June 26, 2015

"American Exceptionalism" in Healthcare: Exceptionally High Costs and Exceptionally Poor Results

"American exceptionalism" is the theory that the U.S.A. is inherently different from other nations. From our origins in the American Revolution, this concept grew as we developed a uniquely American ideology.

But today the term has been corrupted by conservatives and super patriots to mean that we are far superior to other nations, and that our quality of life is by far the best on Earth. The tragic shooting in Charleston last week prompted David Niose of the American Humanist Association to write an article -- "Anti-intellectualism Is Killing America" -- in which he notes that quality-of-life ratings place America far from the top.

Rankings of U.S. on Health Care Issues
Here's a headline in the July, 2015 issue of the University of California, Berkeley Wellness Letter: "The U.S. spends more on health care per capita than just about any other country but ranks poorly in terms of many healthcare outcomes, especially compared to other developed countries. "

Using the latest statistics from the Social Progress Index (compiled by the nonprofit Social Progress Initiative), the newsletter reports that out of 133 countries, America ranks:
  • 30th in life expectancy
  • 37th in a mortality rate from infectious diseases
  • 38th in childhood mortality rate
  • 35th in terms of women surviving childbirth.
We have higher homicide rates than 40 countries, higher traffic fatality rates than 37, and higher suicide rates than 81. 

Here are some additional statistics:
  • The U.S. spends almost $1,000 per person per year on pharmaceuticals. That's about 40% higher than the next highest spender (Canada), and more than twice as much as countries like France and Germany.
  • Most other countries regulate drug prices, either directly through price controls (e.g., France and Italy), indirectly through limits on reimbursement under social insurance schemes (e.g., Germany and Japan), or indirectly through profit controls (e.g., the UK). 
  • Only two countries -- the United States and New Zealand -- permit drug companies to advertise directly to consumers.
Good News Just In
I was getting angry and depressed writing this post. Fortunately, the radio was on and I heard that the Supreme Court today upheld the provision in the Affordable Care Act (ACA) that allows the federal government to provide nationwide tax subsidies to help poor and middle-class Americans buy health insurance. Combined with the court's earlier favorable ruling on other parts of the law, this latest decision seems to assure that the ACA will survive the president's departure from office in 2017.

Initial statistics indicate that the new law is making progress in reducing costs and increasing healthcare coverage. But we've got a long way to go before we catch up with other nations.

                                                                                                                                                                                                                  

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