The ‘Best’ Healthcare In The World (Or, “At Those Prices, It Should Be!”)

A number of folks have pointed me to this article in the New York Times: “American Way of Birth, Costliest in the World.”

via nytimes.com
via nytimes.com

If you’re the kind of person who scrolls through the comments section–not an activity I recommend!–you’ll see that I commented twice in response to the clever little embedded questions in the article. Having given birth once in the US and once in the UK, I had some things to say. In the case of this article, the comments are really telling. For example:

Screen shot 2013-07-02 at 10.54.35 AMI suppose one could justify the extraordinarily high cost of maternity care in the United States if the United States had corresponding extraordinarily high rates of maternal and infant health.

Instead, we have extraordinarily low rates of maternal health among developed countries. We’re 49th in the world.

A few years ago–before the Affordable Care Act had passed–I inadvertently facilitated another woman’s ire when I mentioned how excellent my maternity care had been in the UK, and how much I thought the US could improve maternity care. It’s not possible–America has the BEST healthcare in the WORLD! she cried–before calling me a ‘delusional Communist.’

To which I can only say: read Amnesty International’s report, Deadly Delivery (available free) and then we can talk.

In fact, I can say more than that, because I have actually experienced more healthcare services in more countries than anyone I know, and of the developed countries in which I’ve experienced healthcare, the US is the most expensive and least efficient.

As I wrote in jubilant response to the SCOTUS decision on healthcare, it’s by dumb luck and generous government insurance programs in liberal states like California and New York that healthcare bills haven’t bankrupted me and my family.

It should be within everyone’s ability to take care of their health–and that of their children–without going bankrupt.  A recent guest post on Timothy Dalrymple’s blog suggested that Christians who lean left in politics are “Loud on Poverty” and “Quiet on Abortion.”

But might not those things go hand-in-hand? Can anyone read the Times article and not wonder how many abortions happen  because women cannot afford maternity care, and can’t envision alternatives?

Last year I said:

As far as partisan politics go, no less a Republican than Richard Nixon tried in 1974 to make a ‘Medicare for all’ move. You know who opposed it vocally? Ted Kennedy. So what is this about? Massive change in what each party stands for, or total partisan bullsh*t all around?

I really don’t care which initial is in parentheses after a politician’s name. I just like to see policies that are good for the people who don’t have enough money to buy a dental cleaning, MUCH LESS A SENATOR. Besides, didn’t Jesus expressly say something about doing good to those who CAN’T do anything in return?

If we truly value human life, we must strive to find ways to put quality, humane, and affordable care within everyone’s reach.

I’m sorry this post is turning out a bit rambly and excerpt-happy, but my dad recently shared with me reflections on his first visit to a VA (Veteran’s Association–dad is a proud Air Force veteran) doctor, and I think it is relevant:

As I drive home I think back through all the people I have spoken to who have been in this particular
health care system for a while—men and women, young and old, healthy and sick, pregnant or not—and all have said,
without reservation, that they have found the care to be excellent.  In fact, to date I have not heard a
single complaint.  That’s correct: not a single complaint.  Compare this with the constant complaints we
hear about health insurance plans, and the difference is stunning.

But how can this be?  This is a federal program—it’s socialized medicine!

Of course I’m brand new to the system, so perhaps my initial impressions mean nothing.  Perhaps
tomorrow I’ll find myself face to face with the infamous “death panels” of which we’ve heard so much.  

But somehow I doubt it.

22 thoughts on “The ‘Best’ Healthcare In The World (Or, “At Those Prices, It Should Be!”)

  1. Preach it, sister. My latest blogpost (http://www.livelydust.blogspot.com/2013/07/how-to-make-childbirth-safer-for.html) was in response to the same article.

    I looked at the Deadly Delivery pdf, which was lamenting our extraordinarily high maternal death rate of 13.3/100K in 2006. Things are getting worse. The UN and the CIA now estimate a rate of 21/1000K (see http://www.maternalmortalitydata.org/inner.html?country_selection=O and https://www.cia.gov/library/publications/the-world-factbook/geos/us.html) (latest year: 2010).

    When I examined the 7 countries mentioned in the NYT article, I discovered that the greater the gap between rich and poor in a given country, the higher the maternal/infant mortality rates. And yet half of my fellow Americans think we should reduce benefits to the poor so we don’t have to ask more of the rich.

  2. Thanks, Rachel. You’re right – I did not read the comments. I didn’t think I could take it! But I’m glad you engaged with it.

    1. They are kind of stressful. The NYT commenters tend not to be as abusive as commenters more generally, but I can take only so many specific healthcare horror stories before jumping on the hamster wheel.😉

  3. I’m rather hoping that my military service will protect me from the “delusional Communist” tag. This is especially so in view of the fact that I was a tiny part of the reason why the West isn’t now communist!

    But it’s true– I’ve yet to hear a single complaint about the Veteran’s Administration health system. Granted this is completely unscientific, based solely on my conversations with other vets, but surely that has to mean something, especially since G.I.s are noted for b*tching about nearly everything. Auntie Shari’s dad, who spent his last days in the VA hospital here on L.I., told me that it was far and away “the best” medical facility he had ever been in.

    By the way, I just got the bill for my copay– that initial visit to the doctor set me back a staggering $15.

    1. Without the VA, I am not sure how my grandmother would have survived my grandfather’s Alzheimer’s. I know they are not perfect and especially there seems to be a problem with disability payments for new injuries (and that the disability structure has not been updated since 1946), but the actual medical care seems quite good.

