Tuesday, March 15, 2016

No, the United States does not have the best health care in the world

In the popular imagination, the United States provides very high quality health care services--but only to those who can afford it. In the popular imagination, health care is the one shining exception of the American social welfare state--the one area of social welfare where the United States boasts higher quality services than the rest of the world. This is a myth.

First, the United States is middling at best among peer countries for rates of disease survival. And second, care is demonstrably of very low quality:
According to a recent RAND study published in the New England Journal of Medicine, uninsured patients receive only 53.7 percent of the care experts believe they should get—that is, appropriate, evidence-based treatment. But according to the same study, patients with private, fee-for-service insurance are even less likely to receive the proper care...
In addition to overtreatment and undertreatment, there is also flat-out mistreatment. Consider the following statistics: The Institute of Medicine estimates that lack of health insurance among people aged twenty-five to sixty-four causes 18,000 premature deaths annually, which is appalling. But the Institute of Medicine also estimates that up to 98,000 Americans are killed in hospitals every year by medical errors. In 2006, the IOM issued a new study that found that hospital patients in the United States experience an average of at least one medication error, such as receiving the wrong drug or the wrong dosage, every day they stay in the hospital.
All told, according to the RAND study, Americans receive appropriate care from their doctors only about half of the time, and the results are deadly. In addition to the 98,000 killed by medical errors, another 126,000 die from their doctor’s failure to observe evidence-based protocols for just four common conditions: hypertension, heart attacks, pneumonia, and colorectal cancer...
[A]utopsy studies consistently demonstrate that doctors are only slightly less likely to make misdiagnoses today than they were in the 1930s...


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