I think she (I believe Methinks1776 is a she) does a fantastic job of articulating the problems with the measures commonly used to compare the effectiveness of medical care and makes a few other good points. I thought it would be good to add to my collection. Here’s the comment (with ever so slight editing).
…I immigrated here from a country with socialized medicine and I was gravely ill for several years in that socialized system. So, I have quite a lot of experience with the socialized medical system in more than one country. Socialized medicine is great at administering band-aid and aspirin medicine. It’s not good at handling really serious medical issues.
You raise the old canard of life expectancy and infant mortality. Life expectancy comparisons between developed countries are not an indication of how great the medical system is. There are far too many variables (including lifestyle and genetics) that are baked into life expectancy stats to attribute the difference to health care systems. Infant mortality is calculated differently in European countries and Cuba than it is in the United States, significantly increasing the infant mortality rate in the United States and making the comparison apples to oranges. The higher calculated infant mortality rate in the United States also reduces the life expectancy statistics in the United States.
As a percentage of GDP, European countries spend marginally less than the United States on health care. Also, what defines a health care expenditure is different in the United States and European countries. Elective procedures are often included in U.S. health care stats, for example.
The WHO (an institution for which my father-in-law worked as a doctor and epidemiologist his entire career) is notoriously unreliable for comparing statistics. It does not scrub the data of each country (to normalize infant mortality statistics, for instance) to ensure that it is looking at comparable data. Thus, the WHO is only good for comparing third world countries to first world countries.
Despite worse health care outcomes (which is what matters), European countries spend only marginally less on health care than in the United States. However, that’s less important than the pace at which costs in the OECD countries with socialized medicine are growing. The growth rates are outpacing U.S. growth rates. And, as I pointed out and as you must already know, each and every country with socialized medicine in Europe also has a private system. If socialized medicine worked so well, why the need for private medicine?
The problem with the United States is that it is that it is already closer to the British model than to anything resembling a free market. The socialized medicine does not work – i.e. it does not meet the needs of the population.
If you are truly interested in looking at national medical systems that both reduce prices significantly and ensure basic medical coverage for the entire population, look no further than Singapore. That country spends roughly 4.5% of GDP on health care, has as good or better health care outcomes than in the United States and has done this by providing both universal access and a free market in health care. As irrelevant as it is to the health care debate, Singapore’s life expectancy is higher than the U.S. and European countries