Worth noting that the US leads Europe in outcomes for serious illnesses (particularly cancer), and the US provides access to specialists in days where other countries often have multi-week or even multi-month delays.
Careful--the US does more early cancer screening than is typically done in Europe. This boosts the US score on 5 year survival rates, but it doesn't necessarily mean we actually get better outcomes. E.g., if an American and a European each get a cancer that will eventually kill them in 7 years, and the American finds out in 1 year and the European doesn't find out for 3 years, then the American will show up in the 5 year survivor statistics, and the European will not.
We do gain some outcome advantage from earlier screening, in that it means we will catch some cancers early enough to treat that Europeans would miss, but the outcome differences aren't nearly as big as the 5 year survival stats lead some people to believe.
As far as seeing specialists goes, the US does do well, although I believe Germany and maybe Japan have us beat--showing that universal affordable coverage can be achieved without having to give up reasonable wait times to see specialists.
The thing that makes me sad about the US system is this. Take the top, say, 10 non-US systems. They have quite a diverse range of approaches, ranging from straight up socialized medicine to highly capitalistic market-based systems. All they have in common is that in most areas they have equal or better outcomes than the US, with universal or near universal coverage, for a lot less cost per patient or as a percent of GDP. Based on the evidence, it doesn't appear hard to design a good healthcare system for a first world country. Only the US seems to be able to botch this. WTF!?
By what measure do European countries have better health outcomes than the US? We're seeing in this thread why the most obvious metrics don't work well:
* Cancer survival rates, because of the 5 year survival heuristic, capture people who's illness is detected early but isn't actually cured.
* Life expectancy captures the fact that people drive more and faster in the US, that the US has more violent crime, and that more people in the US kill themselves
Intuitively, "high cost" plus "shortest wait time to specialist" plus "problematic overprescription" (a problem common to all first-world health systems) plus "earliest cancer detection" just doesn't add up to "worse outcomes than Europe".
But, it does make sense that despite the money we pay, our outcomes are not different enough to justify the expense.
I strongly agree: the way we finance health care in the US, primarily through a system of employer-provided health insurance policies that give way to a single-payer socialized system that kicks in right when patients are most engaged with the health care system, all without giving patients control or a stake in the cost of their care --- this system makes no sense.
Yes, but, europeans generally see a healthcare provider more often and are more often diagnosed before they reach an acute stage. If you look at the graphs [1][2][3] that compare per capita expenditures per country with life expectancy per country. You'll see that they are generally getting equivalent or better outcomes at less than half the cost.
And I can tell you that for my own part, even with health insurance, the deductible is so high that it might as well not exist as far as basic checkups and doctor visits go.
Life expectancy is a poor proxy for health care effectiveness. By some methodologies, once you take out things like auto accidents, the United States snaps right back into first place in those rankings. Meanwhile, in disease-by-disease rankings, the US routinely leads.
We do spend a lot for health care in the US, and we probably aren't realizing comparable value, but it is also probably not true that the actual quality of care in the US lags that of Europe.
Something that wasn't confounded with deaths by suicide and high-speed automobile accidents, both of which are so anomalously high in the US that when you factor them out of life expectancy the rankings are totally different.
Say what you will about the worldwide quality of mental health care, but there's not a whole lot a good hospital can do once you've set out to harm yourself, and that one particular tragically underserved health problem is not what people are thinking about when they suggest "Americans pay more money to get less than what Europeans do". That last notion is dubious at best.
> the US provides access to specialists in days where other countries often have multi-week [...]
This is a view that's strongly distorted by the UK. It's seems to hold there, and the wait times sound terrible, but it's definitely not the case in the majority of countries, by a long shot. As far as I can tell from personal experience, wait times are not an issue in The Netherlands, Sweden, Germany, or France; outside of that I've never heard of really long waits in any country of Europe, with the exception of the UK.
The European systems are all different in sometimes surprising ways, throwing them together into one bucket is an incorrect generalization. E.g. the UK system with the NHS is entirely tax funded, where the Germany system has insurance paid 50/50 by employee and employer, and the Swiss system has 100% privately paid but mandatory and state regulated insurance.
These are really massively different systems, and the effects on e.g. waiting times are huge. They are all state regulated and sometimes state funded, but that's by far not the only interesting characteristic of medical systems.
For procedures that aren't time sensitive, like eye surgery, wait times in France are upwards of 2 months.
I don't know what Germany's wait times are, but Germany isn't a pure single-payer system like France, the UK, and Canada; it's guaranteed-issue mandatory-coverage.
