Network News

X My Profile
View More Activity

The Best Paper You'll Read Today

Elizabeth Docteur and Bob Berenson offer whether American health care really is the "best in the world." The two Urban Institute researchers take a comprehensive look at the evidence -- including the difficulties in gathering that evidence and the inadequacies in the current studies -- and conclude:

the picture that emerges from the information available on technical quality and related aspects of health system performance is a mixed bag, with the United States doing relatively well in some areas — such as cancer care — and less well in others — such as mortality from conditions amenable to prevention and treatment. Many Americans would be surprised by the findings from studies showing that U.S. health care is not clearly superior to that received by Canadians, and that in some respects Canadian care has been shown to be of higher quality. ...

Taken together, these studies do provide a strong basis for determining whether proposed health reform initiatives might threaten or, alternatively, strengthen the current level of U.S. quality. While evidence is not conclusive, it is clear that the argument that reform of the U.S. health system stands to endanger “the best health care quality in the world” lacks foundation. Like other countries, the United States has been found to have both strengths and weaknesses in terms of the quality of care available, and the quality of care the population receives. The main ways in which the United States differs from other developed countries are in the very high costs of its health care and the share of its population that is uninsured.

Full paper here.

By Ezra Klein  |  August 20, 2009; 4:00 PM ET
 
Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   Del.icio.us   StumbleUpon   Technorati   Google Buzz   Previous: Obama and Smerconish
Next: Tab Dump

Comments

This isn't a surprise to anyone who knows anything about international comparisons. But it also won't stop the "US health care is the best in the world!" crew because their views aren't based on anything to do with reality.

Posted by: steveh46 | August 20, 2009 4:23 PM | Report abuse

I've always thought it was pretty obvious that when people say "America has the best health care in the world," what they really mean is "America has the most sophisticated treatments for fighting relatively uncommon medical conditions."

Posted by: JEinATL | August 20, 2009 4:26 PM | Report abuse

Ezra, I'll take your Urban Institute study and raise you a Cato and a Heritage study. Can’t we look at something a little less partisan?

Posted by: kingstu01 | August 20, 2009 4:44 PM | Report abuse

Silly researchers, thinking that empirical data can stand up to the doctrine of American exceptionalism.

Posted by: Janine1 | August 20, 2009 4:48 PM | Report abuse

And there is nothing on the health care initiatives proposed that would do anything to improve the standards of care in America on the measures this study evaluates, just give the same overpriced care to more people with money borrowed from the Chinese because we won't raise taxes on the majority of voters.

Why don't we talk to these guys about improving care?
http://www.createhealthcarevalue.com/

Posted by: staticvars | August 20, 2009 5:12 PM | Report abuse

I think the health care initiatives, at least how I read the HELP bill, would, in fact, do something to improve quality results under these metrics. Comparative Effectiveness Research alone would do quite a bit to spread the adoption of best practices and best outcomes throughout the system.

Posted by: scott1959 | August 20, 2009 5:40 PM | Report abuse

"And there is nothing on the health care initiatives proposed that would do anything to improve the standards of care in America on the measures this study evaluates."

Whoops!

The MedPAC or IMAC reform, which is an important intrinsic part of the reform efforts, is directed straight at the problem of health care effectiveness and cost effectiveness.

As Scott1959 says, the whole idea of comparitive effectiveness research is to allow the government, through its own insurance programs and possibly through the insurance exchange, to implement "best care" initiatives. Private insurance companies have repeatedly said that they need the government to initiate this, then they would be glad to follow.

Of course, the tea party types are busy screaming that attempts to "create health care value" are "rationing" and "death panels," and in general doing their best to kill efforts at effectiveness based reforms.

Posted by: PatS2 | August 20, 2009 5:57 PM | Report abuse

"And there is nothing on the health care initiatives proposed that would do anything to improve the standards of care in America on the measures this study evaluates."

Whoops!

The MedPAC or IMAC reform, which is an important intrinsic part of the reform efforts, is directed straight at the problem of health care effectiveness and cost effectiveness.

As Scott1959 says, the whole idea of comparitive effectiveness research is to allow the government, through its own insurance programs and possibly through the insurance exchange, to implement "best care" initiatives. Private insurance companies have repeatedly said that they need the government to initiate this, then they would be glad to follow.

Of course, the tea party types are busy screaming that attempts to "create health care value" are "rationing" and "death panels," and in general doing their best to kill efforts at effectiveness based reforms.

Posted by: PatS2 | August 20, 2009 5:59 PM | Report abuse

The problem is that "The Best" is an ambiguous term. Do you measure it by the ability to solve the most extreme medical problems? Then the US is the best. Do you rate it by the overall health of the populace? Then no. Republicans want to describe "the best" in terms of capability, and Democrats in terms of outcomes. But if there isn't a commonly agreed upon definition of the term, the argument is fruitless and shouldn't be engaged.

Posted by: pj_camp | August 21, 2009 9:44 AM | Report abuse

If we really want the "best" system we have to fight for it.

60 members of the House made it clear they won't vote for a healthcare bill without a public option.

In five days, FireDogLake and partners raised nearly $400,000 for progressive members of Congress who agree to draw a line in the sand over a public plan.

You, too, can offer carrots to these progressive politicians at ACT Blue:

http://www.actblue.com/page/theytookthepledge

Posted by: judybrowni | August 22, 2009 3:38 PM | Report abuse

Ezra,
Your attempts to appear "fair and balanced".. as if this is news...actually strengthens the know-nothing attitude of those who claim America's health care system is "the best". You appear to be intimidated by the anti-fact brigade on the Right. Not to mention that there are already too many studies that say about the same thing, reinforces the assumption that your readers and Americans are essentially illiterate in these matters. They are not or if they are, they are so out of political spite. This is very similar to the stance of Andy Revkin on climate who tries to appear fair and balanced in his treatments of climate skepticism that is poorly grounded in the facts.

Posted by: michaelterra | August 22, 2009 4:36 PM | Report abuse

Ezra,
You cited the same study on mortality from diseases amenable to treatment in your American Prospect blog in January 2008. At that time you added a footnote to your post which said,

"I say "appears" because Warren Meyer raises some fair methodological concerns about the study. I've e-mailed both of the report's authors with the criticisms, and will report back when I receive their replies."

What was the response and have your reported those responses as you promised.

For those interested, the problems with the amenable death study are documented at http://www.coyoteblog.com/coyote_blog/2008/01/uncovering-some.html

Posted by: ktoh | August 22, 2009 7:10 PM | Report abuse

Not to put too fine a point on it, but to suggest that the two studies are at all comparable is not honest.

The amenable death study which purports to show worse U.S. outcomes is funded by a liberal public advocacy group, and you yourself have as much as admitted that it is a deeply flawed, statistically meaningless, and highly misleading study.

The other study showing better U.S. cancer outcomes is statistically rigorous and was published in a purely scientific and highly respected journal.

Posted by: ktoh | August 22, 2009 7:47 PM | Report abuse

The comments to this entry are closed.

 
 
RSS Feed
Subscribe to The Post

© 2010 The Washington Post Company