Another Ludicrous Comparison of International Health Systems

The Commonwealth Fund is run by radical ideologues who believe the government should run everything.  It is funded by whackos, run by whackos and so it produces whacko research.  Every piece of research it ever puts out is slanted to justify a complete government takeover of the health system.  It is all also complete garbage, methodologically putrid.  About once a year they put out a supposed comparison of the US health system with those of other developed countries, most of which are government-run insurance and/or provider systems.  Ask the British how well that is working out for them.  This most recent international comparison report is the usual bilge-water.  (Commonwealth Report)

Ten countries, including the US, were compared on 70 measures in five areas:  access to care, care processes, health outcomes, administrative efficiency and, you guessed it, health equity.  I am here to tell you that the only thing that matters is health outcomes–if a system is working well, people will be in good health and the treatment of any diseases and conditions they have will have good results.  The measures used by this group of knuckleheads were of course selected to make the US look as bad as possible.  And once you do that, you can find that most of the other countries are close on the measures selected, but the “only clear outlier is the U.S., where health system performance is dramatically lower.”

The “research” relies in large part on surveys of patients and providers.  That is worthless.  It is absurd to rank the US 10th on health outcomes, 10th on access to care, 9th on administrative efficiency.  The UK is ranked 2 on access to care and has waiting lists for almost every service that extend for months or years, as do several other government run health services.  Certain treatments that are routine in the US are routinely denied in other countries because they are too expensive.  The report doesn’t even consider these widely reported facts in its analysis.   The US does well on care processes but not on actual health outcomes?  That is supremely illogical, until you look at the outcome measures.  Not one of those measures actually relates to the results of being treated for a particular disease or condition.  What do you think patients care about?

Here is the truth about the US health system–it is exceptional, far and away the best in the world, at diagnosing and treating disease.  Those who can afford it come from all over the world to be treated here.  Another truth is that our population is terribly unhealthy and engages in extremely bad health behaviors.  We smoke too much, drink too much, take too many drugs, shoot and stab each other, overeat and get fat, don’t exercise and on and on.  And we have to endure woke pro(re)gressivism that makes everyone simultaneously anxious, depressed and mentally ill.  And then when we do have health issues, lots of us fail to see the doctor regularly or stick to prescribed treatments.  If you don’t adjust your measures for all manner of demographic, socio-economic, health status and health behavior variables, you are doing a bullshit analysis.  Viola–the Commonwealth Fund work.

Despite the obvious fact that we as a nation are in poor health and disease ridden because of lack of personal responsibility for health and health behaviors; the Commonwealth Fund doesn’t mention this once, much less suggest the equally obvious solution–we need to incent good behavior and punish poor behavior.  It is just that simple–engage in poor health behaviors, you pay more for health insurance and health care.  Engage in good health behaviors, you pay less.

The US system is expensive.  I have explained why before.  We pay our providers a lot more than other countries do.  Want to pay them less?  Think that will help quality and health outcomes?  We also pay our non-profit health system and health plan executives and managers a lot and let them waste money on marketing and fancy buildings.  It is disgraceful for non-profit, tax exempt institutions to do this and it should immediately be legislated out of existence.  We have a patent system that allows drug companies to make grotesque profits on drugs that are sold for far less, but still at a profit everywhere else.  We should reverse the consolidation in and among the provider and health plan sectors that has eliminated competition on price or quality.  And government of course does its part, with excessive and ridiculously useless laws and rules that drive up administrative costs with zero benefit.  Of course, the public health part of the health system is a government responsibility–and that is the worst performing part of the US health care system.

So if you are sick the US is where you want to be; where you will get the best treatment.  And if we want to get healthier, it is as simple as re-instating that long-lost value of personal responsibility.  Want to make the system less expensive–eliminate obvious excessive cost drivers.  But the vested interests spend a lot of money on campaign contributions and lobbying so don’t expect it to change any time soon.