That’s the title of a study published by The Journal of the American Medical Association. The study attempted to determine whether the "considerably greater" US health expenditure of US$5274 per capita vs the UK percapita expenditure of US$ 2164 resulted in a better health outcome for Americans.
Not even slightly surprisingly it doesn’t. It’s bad, shockingly bad. How Bad? This bad:
The top of your American society is as unhealthy as the bottom of their British one.
The United State has a considerably greater expenditure on medical care (US $5274 per capita) than in the United Kingdom (US $2164 adjusting for purchasing power). To determine whether that expenditure translates into better health outcomes for the adult US population, data on the degree of morbidity in each country beyond the childhood years are needed.
Given the strong link between socioeconomic position and health in both countries, cross-country comparisons of morbidity should examine variation of morbidity according to comparable measures of socioeconomic position. Cross-country comparison of social differences in illness provides some insight into potential causal explanations. Access to health care is a particular case in point. Although publicly funded health care is available in both countries to citizens older than 65 years, the UK National Health Service has no age criterion for eligibility. Thus, British households are more isolated from any financial impacts of out-of-pocket medical expenses. A similar argument applies to earnings and job losses, for which the more generous UK income maintenance system should mitigate any effects of health changes on income and wealth there compared with what is available in the United States.
[snip]
US residents are much less healthy than their English counterparts and these differences exist at all points of the SES distribution … The US population in late middle age is less healthy than the equivalent British population for diabetes, hypertension, heart disease, myocardial infarction, stroke, lung disease, and cancer … These differences are not solely driven by the bottom of the SES distribution. In many diseases, the top of the SES distribution is less healthy in the United States as well.
[snip]
Oh but please don’t stop there it gets better …
With the sole exception of cancer, there exists a sharp negative gradient across both education and income groups in both countries … As a result, country differences are larger and tend to be more statistically different at the bottom of the social hierarchy than at the top. Level differences between countries are sufficiently large that individuals in the top of the education and income strata in the United States have comparable rates of diabetes and heart disease as those in the bottom of the income and education strata in England."
There’s lot more very useful ammunition for the discerning firepup where that came from …
Source: Disease and Disadvantage in the United States and in England [PDF] published 2006 The Journal of the American Medical Association.
The thing that leaps out from the pages of the study isn’t just that the desperately underfunded and understaffed NHS outperforms the American health sector on most health outcomes although that is made eminently clear. No, what leaps from the pages is the way in which the American system betrays the overwhelming majority of the American population in the interests of making profits. The ever increasingly bizarre campaign to persuade Americans to keep their current rates of death, misery, and despair is being waged by a pack of parasites interested in one thing and one thing only. Money.
A health system that puts profit before patients as the current private enterprise system in the US does is not in fact a health system — it’s economic sociopathy gone berserk.
markfromireland



51 Comments




Easy summary for you to batter the hard of comprehension with:
Your current top social health outcome is the same as the British NHS bottom social health outcome and costs more than twice as much.
NAMJA study found via Fabian Society.
mfi
Money quotes to blow some GOPer minds:)
http://seminal.firedoglake.com/diary/6726
The GOP Racists (and these days the entire GOP is racist) assume that they don’t need healthcare because they are fine and the money will only be used to help African Americans and not them.
However fine is a relative term I wonder what American life span numbers would look like compared to England divided by race?
After all without Asians and Hispanics the lifespan numbers for America would be much lower.
GOPers complain about the wait for healthcare compared to England but I will gladly wait to live longer. I will gladly to save money.
$5, 274 – $2,164 = $ 3,110 more money than I have ever used as a down payment on a car in my life and thats just yearly savings!
Imagine the boost to our economy in ten years from all that savings all that cash wasted when it could be put back into the economy!
This is where we need some economists to expand on the ideas:)
Thanks for this post. That is an interesting article.
A health system that puts profit before patients as the current private enterprise system in the US does is not in fact a health system — it’s economic sociopathy gone berserk.
Amen, amen!
Your current top social health outcome is the same as the British NHS bottom social health outcome and costs more than twice as much.
brilliant summary!
