Time For A Second Opinion On Health Care
The health care debate has flooded the news as Congress attempts to repeal and craft a replacement for the Affordable Care Act — an increase of governmental involvement and regulation albeit considerably less than a single-payer system such as Canada’s. The costs of the law, it seems, have been the impetus for calls to replace it. In fact, enthusiasm for single-payer coverage plummets when people find out the coverage’s costs.
America’s health care system constitutes one-sixth of the nation’s economy. The Affordable Care Act has obvious problems: it is flawed in its conception and basic design, and is failing the American people. The public was not enthusiastic about the Affordable Care Act but got it anyway.
I recently received a letter from a constituent asking two questions: (1) Why is the United States the only advanced, industrialized country in the world without a single-payer health care system; and (2) Why does health care in the United States cost twice as much as that in other countries yet provides lesser results? I will approach these questions the way I do with every issue — with research. Remember, never substitute emotion for scholarship.
Before we trade America’s health care system for a European-style universal coverage system, we should compare our current system with those in other countries. Here are some facts about America’s health care system.
- Americans have better survival rates than Europeans for common cancers. Breast cancer mortality is 52 percent higher in Germany and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is 40 percent higher.
- Americans have lower cancer mortality rates than Canadians. Breast cancer mortality in Canada is 9 percent higher, prostate cancer is 184 percent higher and colon cancer among men is 10 percent higher.
- Americans have better access to treatment for chronic diseases than patients in other developed countries. Roughly 56 percent of Americans are benefiting from statin drugs, which reduce cholesterol and protect against heart diseases. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons and 17 percent of Italians receive them.
- Americans have better access to preventive cancer screening than Canadians. Eighty-nine percent of middle-aged American women have had a mammogram compared to 72 percent of their Canadian counterparts. Forty-five percent of American men have had a prostate-specific antigen test compared to 16 percent of Canadian men. Thirty percent of Americans have had a colonoscopy compared to five percent of Canadians.
- Lower-income Americans are in better health than comparable Canadians. Twelve percent of American seniors with below-median incomes are described as having excellent health, compared to 5.8 percent of Canadian seniors. Conversely, 20 percent more of lower-income Canadians are in poor health compared to lower-income Americans.
- Americans spend less time waiting for care than patients in Canada and the United Kingdom. Canadian and British patients wait about twice as long — sometimes more than a year — to see a specialist, have a surgery, or get radiation treatment for cancer. Some 827,429 people in Canada and 1.8 million people in Britain are waiting for some type of treatment or hospital admission.
- People in countries with government-controlled health care are highly dissatisfied and believe reform is drastically needed. More than 70% of Germans, Canadians, Australians, New Zealanders and Britons say their health care systems need complete rebuilding.
- Before the adoption of the Affordable Care Act, Americans were more satisfied with the care than Canadians were satisfied with theirs. Fifty-two percent of Americans were very satisfied with their health care services compared to 41.5 percent of Canadians. Also, a lower percentage, 6.8 percent, of Americans were dissatisfied with their health care services than Canadians (at 8.5 percent).
- Americans have better access to important new technologies than do patients in Canada or Britain. The United States has 34 computerized tomography scanners per million compared to 12 per million in Canada and 8 per million in Britain. The United States has 27 magnetic resonance imaging machines per million people compared to six per million in Canada and Britain.
- Americans are responsible for the vast majority of all health care innovations. The top 5 United States hospitals conduct more clinical trials than every hospital in any other developed country. Since the mid-1970s, more United States residents have been awarded Nobel Prizes in Medicine and Physiology than residents of all other countries combined. Also, the most important medical innovations were developed in the United States.
These are some obvious reasons that the United States has not adopted a single-payer health care system and people of other advanced, industrialized countries believe major reform and fundamental changes are needed in their health care systems. Yes, the cost of health care in the United States is higher. After all, when other nations ration and limit health care to their people, as well as refuse to adopt the most important new technologies and innovations, they are by design going to spend much less on health care. Sadly, it does come at a substantial human price, as their health care outcomes are well below what Americans have come to expect. Research and scholarship show other countries experience lesser results than in the United States.
To be sure, our health care system has challenges. But the United States’ health care system is far better when compared to those in other developed countries. Congress now has the responsibility to secure the future of American health care. The Affordable Care Act was a highly complex law that was frantically rushed through Congress. The law mischaracterized America’s medical system despite the facts about superior access, more choice and unsurpassed disease outcomes thoroughly documented in the world’s medical literature.
The Affordable Care Act undermined the greatest medical system in the world, and the law failed by all estimates. Now, it is up to Congress to change course. As the debate over health care reform continues, I hope Congress will address health care access and costs by considering reforms that increase market competition and choice.
I urge you to contact me with any questions or concerns you have about state government so that I can better represent you during the 2017 legislative session.
Contact Me
I always appreciate hearing your comments, opinions, and concerns. Please feel free to contact me in Jefferson City at (573) 751-2459. You may write me at Wayne Wallingford, Missouri Senate, State Capitol, Jefferson City, MO 65101, or email at wayne.wallingford@senate.mo.gov or www.senate.mo.gov/wallingford.
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