I'm basing my comments on our health care system on several different things. There are mountains of peer reviewed research studies that have looked HC around the world and done analysis to compare what we experience in the US. Kaiser Foundation, Robert Wood Johnson Foundation, the National Institute of Health and the WHO, to name a few. I've also followed several different Health System researchers over the last 18-24 months, including Jonathon Gruber who got his BS in Economics from MIT and a PhD. from Harvard, also in economics. Gruber has been a "go to guy" for both Republicans and Democrats. He helped with Mitt Romney's universal coverage efforts in MASS., as well as Pr. Obama's efforts this year. Also, Dr. Aaron Carroll, who in addition to being a practicing pediatrician and professor at Indiana University, is the director of the Center for Health Policy and Professionalism Research. A former Robert Wood Johnson Clinical Scholar. Plus I've read misc. publications from the Rand Corporation, TR Reid's "The Healing of America" and many other papers, studies, etc.

I've never worked in a Hospital, but I have a college education and have invested a lot of time to educate myself on this subject. I don't list the above to impress anyone, but I am prepared to provide links to research and studies if anyone wants them. These aren't my conclusions, they are the conclusions of many industry professionals who job it is to study health care economics and support their claims via data.

Now that that's out of the way, let me make my case.

Three basic components HC economists use to evaluate HC. Access, quality and cost. Our system costs about two to three times per person what most other countries pay. Our outcomes are not as good when compared to other industrialized Countries. We still don't have universal coverage for our citizens. We're not just bad on one of these metrics, not even just two. We perform poorly on all three when compared to the ten richest, industrialized countries in the world. They pay way less, (even in taxes), cover everybody and usually beat us in quality. Our costs alone are unsustainable, so something has to be done...and sooner rather than later.

The US spends 2-3 times more per person than any Country in the world for HC. And we're not getting the best in quality outcomes for the extra money. If we look at it as a % of GDP, we're also in bad shape. We also pay more in public monies (taxes) than any other industrialized country over the last ten years. So, no, they're NOT paying higher taxes than us. But, they get everyone covered, unlike the US.

http://mdcarroll.com/2010/01/20/some-slides-on-costs/

Speaking of quality...

We do poorly not just in infant mortality, but also maternal mortality. And % of immunized for dtp, and life expectancy at birth and preventable years years of life lost, cancer, respiratory illness, Heart attacks, etc.

Now perhaps there's an excuse why the measurements are wrong in "every" one of the above metric or maybe our system isn't that good. Certainly not for the price we pay.

http://mdcarroll.com/2010/01/20/some-slides-on-costs/

Actual OECD research: http://www.oecd.org/document/16/0,3343,en_2649_34631_2085200_1_1_1_37407,00.html

While Gary has relatives who have come to the US for treatment, I'll refer to a peer reviewed study, published in Health Affairs:
http://content.healthaffairs.org/cgi/content/full/21/3/19#R8

In summary, first, they surveyed US border facilities in Michigan, New York, and Washington. It makes sense that Canadians crossing the border for care would favor sites close by, right? It turns out that about 80% of such facilities saw fewer than one Canadian per month. About 40% saw none in the prior year. And when looking at the reasons for visits, more than 80% were emergencies or urgent visits (ie tourists who had to go to the ER). Only about 19% of those already few visits were for elective purposes.

Next, they surveyed “America’s Best Hospitals”, because if Canadians were going to travel for care, they would be more likely to go to the most well-known and highest quality facilities, right? Only one of the surveyed hospitals saw more than 60 Canadians in one year. And, again, that included both emergencies and elective care.

Finally, they examined data from the 18,000 Canadians who participated in the National Population Health Survey. In the previous year, only 90 of those 18,000 Canadians had received care in the United States; only 20 of them had done so electively.

So there you go. Three different methodologies, all with a solid rationale behind them, all showing that the meme is a myth. (Summary by Dr. Carroll)

I'm glad Gary spoke about the value of the research. I'm not getting this info from NBC or some left wing group of crazies. It comes from the studies and research I've cited. It comes from dozens of other works I haven't mentioned. Now, if someone can tear apart each of those citations I provided, that would be something. All this peer reviewed, tested research can't all be left wing propaganda, can it? All of it? not a chance...

We're so screwed up in the Country, we can't even add a simple, straightforward provision into the HC Reform Bill that allows end of life counseling sessions to be reimbursed. Paying for a patients own physician to discuss with them their treatment and care options. The kind of stuff you'd find in a living will. Its not about a "death panel." So, while Gary will warn you about the junk from the Left, I'll make the same warning for the Right. Both sides exploit citizens to gain political ground. Its shameful on all accounts.

Anyway, that's a little bit of why I feel the research supports my earlier claim. The US has the greatest everything, except for delivery systems. Now, if you have money or good insurance, you're all set. But if you don't, good luck.

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Bill in Dayton


[This message has been edited by Bill in Dayton (edited 05-22-2010).]