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Politics : A US National Health Care System?

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To: Archie Meeties who wrote (8409)	8/19/2009 1:17:16 PM
From: TimF	3 Recommendations Read Replies (1) of 42652

Nothing ALWAYS leads to good care. That doesn't keep high responsiveness from being a good thing in gross terms. Good thing in net terms? Meaning cost effective, and good considering what we may give up to get it? Well that's a complex question and somewhat subjective, but any action that appears to greatly reduce responsiveness is going to run in to a storm of objections and protests. Still, after stripping out the WHO variables you don't like we're left with 24th in terms of just plain health! Unlike the situation with their overall rankings, I don't have their data and methodology for "just plain health" drilled down to a level that I can see why they say where 24th and make a specific detailed objection to it, but I don't consider their statement that we are 24th to be solid evidence that we really are. Also the rich countries are fairly clustered together, so 24th might not be nearly as far from 1st as you might think. So even if you do accept the WHO report its not really as bad as it might seem. Also some health factors may be put under responsiveness. Its not as if being responsive gives no health benefit to the patient, its unclear if this benefit is included under "health" or only under "responsiveness". Our ROI is complete shit I'm not sure I'd go that far, but it is lower than it could be, partially because we provide a positive externality to the rest of the world. We pay more, in doing so we get the benefits of new developments, but we don't (at least not directly) get the benefits that the rest of the world gets from the extra resources devoted to such development. And also because of the bureaucracy, extensive government regulation etc. OTOH I think "reform" is likely to increase this aspect.

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