Posted by: New Class Traitor | January 9, 2010

US healthcare ranking by WHO: #37 or #1, depending

(Double h/t: Squatch at C2)

In the WSJ, Mark Constantian MD explains the problem with the common talking point that the WHO ranks US medicine comparatively low:

The comparative ranking system that most critics cite comes from the U.N.’s World Health Organization (WHO). The ranking most often quoted is Overall Performance, where the U.S. is rated No. 37. The Overall Performance Index, however, is adjusted to reflect how well WHO officials believe that a country could have done in relation to its resources.

The scale is heavily subjective: The WHO believes that we could have done better because we do not have universal coverage. What apparently does not matter is that our population has universal access because most physicians treat indigent patients without charge and accept Medicare and Medicaid payments, which do not even cover overhead expenses. The WHO does rank the U.S. No. 1 of 191 countries for “responsiveness to the needs and choices of the individual patient.” Isn’t responsiveness what health care is all about?

Read the rest.

Related story here:

Here’s a brief chronology on my wife’s emergency appendectomy at St. Luke’s-Roosevelt Hospital on Dec. 30:
* 2 a.m.: Horrible stomach pain and other relevant symptoms.
* 5:45 a.m.: 911 call.
* 5:50 a.m.: EMTs arrive.
* 6 a.m.: Arrive at emergency room.
* 6:07 a.m.: Wife in emergency room bed.
* 6:15 a.m.: Nurse takes blood.
* 6:20 a.m.: Initial physician consultation.
* 6:25 a.m.: Wife on saline and anti-nausea drip.
* 7 a.m.: Wife gets some morphine.
* 7 a.m. to 11 a.m.: Wife rests comfortably waiting for CT scan.
* 11 a.m.: CT scan. (One machine out of service, hence the long wait.)
* 11:10 a.m.: Resident confirms diagnosis of appendicitis.
* 11:15 a.m.: Initial consultation with surgery resident.
* 1 p.m.: Surgery prep.
* 2 p.m.: Surgery.
* 3:30 p.m.: Recovery room.
* 5 p.m.: Admitted to empty room.
* 9:30 a.m. (the following day): Released.

To use a pain-intensity scale analogy, the entire experience was “moderately painful.”

I used Facebook to let my friends and family know about my wife’s condition.

The Americans were all appropriately sympathetic.

The Europeans — who suffer under socialized medicine — were mostly amazed.

Amazed that we didn’t wait hours for an emergency-room bed.

Amazed that we saw a doctor in less than five or eight hours.

Amazed that we weren’t told to go home and come back at a later date — because her white-blood-cell count was only slightly elevated and the appendix wasn’t in danger of bursting.

And not amazed but astounded that the surgery was done immediately. That there was actually a room available and that it was vacant — at a large urban hospital — they couldn’t even fathom.

Here is one verbatim comment from a continental comrade: “I waited three days in London to see a GP and 20 hours at ER for an ‘exploratory op.’ It burst and I nearly died (to say nothing of the two life-threatening incidents whilst I was being ‘cared’ for). But hey! The public option is better . . . right?”

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Responses

  1. I’m very happy to hear that your wife received such an outstanding service and that she’s doing well.

    You and your wife must have decent health insurance and live in an affluent neighborhood to get such service and you must have lived quite close to an EMT unit and to a hospital.

    I guess if your wife did not do well because of the *4 hour wait* to get a CT scan, in a hospital with one broken machine, then this article would have been written differently.

    It’s a bit naive to generalize about an entire system based on one data point.

  2. It’s not my wife, but that of the person who wrote the NYPost story I was quoting.

    I have lived in several different countries with different healthcare systems (see the case studies in my sidebar). No argument that there are problems with the US healthcare system. But, having lived in Euroland, socialized medicine will be a cure that is worse than the ailment.

    And in several of the countries I have lived, the quality of care one received was just as unequal as in the USA. The main difference: in the USA the differentiator was insurance and/or ability to pay out of pocket. In those countries, it was connections (or lack thereof) within the medical establishment. True “equality” only exists as equality of misery.

    Full disclosure: I probably owe the fact that I am alive and well today to a US physician.


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