Careful--the US does more early cancer screening than is typically done in Europe. This boosts the US score on 5 year survival rates, but it doesn't necessarily mean we actually get better outcomes. E.g., if an American and a European each get a cancer that will eventually kill them in 7 years, and the American finds out in 1 year and the European doesn't find out for 3 years, then the American will show up in the 5 year survivor statistics, and the European will not.
We do gain some outcome advantage from earlier screening, in that it means we will catch some cancers early enough to treat that Europeans would miss, but the outcome differences aren't nearly as big as the 5 year survival stats lead some people to believe.
As far as seeing specialists goes, the US does do well, although I believe Germany and maybe Japan have us beat--showing that universal affordable coverage can be achieved without having to give up reasonable wait times to see specialists.
The thing that makes me sad about the US system is this. Take the top, say, 10 non-US systems. They have quite a diverse range of approaches, ranging from straight up socialized medicine to highly capitalistic market-based systems. All they have in common is that in most areas they have equal or better outcomes than the US, with universal or near universal coverage, for a lot less cost per patient or as a percent of GDP. Based on the evidence, it doesn't appear hard to design a good healthcare system for a first world country. Only the US seems to be able to botch this. WTF!?
By what measure do European countries have better health outcomes than the US? We're seeing in this thread why the most obvious metrics don't work well:
* Cancer survival rates, because of the 5 year survival heuristic, capture people who's illness is detected early but isn't actually cured.
* Life expectancy captures the fact that people drive more and faster in the US, that the US has more violent crime, and that more people in the US kill themselves
Intuitively, "high cost" plus "shortest wait time to specialist" plus "problematic overprescription" (a problem common to all first-world health systems) plus "earliest cancer detection" just doesn't add up to "worse outcomes than Europe".
But, it does make sense that despite the money we pay, our outcomes are not different enough to justify the expense.
I strongly agree: the way we finance health care in the US, primarily through a system of employer-provided health insurance policies that give way to a single-payer socialized system that kicks in right when patients are most engaged with the health care system, all without giving patients control or a stake in the cost of their care --- this system makes no sense.
We do gain some outcome advantage from earlier screening, in that it means we will catch some cancers early enough to treat that Europeans would miss, but the outcome differences aren't nearly as big as the 5 year survival stats lead some people to believe.
As far as seeing specialists goes, the US does do well, although I believe Germany and maybe Japan have us beat--showing that universal affordable coverage can be achieved without having to give up reasonable wait times to see specialists.
The thing that makes me sad about the US system is this. Take the top, say, 10 non-US systems. They have quite a diverse range of approaches, ranging from straight up socialized medicine to highly capitalistic market-based systems. All they have in common is that in most areas they have equal or better outcomes than the US, with universal or near universal coverage, for a lot less cost per patient or as a percent of GDP. Based on the evidence, it doesn't appear hard to design a good healthcare system for a first world country. Only the US seems to be able to botch this. WTF!?