Viewing a single comment thread. View all comments

tiredstars t1_je914ac wrote

There are a range of comparisons around, and they're often not easy to use. The OECD gathers data but I think it's deliberately shy of making comparisons easy. The UK-based Nuffield Trust does a report comparing systems, which I think is based on the OECD data.

I'm sure I've seen some others but don't have time to look them up right now.

COVID 19 has made things more complicated, so I think most comparisons are two or three years old now. Not that I imagine much has changed - though I think the US had a particularly bad experience of COVID, which is not unrelated to the problems in its healthcare system.

As a general rule, compared to other wealthy countries, the US:

  • has middling health outcomes

  • has some really great healthcare. If you can pay for it, you can get absolutely world-leading healthcare in the US

  • but access to healthcare is poor, and the system drives some perverse behaviour - the classic example is putting off dealing with a problem until it requires emergency treatment

  • at a country level this is one factor that makes US health spending extremely inefficient in terms of outcomes - focusing a lot of attention on expensive treatment with marginal benefits, as compared to wider availability of lower cost treatment and prevention

  • other aspects of US society and the economy contribute to poor outcomes - eg. Americans work longer hours, have fewer holidays, less access to sick pay and less security in their jobs than most rich countries

  • it's also worth noting that even the rich can't completely isolate themselves from the effects of the health of others - if your housekeeper comes in to work when they're ill because they can't afford to see a doctor and can't afford a day off, you're at risk of catching whatever they've got

  • the US spends far more than any other country as a proportion of GDP. Not only that, but government spending is higher than almost any other OECD country. Put another way: if you could magically transplant the NHS to the US, the US government would spend less on healthcare.

The general rule in international comparisons is that there are a range of ways of funding and providing healthcare and there's debate about which models work better - except for the US model, which nobody wants.

3