The Thinking ‘Kat: Universal Reality, P2
Following on from this post, and some comments from Citizen Tom, I thought I’d offer a second post regarding universal healthcare, starting with a deeper look at some of Tom’s remarks.
Great Quality, for a Price
Tom referenced that high-quality medical care is available in the USA. I don’t dispute that. The USA has some of the finest standards of care anywhere in the world, if you can afford it. If you can’t, then you face a stark choice: either seek treatment for ailments, or don’t eat. Millions of Americans are having to choose between food and utilities, or medical needs. For those who are in the comfortable position of inherited wealth, such choices never come into play. For those who live in the real world, it’s a terrible decision to have to make.
It’s one thing to exalt the quality of the system, but let’s not conflate the quality of care with the flawed regulatory policies backing it up. US healthcare has long favoured profit ahead of anything else, and it’s only gotten worse in recent years. This has created a two-tier system that, as per the supplied links, leaves millions unable to afford medical care without sacrificing other essentials. Whilst there are other parts of the world where people face serious financial hardship from medical issues, this is rarely down to the cost of medical care, and not remotely to the same scale as the USA.
Quality of Outcomes
Tom lamented that the NHS is run as a monopoly, which overlooks that the NHS is not a business, and not run as one. It is a healthcare service, and whilst not without its flaws, it does pretty well. It is also worth noting that looking at global circumstances, numerous developed nations have some form of universal payer system, with tight regulatory standards designed to stamp out the sort of profiteering that’s created a two-tier healthcare service in the USA, and it’s also worth noting that the quality of outcomes is generally every bit as good as the top-end of the USA’s system. For example, life expectancy:
| Country | Life Expectancy (M) | Life Expectancy (F) | Life Expectancy (All) |
| USA | 76.5 | 81.4 | 79 |
| UK | 78.8 | 82.8 | 81.1 |
| France | 80 | 85.5 | 83 |
| Germany | 78 | 83 | 81 |
| Japan | 81 | 87 | 85 |
Granted, there are numerous factors that determine lift expectancy, but among those factors is inevitably going to be healthcare. Lest Tom reference cultural differences, lifestyle choices and the like, it is worth noting that the UK has a lot in common with the USA in those regards (though I’ll grant that we have much better quality control over food standards).
Next, what about infant mortality? This unfortunate set of circumstances is a bigger revealer of the quality of healthcare services.
| Country | Infant Mortality Rate (per 1,000 live births) |
| USA | 5.61 |
| UK | 3.9 |
| France | 3.4 |
| Germany | 3 |
| Japan | 1.8 |
Then there’s hospital mortality rates.
| Country | Hospital Mortality Rate |
| USA | 2.2% |
| UK | 1.5% – 2% |
| France | 5% – 8.5% |
| Germany | 2% – 2.3% |
| Japan | 3.9% – 4% |
How about average hospital wait times for emergencies?
| Country | Wait times |
| USA | 2 – 3 hours |
| UK | 4 hours |
| France | 2.5 – 3 hours |
| Germany | 3 hours |
| Japan | 35 minutes |
So far, it’s apparent that the USA’s medical system hardly performs poorly, but nor does it exceed the overall performance of countries with single-payer, universal systems. How does it fare in terms of the cost of medication?
Insulin is a necessity for diabetics. They will die without it. What does it cost across these five nations?
In the USA, insulin costs $35 per month with insurance. This price has been capped, preventing price gouging, though without insurance it swiftly rises in cost.
In the UK, insulin is free on the NHS for anyone with Type 1 diabetes for those in Scotland, Northern Ireland and Wales, and free for those in England with the right certification.
In France, it is free, as diabetes is termed a long-term condition.
In Germany, it’s between five and ten Euros, so at most, around $11.60 per prescription.
In Japan, a diabetic pen is between $2 – $3, rising to $10 if you don’t have insurance.
Early Conclusions
It would be easy to cover more ground with this. How about the cost of an ambulance ride, blood transfusion, or any one of a number of procedures performed all around the world. We could get consider other countries as points of comparisons. So far, what is apparent is that the UK, France, Germany and Japan all have good healthcare, certainly no worse overall than the USA, and none of these nations leave people forced to choose between food/utilities, and treating medical conditions. In these countries, the quality of medical care is not dependent on income and wealth, so it is generally consistent.
It’s hard to imagine why this would be perceived as wrong or bad.
‘Kat Comments