Blessings and thanks,
You’re welcome. Hopefully somebody will take this up and run with it.
That the results for the richest in the US are only as good as the results for the poorest in the UK really is remarkable. The entire article provides lots of ammunition. I hope it gets picked up and run with.
Yeah it should be front paged.
The richest in the U.S have healthcare results only as good as the poorest in the UK Lots of GOPers heads should explode over that fact if that is not a sign of an empire in decline I’m not sure what is.
Americans are also nolonger the tallest I heard recently too I’ll have to search for that link. Height, Lifespan remove the Hispanics and African Americans I wonder what the birth rate would be.
one could say the insurance CABAL/
MOB are killing us slowly
Along with the mass produced food industry and the major polluters.
Outstanding post, mfi. Recommended. This needs to be front paged.
MarkfromIreland, thanks for this.
Great stuff Mark, thanks SO much for sharing this.
As was said above, this is money quote fodder to counter teh stoopids IF one found oneself in a POLITE sitch to discuss same.
Again, thanks, great stuff.
And rec’d by me, too, and concur, this just HAS to be main page, and forwarded to every blog anyone knows of. And to media everywhere, whether they use it or not . . . . this should go viral. It’s THAT good.
It’s not often that such perfect ammunition comes to hand, there’s lots of good stuff in the study. I hope people do take it and run with it. Health care is such a basic right….
All that, and the anti-reform folks keep pushing the “NHS is bad” line of cr*p.
mark, everyone I’ve heard talk about health-care systems who lives outside the US makes it clear that the US ’system’ (it’s more of a patched-together mess) is little better than third world in many ways.
We need to go to single payer.
Great story by Mark–
There are, of course, yearly savings granted by Universality….
But there are also yearly ‘End Of Life’ Doctor-assisted ‘Panel’ add-ons as well.
Like this one, which is the story of my Grandma’s 15 extra years granted to her BECAUSE of Canada’s Universal system.
.
PBS’s Newshour had a segment yesterday where they talked about the British NHS official going around on Fox News discrediting their system on the other side of the pond. In the segment the head of their Conservative Party David Cameron disowned him. Pretty good stuff.
http://www.pbs.org/newshour/vi…..1s2ecdqb0e
Of course we’re not acknowledging the downside of Britain’s healthcare system: the undeserving are getting healthcare. This is why America has so much more excellence than Britain.
/snark
We won’t have to worry about fixing health care, Glenn Beck has a brilliant plan. Watch this clip to see just how big of an idiot this man is.
http://progressnotcongress/?p=2545
One of the details in the report that is interesting is the test results showing higher – much higher – rates of C-reactive protein and fibrinogen (precursor inflammatory markers for heart disease and heart attacks) for the US than for UK. The question is: What is causing this? Is it the tendency in the US to use high fructose corn syrup (and other corn derived sweeteners such as maltose syrup)in everything?
great post! bang-on!
Greg Palast has a piece up about Obama’s sellout to those very profitable corporations who are absorbing all that money America spends on healthcare:
http://www.gregpalast.com/obam…..#more-2664
pullquote:
We’re all cornfed inbred’s??
We all should be pushing to abolish the exemption the health insurance industry has from the Sherman Act.
Thanks for the post. I skimmed the AMA doc and found at the end this quote:
To correct the evils, great and small, which spring from
want of sympathy and from positive enmity among
strangers, as nations or as individuals, is one of the
highest functions of civilizations.
—Abraham Lincoln (1809-1865)
Is not this what we are about in trying to overcome Republcan opposition to health care reform? Our inability as a country to tackle and solve the problems delivering decent health care to our citizens over the years belies our self proclaimed greatness, and even civility. IMHO
It’s only mildly ironic that the protester’s are just exposing this for everyone to see. Given how we’ve dropped in overall world opinion in the last 8 years, it’s no wonder everyone in Europe thinks we’re the crazy ones. Not that anyone else’s opinion ever changed their minds.
Book Salon up at the Mothership with Manufacturing a Better Future for America hosted by emptywheel.
Amazing numbers.
