Health care outcomes

Krugman discusses health care reform today. Key point: US health care costs are much higher than those of big countries with universal health care, but our health outcomes are worse.

"In 2002 the United States spent $5,267 per person on health care. Canada spent $2,931; Germany spent $2,817; Britain spent only $2,160. Yet the United States has lower life expectancy and higher infant mortality than any of these countries."

Here's a link to the study he cites by Schoen et al., Health Affairs 2005. This table gives us some interesting information:

Comparing the US and Germany, for example: 30% of US patients can see their doctor on the same day versus 56% in Germany; 26% of US patients went to an ER for a condition that could have been treated by their regular doctor had he/she been available, versus 6% in Germany; 20% of US patients had a wait of less than one week to see a specialist versus 27% in Germany; 51% of US patients reported access problems due to cost (e.g. did not fill a prescription because it cost too much, did not see a doctor when sick, etc.) versus 28% in Germany. Someone tell me again what the advantage of our system is?

Another table presents some puzzling information. Again comparing the US and Germany, we find that more patients in the US report being the victim of medical error, coordination failures, going without care because of cost, waiting 6 days or more for care when sick; about the same number report waiting more than 4 weeks for an appointment with a specialist; yet when asked whether their health care system required fundamental change, 44% of US patients said yes versus 54% of German patients. Either (1) Americans are ignorant of the existence and potential of better health care systems, (2) Germans are complainers, or (3) the study omits important indicators of health care quality on which the US scores higher than Germany. I'm guessing the answer is #1.