How good is our health care rated worldwide https://www.thelocal.ch/20170519/study-swiss-healthcare-is-third-best-in-the-world Switzerland has the third best standard of healthcare in the world, according to new research. The Healthcare Access and Quality Index (HAQ), published in the UK journal The Lancet on Thursday, studied the quality of healthcare in 195 countries by measuring mortality rates from causes that should not be fatal in the presence of effective medical care. The study analyzed death rates from 32 such diseases and conditions over the period 1990 to 2015 and found that nearly all countries saw their rating improve over the years. Andorra topped the Index with a score of 95, followed by Iceland (94) and then Switzerland in third place on 92 points. Sweden and Norway made up the top five and 13 of the top 15 countries were in Western Europe, joined by Australia (6th) and Japan (11th). The UK placed 30th and the US 35th. At the bottom end of the table was Central African Republic on only 29 points.
They did not include cost in their evaluation. The US is not only at the bottom of the First World systems in terms of outcome, but at the very top - by a very large margin - in per capita cost. So ranking the US 35th, a Second World system, is quite generous - in bang for per capita buck, the US would be somewhere among the Third World shitholes.
From today's Washington Post: The U.S. spends $9,000 annually per person on health—more than any other country. But our population of well-trained doctors with access to the latest medical technology don’t always correlate with staying alive. A new global study on “amenable mortality” deals with deaths that could have been avoided by timely and effective medical care. Having a strong economy and great medical technology don’t guarantee good health care. Many people in the USA are not getting the care that should be expected for diseases with established treatments. The USA scores 80 on this index—on a par with Estonia and Montenegro. We measure well for diseases preventable by vaccines, but we get almost failing grades for nine conditions that can lead to death: lower respiratory infections, neonatal disorders, non-melanoma skin cancer, Hodgkin’s lymphoma, ischemic heart disease, hypertensive heart disease, diabetes, chronic kidney disease, and, surprisingly, the adverse effects of medical treatment itself.
All of those - including the iatrogenic stats - are predictable effects of a medical care system that is too expensive to make routine use of, among a population that is overworked. They are conditions whose early stages are relatively easy to live with and seem "normal", that are exacerbated by stress and long hours at work, and whose symptoms don't seem worth taking in when the cost is easily thousands of dollars out of pocket. So by the time the doc is involved, the situation is serious and even minor medical errors can easily kill, preventive and early stage heading off is impossible, and mild low-risk measures are less likely to be adequate. If people are routinely checking in with a doc, and have time to deal with stuff, and so these things are discovered before they are serious, then everything becomes easier and cheaper and more likely to work - even medical error becomes less likely, and certainly less likely to be fatal. We have the stupidest medical care payment system on the planet, and getting killed by non-melanoma skin cancer (or a mistake made in treating one of its many complications) after paying tens of thousands of dollars to treat what would have been in a sane setup merely an easily diagnosed and easily removed skin blemish, is just one of the penalties we pay.
