Adopting European health care model a step backward

Many liberals seem to believe that they never lose debates over policy; they are instead undone by conspiracies, lies, and manipulation by dark forces (usually corporate) on the right. New York Times columnist Nicholas Kristof, as does Newsweek, have used the old saw about infant mortality rates to push health-care reform. We spend nearly twice as much per person on health care as Canada, Kristof writes, “yet our infant mortality rate is 40 percent higher.” Advocates of single-payer commonly cite infant mortality rates because the U.S. lags behind other industrialized nations on this measure.

But these numbers are not reliable. Nations have different standards about how to measure infant mortality. In some countries, a severely premature infant is labeled a fetal death instead of an infant death. Not in the U.S. In many nations, if a child dies within 24 hours of birth, it is labeled a stillbirth. Not here. Social and cultural factors — including maternal drinking, drug use, and age — are key to infant mortality.

Other international comparisons are more useful.

Consider five-year survival rates after a cancer diagnosis. Cancer survival rates are a pretty good measure of the quality of a health system.

These numbers aren’t perfect either. They are affected by factors like the uninsured in the U.S. who tend not to get early screening for cancer and have more advanced cases at the time of diagnosis. The journal Lancet Oncology has reported that American cancer patients live longer than those anywhere else. Betsy McCaughey, former lieutenant governor of New York and a health statistics numbers cruncher, interprets the Lancet’s (and other) findings as follows:

American women have a 63 percent chance of living at least five years after a cancer diagnosis, compared with 56 percent of women in Europe.

For American men, the numbers are even more dramatic. Sixty-six percent of American men live five years past a diagnosis of cancer, but only 47 percent of European men do. Of cancers that affect only women, the survival rate for uterine cancer is 5 percentage points higher in the U.S. than the European average, and 14 percent higher for breast cancer. Among cancers that affect only or primarily men, survival rates for prostate cancer are 28 percent higher in the U.S., and for bladder cancer, 15 percent higher.

The British Health Service keeps costs down by rationing care through long waiting lists. The Manhattan Institute reports that an estimated 20 percent of British lung cancer patients considered curable when first placed on the waiting list for chemotherapy or radiation were incurable by the time of treatment.

We have a lot to lose if we follow the example of Europe and Canada. In fact, those countries are starting to move back toward more market-grounded approaches. Let’s not go backward in the name of progress.
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