Battle of the belly: US vs. UK

So the Journal of the American Medical Association just published a study comparing the health and health-spending habits of Americans versus Britons. And shockery-doodle, Americans fared worse with twice the diabetes and lung cancer, more high blood pressure and heart disease. This despite the fact that, per capita, Americans spend double the amount on health care.

Well, duh. As Britain freaks out over its blubbery National Health Service oozing money like a beached whale, I'd like to point out a few facts/blatant opinions about US health care:

1) Insurance premiums in the US do not reflect spending on actual health care. They factor in a probability costs of lawsuit protection for doctors/hospitals, which can be huge.
2) Because not everyone in the country buys into insurance schemes (as we are forced to in UK/Canada), insurance is even more expensive.
3) Lack of collective government-powered bargaining on drug prices (as they have in Canada, UK) means that treatments can easily cost twice as much. Note the attraction of Canadian internet pharmacies - it isn't just lower overhead.
4) Much of the difference in overall health can be attributed to preventable diseases related to diet, lifestyle etc. When people get to go to the doctor whenever they want and for free free free (as opposed to a $200 co-pay), they are going to be better at nabbing their high blood pressure, glucose intolerance etc, sooner. Which means it costs less money, overall, to treat. Preventative medicine saves money (and lives, but that is not the point).
5) My grandmother (who lived in New York) broker her arm washing windows (fell of a ladder) at our house in Vancouver. Her x-ray cost $75 (full price for an non-Canadian totally uninsured person). The same x-ray cost $300 at her hospital in New York when she got home. I have no idea why.

So are we surprised that Americans spend twice as much money to be half as healthy?

Comments

[Chz]

They also vaguely hint that 10 days of legislated holiday versus 28 days (not even counting the corporate culture of unpaid overtime in the States) had an effect. very vaguely, but it's there.

[Anna]

Really? Would it be fantastic if this could help Americans get more holiday? I think its a bloody crime, two weeks is barely enough to go somewhere get relaxed and then come back. Not enough for a whole year.

And with all the really cool research coming out about the long term effects of stress - aging to heart disease to you name it - I wouldn't be surprised.

[Squander Two]

The interesting thing about time off and stress and health is that the British were far healthier during the War than they are now. In fact, it was the peak of British public health. And then there's the well-documentedly excellent health of sailors in the Georgian Royal Navy, who were under insane levels of stress at all times and got no time off whatsoever. Go figure.

> Because not everyone in the country buys into insurance schemes (as we are forced to in UK/Canada), insurance is even more expensive.

That's the opposite of how economics works. When something is compulsory, it goes up in price. That's why car insurance is cheaper in South Africa (where carjackings are common) than in the UK (where car insurance is compulsory).

> When people get to go to the doctor whenever they want and for free free free (as opposed to a $200 co-pay), they are going to be better at nabbing their high blood pressure, glucose intolerance etc, sooner.

As British GPs have been telling us for years, when people get to go to the doctor for free, they take the piss: they miss appointments, they turn up when there's nothing wrong with them, etc. In short, because the money's not theirs, they throw it away. And people in Britain most certainly don't get to go to the doctor "whenever they want" -- outside office hours or over the weekend, they get to call "NHS 24" and speak to a non-doctor who tells them to take two aspirin.

Look up survival rates for any type of cancer. They're all higher in the US than the UK. As are survival rates for most other diseases, too. Americans may be unhealthier, but, once they get unhealthy, they get cured.

Interesting that you mention diabetes. In the USA, diabetics get insulin pumps, which work extremely well. The NHS thinks they're too expensive. Again, maybe there are more diabetics in the US, but they're better treated and healthier than British diabetics.

Because a tax-funded operation has no incentive to maximise returns on investments, they don't. So they run MRA machines 24 hours a day in the US, because the machines are insanely expensive and the owners want their money back ASAP. In the US, you can get an MRA pretty much immediately. In the UK, MRAs are only operated during office hours, as the convenience of the machines' operators is considered far more important than the investment in the machine, and so it takes about three months to get a scan. Which is sometimes too slow to diagnose the problem in time to save you.

The American system is far from perfect, but it's a million times better than the NHS. And Canada? The only developed nation to have a SARS outbreak? Which was spread, not contained, by a hospital? I'll give that one a miss, thanks.

Believe it or not, I'm not even starting on my own personal experiences of the NHS. I could rant for weeks about the way my family have been treated. As soon as our child's born, it's getting private health insurance. The NHS kills people.

[sara]

Yeah, I think that there are multiple factors at work beyond just the healthcare system -- I'd be interested to see where Canada falls in this study, as a nation with national healthcare but habits more in line with the US. Other articles point to the amount of exercise and eating habits as other factors that could cause the discrepancy.

I'm not sure compulsory health care means that less money is spent. How do they measure this? I have found that in Quebec the socialized healthcare has only meant more visits to the hospital since doctors will choose the cheapest form of treatment, often causing lots of misdiagnoses when corners are cut. But this evidence is anecdotal, so I'm not sure.

[MT]

Americans just value their grandmothers more than Canadians do.

[chris]

this is interesting to read from an American perspective. Especially since all the health policy people over here are touting the british model of health as the perfect model. We always here people lamenting our system and not the other way. Does anybody have any links to credible sources about the cons of the NHS? it seems the NHS is very good at hiding alot of information