  4. Yup, I’m with you! It’s astonishing to those of us who didn’t grow up with it that a difficult birth or any other medical mishap could end up making Americans bankrupt, using up all your savings, mean you’re actually not going to get health care. It blows my mind and it’s certainly not the case in the UK, New Zealand, Australia. No way is ‘not going to hospital ‘cos you can’t afford it’ best healthcare in the world!

  5. Part of my frustration with the discussion of health care in the US (and abortion) is that the different players end up being more about ideology than solutions. There is a study in St Louis, targeting women that are most likely to get abortions. What made a difference is free birth control. Not subsidized, but free. There was a very significant drop in abortions. But that free birth control is what so many are resisting as part of Obmamacare

    http://www.cbsnews.com/8301-204_162-57526550/study-free-birth-control-leads-to-way-fewer-abortions/

  6. I’m an Army wife and had my first baby last year. I had a schedule c-section since my little one was frank breech and not about to turn, even after an attempted external version (also completely covered). The price for that baby’s arrival, aside from several deployments and long days of service for my husband, was nothing. Not a dime. Everything was paid for. The maternity ward was certainly packed full though- women who gave vaginal births shared rooms, but the staff tried to phase them so they only shared a room for 12 hours at a time. This is a particularly tricky thing to do during a baby boom (that which occurs approximately 9-10 months after the Division, in this case the 101st Airborne, returns home from deployment), and yet they managed. I had professional encounters with doctors, nurses, check in staff, etc etc. I will say that I have heard MANY complaints from women about the nightmares they’ve experienced here or there, but my sense is that in a thing such as birth, or medicine in general, where people are… people… there is bound to be error, and problems. I should also mention that the care and facilities can very wildly: at one post you might see the same pediatrician for your child ever visit, while at another (as in my case currently since we’re not near a large installation), your child’s primary care doc is a PA with very little experience with children. Even then, the care is thorough, if a bit less seasoned. Anyway, just wanted to toss in my “socialized medicine” perspective since I’m happily a member of the group who gets this care.

  7. I agree! My maternity care in Scotland and Canada was very good. I haven’t had any complaints about our medical care over the last 10 years out of the US. I will say, though, that we’ve only experienced maternity care, and general check-ups and care for minor illnesses. You do hear stories of people needing to wait for doctor appointments and surgeries longer than people probably would if they had good insurance in the US. I guess we’ll see how that goes if/when we face something major.

  8. Amen to that!

    It’s strange, but I don’t recall hearing too much mention of the V.A. at the height of the ‘Obamacare’ debate. One would think that a federally funded and evidently well-run national program would have been a key element in the discussion.

    1. I snickered at your wisecrack about death panels, Rachel’s dad (yes, I knew you were joking!). From what I’ve heard about VA healthcare from relatives who have used it for years, the VA leans in the opposite direction. I wrote this at the height of the ‘Obamacare’ debate: http://livelydust.blogspot.com/2009/08/death-book-claims-vs-what-really.html . T.R. Reid in “The Healing of America” likens VA care to Britain’s NHC and Medicare to Canada’s system. Fortunately for you and for me (I go on Medicare next month), Brits and Canadians have longer life expectancy than Americans!

      1. Thanks for sharing that about your VA experience– very interesting indeed.

        In that initial meeting with the VA doctor she noted that all of my numbers were very good, whereupon I informed her of my healthy lifestyle (eat with joy!), as well as the fact that I’ve got grandparents and great-grandparents on both sides that made it well into their 90s.

        “My expectation,” I told her, “is that you guys won’t be losing much money on me!”

  9. A relevant fact for reading international reports on healthcare, watch for consistency of statistics. In this case, US healthcare usually has higher mortality rates because of reporting requirements and definition of live birth. Or put another way, many countries can tout low mortality rates because hospitals have some discretion on when and what to report and countries might define live birth very loosely.
    “In the United States, however, we count any infant exhibiting any sign of life as alive, no matter the month of gestation or the size of the fetus. In other European countries, they define the month of gestation and the size of the fetus before they count it as a live birth. For example, in France, Czech Republic, Ireland, Netherlands and Poland, the fetus must be at least 22 weeks and/or weigh 500 grams, if not, it is not a live birth and not counted as a part of the infant mortality rate. Another challenge to comparability is the practice of counting frail or premature infants who die before the normal due date as miscarriages or those who die during or immediately after childbirth as stillborn. Therefore, the quality of a country’s documentation of prenatal mortality can matter greatly to the accuracy of its infant mortality statistics. This point is reinforced by the high ratios of reported stillbirths to infant deaths in Hong Kong and Japan in the first 24 hours after birth, a pattern that is consistent with the high recorded sex ratios at birth in those countries and suggests that many female infants who die in the first 24 hours are misreported as stillbirths rather than infant deaths.”
    via http://www.standard.net/topics/opinion/2010/01/18/definition-live-birth-varies-country

    1. According to the CDC (http://www.cdc.gov/nchs/data/databriefs/db23.htm), “the U.S. infant mortality rate was still higher than for most European countries when births at less than 22 weeks of gestation were excluded.” In 2004, excluding births before 22 weeks lowered the US rate from 6.8/1000 to 5.8. Cf the rate in the countries mentioned above: France, 3.9; Czech Republic, 3.7; Northern Ireland, 4.0; Ireland, 4.6; Netherlands, 4.6; Poland, 6.8. We still have a long way to go – and there’s no getting around our dismal maternal mortality figures either. In 2010, our rate was #50 in the world.

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