I’ve direct experience of the Irish system, the UK’s NHS, the French system, and the Danish system. I’d agree with you about the US being a patched together mess. Parts of it work very well indeed – if you’re very rich. That mix of private splendour and public squalor is, in my experience, very typical of the third world.
Or the generally lower food quality?? Or the generally higher stress levels????
I find myself wondering what will happen when the American economy can no longer fund itself by borrowing from the Chinese.
I think what you’re up against is the idea that “greed is good” carried into actions.
It’s that the figures are so clear and so stark – it’s also handy that the study dates from before the current controversy.
The priority expressed by our health care industry is not unusual. It’s just one industry that shares the priorities of its corporate brethren – banks, auto companies, insurers, big oil and big ag. You name it.
What’s unusual is that corporate America and the Republican Party have persuaded a hundred million Americans that that’s not so. As they say, the devil’s greatest trick was convincing us she doesn’t exist.
Couldn’t agree with you more. Once the financialisation of an activity – any activity is complete then watch out.
you saw what happened to Iceland?
something like that.
yikes!
Isn’t the per capita figure of ~$5000 deflated by the fact that $40 million plus have no health insurance, even if we were to take into account emergency room visits.
Yes indeed, something very like that. The difference being that they’re small enough for it to be possible to bail them out.
The figures are adjusted for purchasing power.
It’s gone 1 a.m. here so time for me to get some sleep. I’ll pop back in the morning until then ….
g’nite folks.
What Mark said on statistical methodology I am not an expert I have heard of no challenges to the numbers though.
Remember every American has the right to have emergency room care which is more expensive
after all you the patient wait until the pain is so great you don’t care about the bill and by then the problem is much worse. Think of it as a leaky roof if you put off repairs until every room in the house has a leak then all the wood in the roof is likely rotted and has to be replaced.
Also Emergency Room care is not free they will try and bill you if they can which further encourages people who are poor but not to poor to pay to avoid going to the doctor. Because while they can pay 6 months or longer of eating beans and rice and not going out at all is a little much so they wait until they can’t take it anymore.
We need to point out that top earners like Rush Limbaugh, Glen Beck etc despite all their money live less than poor people in England we need to set up and ambush question for them where they don’t control the camera (no fox news questions).
We need someplace Neutral CNN maybe and a CNN host willing to say when Glen and Rush lie and deny the facts say we have the numbers right here the study has been out since 2006 no questions have been raised about the methodology used to find these numbers!
Is there anyone at CNN or who can do that? I don’t see Rush or Glen going on PBS or MSNBC. They might go on the View though Rush does have to do something about his negative numbers with women.
We need to ask GOP Senators House members and the Blue dogs the question do you like living in a country where the richest people like yourselves only live as long as the poorest people in England?
I want their expressions on Camera? If they lie and deny it or plead ignorance to the facts Ha! trap Question!
Just how can you ( insert name) oppose Obama’s healthcare bill when you don’t know the facts sir?
Tell me does a Healthcare lobbyists do all your reading on all the issues and bills that come your way? Does he tell you how to vote? How can you trust a paid lobbyist to give you honest information?
Your Voters back home elected you NOT A FREAKIN LOBBYIST to read up on the issues and yes to READ THE BILLS YOU SIGN that is what you get a paycheck for and government healthcare! If I don’t do my job I don’t get paid if someone else does my job they get paid as soon as the boss finds out But Congress Nooo they are Entitled!
If you are unaware of the other sides arguments how can you know that your own arguments are true? Your job is to know the truth and vote for what is best.
If you start from the JAMA abstract of that article you can find all sorts of links to followup and citing letters and papers (most wanting payment for access though abstracts or extracts are free.)
Here is one I found and part of its abstract:
Health Disadvantage in US Adults Aged 50 to 74 Years: A Comparison of the Health of Rich and Poor Americans With That of Europeans
Methods. Representative samples of adults aged 50 to 74 years were interviewed in 2004 in 10 European countries (n = 17 481), England (n = 6527), and the United States (n = 9940). We calculated prevalence rates of 6 chronic diseases and functional limitations.
