My experience as a child was great. As a working adult I spend hours fighting with insurance, hospitals, and doctors to get my bills properly covered. It feels like a bunch of wolves arguing over whose gonna eat the sheep (me). For this privilege I get to pay insurance a minor fee of 3k/month for my family of 5.
There definitely had been a few snags with insurance that we had to work through - not claiming it's perfect.
However I recall the night my son was born - the facilities, staff and resources of the hospital were unmatched - the mother and baby would not have the same experience anywhere else in the world.
My wife works in the ER - they constantly use procedures and deploy resources in ways that would be considered impractical elsewhere in the world.
For example: an 65+ year-old patient comes in with a specific complaint. It could be cause A or the more rare but serious cause B. It takes imaging to determine whether it's A or B. Elsewhere in the world, they just assume it's A as the patient is "old" because it's financially impractical to test for B. My wife on the other had has no constraints from ordering the imaging test even though 9/10 times it's "wasted" as it just confirms A. But the other 10% of the time, it saves the life.
We make a different tradeoff in the US, some of us prefer this trade off.
> For example: an 65+ year-old patient comes in with a specific complaint. It could be cause A or the more rare but serious cause B. It takes imaging to determine whether it's A or B. Elsewhere in the world, they just assume it's A as the patient is "old" because it's financially impractical to test for B. My wife on the other had has no constraints from ordering the imaging test even though 9/10 times it's not needed. But the other 10% of the time, it saves the life.
This just plain isn't true in general. I grew up in the US with probably the best insurance of anyone I've ever known. I've also lived in Sweden with the state-run insurance (without any private addition). I've had great care in the US. I've had great care in Sweden. In fact, my care in Sweden has honestly probably been better in my cases including where I had overuse injury to my knee due to sports where they really could just say "well quit running so much and let your body rest and leave the healthcare system to those not actively inducing their own injury", but they did not. Fast MRIs, fast diagnosis, fast help, fast everything. I understand this is entirely anecdotal, but the fact is there are many much cheaper systems out there run by governments that actually function _better_ than the US system even for those in the US with good insurance.
> However I recall the night my son was born - the facilities, staff and resources of the hospital were unmatched - the mother and baby would not have the same experience anywhere else in the world.
We had a wonderful experience with the birth of our daughter, but I have no idea how I could claim it was better than anywhere in the world. I'm asking because you seem to be making a low-hyperbole claim here: what is your basis for saying that? Particularly, when the US has some of the worst metrics for infant mortality, birth weights, and mother mortality rates in the developed world.
> My wife works in the ER - they constantly use procedures and deploy resources in ways that would be considered impractical elsewhere in the world.
Does this actually lead to better health outcomes? The US ranks low in the developed world in many health-related areas. Some of them are at least in part due to cultural issues and it is completely fair to attribute to our healthcare system. But some of them like our rates of medical and lab errors clearly are. I'm genuinely looking for data to support the idea that the tradeoff you mentioned actually exists.
// but I have no idea how I could claim it was better than anywhere in the world. I'm asking because you seem to be making a low-hyperbole claim here: what is your basis for saying that?
Conversations with friends and family abroad.
// Particularly, when the US has some of the worst metrics for infant mortality, birth weights, and mother mortality rates in the developed world.
Not an expert but I understand there's a ton of measurement variability. Something like:
Baby born 3 months premature and dies shortly after. Many countries just consider that still birth and it doesn't count towards infant mortality. In the US we actually fight to save these kids so if they die, they count towards infant mortality. Perhaps weight at birth works the same way?
All countries do their best, and Sweden seems to be the most successful country at the moment [0]. Neonatal mortality rate in Sweden was 1.38 per thousand in 2019, compared to 1.4 in Norwy, 2.77 in the UK and 3.7 in the US [1]. But you are right that the rate of premature births is higher in the US than most European countries (10-15% in the Us compared to <10% in Europe) [2], and so is the rate of very preterm births (14.1 per thousand in the US compared to 8.3 in Norway, 7.7 in Sweden and 6.7 in Finland) [3]. It is likely that the rate of premature births is also a sign of the quality of maternal care.
The rate of still birth in 2009 in the US was 2.95/1000 compared to 2.74 in Sweden and 2.2 in Norwy [4]
That the statistics of neonatal deaths are manipulated is also a bold claim, it deserves some references?
There is a huge Caviat in your scenario. A lot of people won't come in because they can't afford it, or they won't get the test because they can't afford it. Your wife can order the imaging test, but she doesn't have to deal with the debt, and/or months of arguing on the phone with administrators that her patient sees.
I live in Canada where I am enrolled in the provincial health plan. If a doctor recommends a test or treatment I get it. Cost isn't a consideration. My age isn't a consideration. Please don't spread lies about how universal healthcare works. Unlike insurance in the US, if the doctor orders it, it is covered by the healthcare system here.
Truth: I may have to wait based on a triage system.
If the doctor doesn't recommend a test as necessary or I don't want to wait for my place in line, I can go to a medical clinic that offers these tests privately and pay/have my employer provided secondary coverage pay.
In that way it turns out that we don't have to make the tradeoff.
I've had the best insurance I could buy in the US, and now I have the standard health care that every person in my Canadian province gets. My experience, which is backed up by studies, is that I am healthier, and the population in general is healthier under the Canadian system.
