Wednesday, February 18, 2009


As politicians, economists, popular media and an ever increasing list of others convincingly proclaim cures for the ills of American health care, we Americans are subjected to a stream of opinion deriding as utterly miserable our health-care system compared to the rest of the developed world.

Much of this chatter resonates with the public; many assume the arguments are sound and the expertise of the presenters profound because the calls for change are so ubiquitous and the topic so complex.

In their haste to address such serious challenges as escalating costs and the uninsured, many economists, government officials, insurers and academics alike are beating the drum for a far larger role for government in health care.

In this interlude between health czar nominees, and before we legislate government as the solution and final arbiter of medical care, it may be a good time to consider a few unheralded facts about America’s health-care system. For instance, did you know:

(1) Americans have better survival rates from both common and rare cancers than Europeans? (Sources: Lancet Oncology, 7, No. 2 ( February 2006): 132-40; Verdecchia et al., “Recent Cancer Survival in Europe : A 2000-02 Period Analysis of EUROCARE-4 Data,” Lancet Oncology, No. 8 (2007): 784-96.)

(2) Americans have significantly better survival rates from cancer than Canadians? (Sources: United States Cancer Statistics, National Program of Cancer Registries, Centers for Disease Control; Canadian Cancer Society/National Cancer Institute of Canada; also June O’Neill and Dave M. O’Neill, “Health Status, Health Care and Inequality: Canada vs. the U.S.,” National Bureau of Economic Research, NBER Working Paper 13429, September 2007. Available at

(3) Americans have better access to treatment for chronic diseases than Canadians? (Source: O’Neill and O’Neill, “Health Status, Health Care and Inequality: Canada vs. the U.S.”)

(4) Americans have better access to preventive screening for major cancers than Canadians? (Source: O’Neill and O’Neill, “Health Status, Health Care and Inequality: Canada vs. the U.S.,” Table 8.)

(5) A marker for inequality of access and quality of health systems, the “health-income gradient” (i.e., that higher incomes achieve better health and lower incomes mean worse health) for adults 16 to 64 years old reveals a more severe disparity in Canada than in the United States? (Source: O’Neill and O’Neill, “Health Status, Health Care and Inequality: Canada vs. the U.S.”)

(6) In the United Kingdom and Canada, patients wait far longer than Americans (about twice as long, sometimes even more than a year) to see a specialist, have elective surgery like hip replacements or cataracts, or get radiation treatment for cancer? (Sources: “Waiting Your Turn, (17th edition) Hospital Waiting Lists In Canada”; Critical Issues Bulletin 2007; N. Esmail, Michael A. Walker MA, and M. Bank, Studies in Health Care Policy, August 2008; N. Esmail and D. Wrona “Medical Technology in Canada,” Fraser Institute; Sharon Willcox et al., “Measuring and Reducing Waiting Times: A Cross-National Comparison Of Strategies,” Health Affairs 26, No. 4 (July/August 2007): 1078-87; O’Neill and O’Neill, “Health Status, Health Care and Inequality: Canada vs. the U.S.,” M.V. Williams et al., “Radiotherapy Dose Fractionation, Access and Waiting Times in the Countries of the U.K.. in 2005,” Royal College of Radiologists, Clinical Oncology 19, No. 5 (June 2007, 273-286).

(7) Sixty percent of Western Europeans say their health systems need “urgent” reform? (Source: H. Disney et al., “Impatient for Change: European Attitudes to Health-Care Reform;” The Stockholm Network, 2004.)

(8) More than 70 percent of Germans, Canadians, Australians, New Zealanders and U.K. adults (all countries in the survey except the Netherlands, with “only” 58 percent) say their health systems needs either “fundamental change” or “complete rebuilding”? (Source: C. Schoen, R. Osborn, M. M. Doty, M. Bishop, J. Peugh, and N. Murukutla, “Toward Higher-Performance Health Systems: Adults’ Health Care Experiences In Seven Countries, 2007,” Health Affairs 26, No. 6 (2007): w717-w734.)

(9) Although much maligned by economists and targeted by policymakers, an overwhelming majority of America’s leading physicians themselves recently listed the computerized tomography (CT) scan and magnetic resonance imaging (MRI) as the most important medical innovations in improving patient care in the previous decade? (Source: V. R. Fuchs and H. C. Sox Jr., “Physicians’ Views of the Relative Importance of 30 Medical Innovations,” Health Affairs 20, No. 5 (2001): 30-42.)

(10) By any measure, the vast majority of all the innovation in health care in the world comes out of the U.S. health-care system? (Sources: “The U.S. Health Care System as an Engine of Innovation,” in the 2008 Economic Report of the President, Chapter 4, Economic Research from the Federal Reserve Bank of St. Louis, Federal Reserve Archival Service for Economic Research; T. Cowen, New York Times, Oct. 5, 2006; Coburn et al., Heritage Lecture No. 1030, April 2007; T. Boehm, Journal of Medical Marketing 5, No. 2 (2005): 158-66; U.S. Department of Health and Human Services, July 2002.)

Let’s be careful about what we believe when we listen to all those health-care “experts” in Washington.

Scott W. Atlas. M.D., is a senior fellow at the Hoover Institution and a professor at the Stanford University Medical Center.

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