Results. American adults reported worse health than did English or European adults. Eighteen percent of Americans reported heart disease, compared with 12% of English and 11% of Europeans. At all wealth levels, Americans were less healthy than were Europeans, but differences were more marked among the poor. Health disparities by wealth were significantly smaller in Europe than in the United States and England. Odds ratios of heart disease in a comparison of the top and bottom wealth tertiles were 1.94 (95% confidence interval [CI] = 1.69, 2.24) in the United States, 2.13 (95% CI = 1.73, 2.62) in England, and 1.38 (95% CI = 1.23, 1.56) in Europe. Smoking, obesity, physical activity levels, and alcohol consumption explained a fraction of health variations.
Conclusions. American adults are less healthy than Europeans at all wealth levels. The poorest Americans experience the greatest disadvantage relative to Europeans.
So. Americans are worse off than the English who are worse off than Europeans in the 10 selected continental countries.
I haven’t read the comments, but I suspect that some of them mention life styles as being important in health along with medical care. That is true enough, but consider this. The UK has the highest rates of obesity in Europe and is fast approaching that of the US, so the difference in life style isn’t all that much. In addition, I suspect that they probably drink a lot more than we do, which some may argue is a positive factor reducing their health problems.
Yes, the UK is at the bottom of the heap in Europe for health Moreover the NHS is considered to be at the bottom of the heap in terms of quality and coverage when compared with the systems in the top 10 European countries.
Very true.
Can’t comment one way or another on their comparative drinking habits with the US. I do remember reading that the levels of public drunkeness are higher than on the continent, but can’t remember where I read it.
The brouhaha in the States has led to a spate of coverage in the UK of US health system problems The Independent had this on Saturday for example:
The brutal truth about America’s healthcare – Americas, World – The Independent:
The article has a list of links to related coverage.
’Related articles
Leading article: The healthcare debate comes back across the Atlantic Christina Patterson: The big problem with the NHS isn’t funding
Rupert Cornwell: America needs to cool down
Second MEP defies Cameron with NHS attack
Stephen Foley: ObamaCare is bad news for Big Pharma
Not so
This survey was based on information obtained in a 2002 study.
As UK approaches us in obesity and unhealthy life style, it
will take a while for the results and data to catch up.
If you gained 20 lbs today, it would be several years from now
before you would see the results.
the results of the study are after adjustment for differint prevlance of major health risks. A quote from the methods section of the study:
“age-specific disease prevalence of diabetes, hypertension, all heart disease, myocardial infarction, stroke, lung disease, and cancer in both countries is modeled as a function of
the 3 education and income indicators,
sex,
and indicators for
smoking,
alcohol consumption,
overweight,
and obesity”
(age, race and ethnicity were implicitly controlled for by their selection of matched white non-Hispanic populations)
The study used data on UK and US individuals, so the adjustments for these factors were done on an individual basis.
The real potential weakness of the study is that prevalence of these conditions are involved in constructing the outcome measures. As comments to JAMA indicate, the results could be misleading if prevalence was lower in the UK because they killed off their population with chronic disease more quickly. That is the major potential flaw not addressed in the article. That is unlikely to be the case, however, since there is no evidence that, overall, the UK has higher mortality rates by major classes of disease. It has higher mortality rates for some cancers, but lower for diabetes and other non-malignant chronic conditions.
The idea that the US has uniquely bad health risks can explain the differences in outcomes is unlikely. One can look up measures of health risks in both countries. For 2002
prevalence of smoking:
women: 25% UK, 17% US
men: 27% UK, 21% US
alcohol ocnsumption: 11 liters/capita UK, 8 US
obesity: 23% UK, 30% US
So which is ‘better’?
The obesity rate in the UK in 2002 is almost exactly what it was in the US ten years earlier (1991). If the initial rise in obesity in the US, starting in the late seventies was the unique driving cause of of the stagnation in US life expectancies from around 1980 to the late 1990s, why did not a similar rise in the UK (lagged ten years) produce a similar stagnation in their life expectancies?
The issue of health risks is not relevant for this article, unless you want to hypothesize some poorly measured factor, suchs a poorer diet, or lack of excersize (both of which are possibilities).