On quality of care, U.S. is not always best

Sep 25 2009

The Washington Post interviewed Sen. Kent Conrad, D-N.D., about other developed nations' health care systems: "We won't adopt the German system or French system or anything of the like. But I think we can get clues on the fundamental differences of various systems," he said. Conrad added that the system that has "largely been adopted in France, Germany, Japan, Belgium and Switzerland, is not government-run. That doesn't mean there's no government involvement. But it's not a government-run system. They have largely private insurance, with employers contributing. The big difference between those systems and ours is that private insurance is not-for-profit insurance. ...The major role for government is to help people who can't afford coverage on their own. That's the proper role" (Klein, 9/24).

Kaiser Health News interviewed Dr. Robert Ouellet, the immediate past president of the Canadian Medical Association, who "recently participated in a fact-finding mission to five European countries to learn ways to improve the Canadian system. What he found, he said, could also offer lessons for the United States." He also defended the Canadian system: "[P]eople are not dying on the streets in Canada. I think there is a lot of exaggeration in what we have seen in the ads in the United States about the Canadian system. We have a problem of access and we want to fix that, that's for sure. We're not denying patients care because they don't have money. We have good quality. Many doctors, I am one of them, went to the United States for training. So it's not fair to say our system is so bad. That's not true" (Villegas, 9/25).

KHN also reports on a study that concluded the quality of U.S. health care does not stand out when compared to other developed countries. "The study, which was conducted by Elizabeth Docteur and Robert Berenson and released in August by the Urban Institute, compared U.S. treatment outcomes and other quality indicators with that of at least 30 developed countries, including Australia, France and the United Kingdom. ... They did find that the U.S. had high scores in some specific treatment areas, such as cancer care. However, it didn't do as well when compared to other nations at handling preventive care or treatment for acute conditions, including heart disease and hip fractures"  (Schiff, 9/25).

Meanwhile, Puerto Ricans -- who are U.S. citizens -- are wondering how health reform might affect them. "The national health care reform pushed by President Barack Obama seeks to provide coverage for every American citizen, but millions of people in Puerto Rico may be excluded from key aspects of the plan," Reuters/Yahoo reports. "With Obama having pledged to provide equal treatment for U.S. territories in federal programs, the commonwealth's political leaders see the push for comprehensive health care reform as an opportunity to overturn spending caps and other regulations that have resulted in what they see as decades of discriminatory treatment in federal programs. There are growing doubts, however, about what benefits some 4.5 million residents of Puerto Rico and other U.S. territories would see under the healthcare reform legislation that emerges from a divided Congress" (9/24).

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