Trudy Rubin and Health Care

In her recent column, Lessons can be learned from European health systems,  Trudy Rubin makes a case for government health care.

Trudy references a book by a former Washington Post writer, T.R. Reid.  Reid’s points are:

  • Countries such as France, Germany, Switzerland and Japan have universal health coverage but do not have socialized medicine.
  • Medical care in France, Germany and Japan do not require long wait times.
  • Universal care is not necessarily backed with bloated government bureaucracies.

She then goes into how these countries control costs by making health care not-for-profit with standardized, government mandated fee schedules and mandated insurance purchases for citizens.

Great, what about results?  Look at page 5 of this document from the much quoted OECD.  It shows the U.S. ranks:

  • #1 in 5-year breast cancer survival rates
  • #2 in 5-year colorectal cancer survival rates

And the survival rates are significantly higher than other countries.  With breast cancer, the U.S. is #1 with a 90.1% survival rate,  Japan is #3 with an 86.1% survival rate and France is #4 with 82.6%.  I wonder if the additional 7.5% of people who survive breast cancer in the U.S. vs. France thought the extra expense was worth it?

This document also says about the U.S.:

There are many good things to say about the quality of the US health system. It delivers care in a timely manner –
waiting lists are unknown, unlike in many OECD countries. There is a good deal of choice in the system, both in health care providers and, to some extent, the package of health insurance. The system delivers new products to consumers more quickly than in any other country. The United States is the major innovator, both in medical products and procedures.

Here are some questions I have for Trudy:

1. What are the tort rewards like for people who are mistreated in the European countries that she mentions?

2. How do the premium of doctor malpractice compare in these countries and the U.S.?

3. What are other specific results of health care in these countries, like the breast cancer above? For example, how exactly do the wait times compare, how effective are treatments that are administered relative to the U.S. and what percentage of people have complications as a result of mistreatment and infections?

4. What innovations have come out of these other countries relative to the U.S.?  Has their level of improvement in quality of care relied on adopting innovations from the U.S. market?

5. What degree of freedom do patients have in determining which care and treatments they will receive?  Has anyone been denied care in these countries?  If so, why?