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The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

U.S. Health Care: Poor Grades from Consumers

One of the standard features of most debates about health care reform is the comparison of our system with that of other industrialized nations. Usually the evidence presented is anecdotal, but sometimes statistics having to do with mortality rates, expense etc. are trotted out. Rick Newman of U.S. News & World Report has an angle on international health care systems comparisons that merits some consideration, as he reports (flagged by TomPaine.com) on a health care consumer satisfaction study in six nations, including the U.S.:

The Deloitte Center for Health Solutions surveyed 14,000 people in six countries, asking them to grade their own healthcare system from A to F. The standardized results allow comparisons among all six countries…Here’s how all six countries fared. The survey data are from Deloitte. Also included are cost data from the OECD, to give a sense of who’s getting the most satisfaction per healthcare dollar:
Canada: Percent rating the healthcare system A or B: 46 percent; D or F: 15 percent; annual healthcare spending per person: $3,895
France: A or B: 63 percent; D or F: 12 percent; spending: $3,601
Germany: A or B: 18 percent; D or F: 44 percent; spending: $3,588
Switzerland: A or B: 66 percent; D or F: 14 percent; spending: $4,417
United Kingdom: A or B: 32 percent; D or F: 20 percent; spending: $2,992
United States: A or B: 22 percent; D or F: 38 percent; spending: $7,290

As Newman notes, Germany is the real shocker here. He doesn’t explain why. But, clearly the U.S. is the worst bargain of the lot when cost is factored in. So much for the “greatest health care system in the world” meme. As Newman concludes:

…Deloitte’s survey data show that socialized medicine in Canada and Britain is more popular than the quasi-capitalist healthcare system in America—which costs far more. Brits and Canadians may be more satisfied partly because they have a higher tolerance for government bureaucracy than Americans do. But the findings also undercut claims that the British and Canadian systems don’t work.

Newman doesn’t report on the reasons behind the satisfaction stats. But a couple of the reader comments responding to his article are instructive. Here’s Jim Atherley’s explanation:

I’m a Canadian currently living in the US. I’ve spent 22 years in Canada and 27 in the US, so I have plenty of experience with both systems. Having said that, I can assure you that the Canadian system is far superior. The US system is an expensive nightmare by comparison.
In the US, I have lower taxes but I’m forced to deal with outrageous monthly premiums, fear of being dropped at any time, fear of losing my coverage if I change jobs, fear that my wife won’t be covered because she had a benign tumor 10 years ago, etc. I also have to cough up “co-pays” for every office visit, must meet high deductibles (thousands of dollars out of pocket) before insurance even pays a penny, then have “lifetime maximum” limits on top of that – and the price just keeps going up every year. When it’s all said and done, my tax advantage here has vanished.
Meanwhile, in my 22 years in Canada, I never once paid a penny for medical care. I had gall bladder surgery, spent time in ER for a badly cut hand, spent a week in hospital with broken bones from a motorcycle crash, had many trips to the family doctor with sick children – and NEVER had to wait any unreasonable amount of time – and certainly never paid a bill. Prescriptions are also half the price in Canada.
When you phone the doctor here, the first question they ask is “what insurance do you have?” When you phone the doctor in Canada, the first question is “What seems to be the problem?” This whole debate about which system is better is a non-issue to anyone who’s actually lived under both systems. If I get laid off here (and lose my insurance), I can always go back to Canada – thanks God for that.

if the fear-mongers succeed in blocking health reform in the U.S., maybe the Canadians will have to build a long fence to keep Americans out.

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