop it happening.
So, arguing the doctors' point of view of a terminally ill child's best interests is "authoritarianism", and arguing the parents' point of view is not? OK.
Fortunately English law disagrees, and believes that children are not their parents' property. If you want to know more, start here and follow the thread: https://twitter.com/BarristerSecret/status/98919574700547686...
American religious fundamentalists, that's who: https://twitter.com/BarbaraRich_law/status/99200573272698880...
Terminal illness happens to us all eventually, you have to face that. It happens to children too sometimes, you have to face that too.
There's a huge US tax spend on a health care system that doesn't provide universal coverage and has worse outcomes across a range of measures.
Survival rates in the USA were better in the 1960s but most of the OECD now has much lower mortality rates from a diagnosis of cancer than the USA. One exception is the UK but the margin is very narrow.
What the USA is good at is over-treatment which can extend life expectancy of a cancer patient a little bit (days, weeks on average) but you could argue the quality of life is not there. This is a direct a bi-product of an extremely inefficient health system which is designed to make as much money as possible for all of the participants rather than treat patients.
As a percentage of GDP health care spending in the USA is completely out of control.
But are you really treated more humanely in Europe? Instead of a cash cow, you're a statistical number that determines where you will get placed in the queue and how long you'll wait. In the US, you at least have the potential for autonomy to pay the best doctor you can find you to treat you as soon as possible. That autonomy (or illusion thereof if you're a cynic) is a core component of the American identity. That feels more human to me.
However, I do agree spending is completely out of control. A big reason is because Americans are extremely unhealthy. Many are obese, don't exercise, and eat like shit. I think those people should be punished with large insurance premiums, instead of being treated equally to someone who proactively takes care of their health and has a higher chance of long-term survival. What's left of the insurance market does still respond to those incentives. There's some fits and starts with this in insurance (e.g. step trackers) but these are values and habits that need to be instilled in people from youth. That is an area I can see the state stepping in, and something they're better equipped to handle than a complex healthcare system.
Genetic diseases are a different case, and should be treated differently. There is a huge opportunity for prevention through genetics, but everyone raises a stink because of the "eugenics" bogeyman. This is an area where I agree with the transhumanist types in that we should really be taking a close look at our genetics and taking a scientific approach to improving them for longevity. I'd love to see a Manhattan Project for life extension.
The main problem I see with universal healthcare, besides the stupid communistic utopianism, is that it doesn't really fix the underlying problems with the incentive structure. I think we could agree that the incentive structure should revolve around proactive physical fitness and the early prediction and prevention of disease, not pills and palliative care. From my perspective, it looks like European governments are struggling and failing with their systems. They're slow to treat people and are not innovating in medicine at a high level. Yes, corporations want to extract wealth from individuals with high prices but so do government agencies with high taxes. And governments have much less incentive to innovate; they tend to ossify.
My point is, Americans have other options other than universal healthcare. I think we should not settle for the European-style socialist system because it relies on a religious holdover manifest in a secular world: that if we treat everyone equally we'll all be magically saved. Instead, Americans should draw from our founding principals of individual autonomy and manifest destiny to form a healthcare system that embodies our ideal future.
I've lived in the US and in more than one country with universal healthcare, and know quite a few people in similar situations. Some prefer living in the US, but I'm not familiar with a single person who, given a choice, would take the US model over the European model. Do you?
I wonder if "better cancer outcome in the US" is actually a result of selection bias, because the really poor people don't even get diagnosed, e.g. the money quote from [0]:
"""Danielle Scott, an employee at the store where Savastano bought the winning lottery ticket, told WABC that Savastano used the money for a visit to the doctor because he was uninsured. It was then he learned he had cancer, she said. """
[0] https://www.usatoday.com/story/news/nation/2018/02/02/lotter...
You can do that in countries with universal healthcare too.
https://blogs.scientificamerican.com/cross-check/cancer-spen... Quote: A new study shows that the U.S. spends far more than Europe on cancer care but has a higher mortality rate for lung cancer, the leading killer
https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2014.0...
Uh, something is going to kill me anyway. And the percentage difference isn't that high. I'd much rather have everyone state funded healthcare than a bit higher statistical chances for myself.
A second of care costs something on the order of $40...
Medication costs, simple drug imatinib. $28000/annum vs $1000/annum (USA vs Poland, 2000, PPP adjusted.) Control checks, thousands dollars difference and they're the exact same.
This isn't an option if you are poor