Almost all advanced countries, if not all, have national medical care. It is telling that in the debate over Obamacare, few looked at systems in other countries to see how well what worked. The reason seems to have been a mixture of the classic American arrogance and lack of interest in anything beyond the borders. Characteristically, discussion usually turned on the evils of socialism–for some reason, Europe is thought to be socialist–and who was going to make money.
The results are what one would expect. Study after study has shown that American health care is of poor quality compared with that of other First World nations, and way more expensive.
Recently I encountered a casual friend–he was dancing in a local club–whom I had not seen for a while. Where ya been, I asked? In Guadalajara for cardiac surgery, he said, double bypass and valve replacement. The replacement valve was from a pig so we made the mandatory jokes about did he say oink-oink, and parted.
Later, for the hell of it, I asked by email what it had cost. His response, verbatim, except for my conversions to dollars at 17 pesos to the dollar:
“The costs of my surgery were as follows:
330,000 pesos to the surgeon and his surgical team. $19,411
122,000 pesos to the hospital for eight days $7176
15,000 to the blood bank. $882
467,000 total $27,470
The time frame was March 13 to March 21. The exchange rate around this time period was about 17.5 which would make the USD cost app. $27.000.”
Wondering what this would cost in the US, I googled around and found things like this:
“For patients not covered by health insurance, valve replacement surgery typically costs from about $80,000-$200,000 or more with an average, according to an American Heart Association report , of $164,238, not including the doctor fee. A surgeon fee can add $5,000 or more to the final bill.”
This was only for the valve replacement. The price for a simple bypass in the US runs to $50,000 to $70,000 at the lower end. What the bypasses would add to the replacement, I don’t know, and shudder to think.
The huge difference in price between American and other care occurs in almost everything. For example, corneal transplant in the US:
“For patients who are not covered by health insurance, the average cost of surgery can range from $13,000 to $27,000 or more. According to the Agency for Healthcare Research and Quality , a corneal transplant typically costs $13,119 when done as an ambulatory procedure and $27,705 when performed as an inpatient surgery.”
In Mexico, about $3000, according to my ophthalmologist, who does them constantly.
Why the prices? Several reasons offer themselves. Advanced countries–Mexico is not one–have less corruption than does the US, and a greater concern for the well-being of their people. In Europe, for example, this is obvious not just in medical care but in unemployment insurance, length of vacations, and public amenities. In Seville, among my favorite cities, sidewalks are very wide, bicycle lanes are actually usable, in intercity buses are clean and comfortable. In the US all of this would be regarded as hippy dippy or socialism or the malevolent workings of the nanny state.
I tell you, boys and girls, America is a collection of self-interested interests concerned with maximizing profits and nothing else. Hospitals are run for profit, with the result–surprise, surprise–that they charge what they can get away with. Compare Japan:
“Hospitals, by law, must be run as non-profit and be managed by physicians. For-profit corporations are not allowed to own or operate hospitals. Clinics must be owned and operated by physicians.”
Anybody want to take bets who gets better care at lower prices?
When national medical care is considered in America, nobody–so far as I am aware, anyway–thinks to look at other countries, see what they are doing, and ask, “Does it work?” To do so would make sense, and so is rejected out of hand, and anyway Americans apparently cannot conceive that other countries might do things well. Instead we hear about this that economic theory, and freedom, and what Adam Smith said about bypass surgery, and tyranny.
Invariably you hear of the pregnant woman in London who couldn’t see a doctor under national health care and had to giver herself a Caesarian with a chainsaw. These nightmares are offered as proof that national care doesn’t work. In fact the medical business lobbies to underfund national care, ensuring that it won’t work well. Then they talk about the evils of socialism.
Suppose we did make comparisons?
Military medical care is the obvious, available, and easily studied alternative to Obamacare. So far as I know, nobody thought of this. In the military you go to the hospital or clinic, show your ID card, get done whatever you need, and leave. Thank you, good day. No paperwork. No paperwork. No insurance forms, deductibles. receipts. No insurance companies trying to pay as little as possible, since that’s how they make money. The doctor doesn’t order a PET scan, three MRIs, and a DNA analysis of your grandmother’s dog to run up the bill.
“Canadians strongly support the health system’s public rather than for-profit private basis, and a 2009 poll by Nanos Research found 86.2% of Canadians surveyed supported or strongly supported “public solutions to make our public health care stronger.” A Strategic Counsel survey found 91% of Canadians prefer their health care system instead of a U.S. style system.”
From the taxpayer’s point of view, real national care involves no insurance companies. For this reason Congress, for sale to the highest bidder, will never consider such a system.
“The French health care system is one of universal health care largely financed by government national health insurance. In its 2000 assessment of world health care systems, the World Health Organization found that France provided the “close to best overall health care” in the world. In 2011, France spent 11.6% of GDP on health care, or US $4,086 per capita, a figure much higher than the average spent by countries in Europe but less than in the US.”
People who have used it–well, the three I know–love it.
The foregoing paragraphs by themselves do not justify a sweeping change of policy–but might they not suggest to our rulers the wisdom of at least looking at what other countries have done?
——————————————————————————————-Note: In last week’s column I made disparaging remarks about the accuracy of the AR15, and was taken to task by many readers. I should have said what I meant by accuracy, and I guess it isn’t what most people mean. In my days at Soldier of Fortune, we got into exotic stuff, such as sniper rifles, and it probably distorted my ideas of things. Google on “sniper rifles,” and you will find virtually nothing in .223. At Parris Island we fired .762 at 500 meters. And I don’t pretend to understand the photo with the “smoke disk,” which I can’t figure out.
Fred can be reached at firstname.lastname@example.org. Put the letters “pdq,” quotes not needed, somewhere in the subject line or a filter will heartlessly delete your email.