[lmm]

Because every comparable country that has a government-run healthcare system has somehow ends up with it being ~twice as efficient. I get that there's theory that says a private healthcare system should be better at keeping costs under control, but it's not borne out by the evidence.

[yes_really]

"~twice as efficient" is a stretch. They might cost half the price, but they are not necessarily twice as efficient.

Medical treatments and equipments in the US are the best in the world (discounting super small countries). Americans have the highest life expectancy in the world (discounting homicides and transit deaths). Americans can get treatments fast while people in Canada or the UK have to wait for months because the government is rationing treatments.

And we should consider other reasons that explain the costs besides "private system inefficiency": American companies carry the world on medical innovation (so other countries are benefitting from the Free-Rider Problem, and Americans are paying for it). American regulation requires doctors to spend several more years in training than at other countries (in other countries the medical school is usually merged with undergrad). And, finally, Americans just earn more than people in other countries. GDP per capita is 60k in the US, 40k in other developed countries.

[arcticbull]

> Medical treatments and equipments in the US are the best in the world (discounting super small countries).

Not really. They're fine. In line with OECD. And further, America has a number of blemishes such as among the highest maternal mortality and infant rate in the entire OECD. [1]

  ...the U.S. ranks 33 out of 36 Organization of Economic Cooperation and Development (OECD) nations. In 2018, while infant mortality reached an all-time low in the U.S., at 5.9 infant deaths per 1,000 live births, still more than 21,000 infants died. Compared to countries with a similar GDP, the U.S. infant mortality rate is much higher. France and the U.K., for example, have 3.8 deaths per 1,000 live births.

The only area the US really excels is in cancer 5-year survival rates - not because the mortality rate is lower, however, it's about the same as everywhere else. The US just biases towards earlier screenings that do not extend life or reduce mortality.

> Americans have the highest life expectancy in the world (discounting homicides and transit deaths).

Are you sure about that? It doesn't look like that on this chart. [2] Not to mention the US spends dramatically more to achieve that much lower life expectancy than anyone else does.

> Americans can get treatments fast while people in Canada or the UK have to wait for months because the government is rationing treatments.

This is a straight-up lie peddled by the US medical insurance industry. Here's an admission and an apology by a Cigna executive tasked with doing so. [3]

  "Our industry PR and lobbying group, AHIP, supplied my colleagues and me with cherry-picked data and anecdotes to make people think Canadians wait endlessly for their care. It's a lie. And I'll always regret the disservice I did to folks on both sides of the border."

They pulled the same thing when Canada instituted single-payer healthcare in 1962. [4]

> American companies carry the world on medical innovation.

Not really. There are as many European as there are American medical companies in the top R&D spenders worldwide. That's before we factor in government expenditures worldwide.

> And, finally, Americans just earn more than people in other countries. GDP per capita is 60k in the US, 40k in other developed countries.

Now imagine what they could do with an extra $5K per person per year - the difference between what the US and Canadian medical systems cost per capita.

[1] https://www.forbes.com/sites/joshuacohen/2021/08/01/us-mater...

[2] https://ourworldindata.org/grapher/life-expectancy-vs-health...

[3] https://www.npr.org/2020/06/27/884307565/after-pushing-lies-...

[4] https://canadiandimension.com/articles/view/the-birth-of-med...

[yes_really]

The infant mortality rate is based on extremely misleading statistics.

In the US, if a baby is born who can be saved but isn't, their death is reported in the neonatal mortality statistics. But in other countries it is more common for babies in these situations to be counted as miscarriages or stillbirths.

In the US, very low birth weight infants are considered to be alive (because, of course, they are), but in Canada, Germany, Australia, and other countries, a premature baby weighting less than 500g is considered to be already dead, even if it is breathing and has a heartbeat. So they don't have to add it to their infant mortality statistics when their healthcare system fails to save its life.

In fact, since the year 2000, of the 52 surviving babies who were born weighting less than 400g, 42 were born and saved in the US.

Sources:

- https://youtu.be/KEHM3EHUTew?list=PLWu1-TbpoIFJZga03X-Wzf1UH...

- https://www.healthsystemtracker.org/chart-collection/infant-...

- https://www.forbes.com/sites/physiciansfoundation/2016/04/12...

[arcticbull]

The 4th worst maternal mortality rate in the entire OECD too. That would be the mother dying during childbirth. [1] More than double Canada in 2018 and 10X New Zealand. [2] Without getting into your data re: infants (because I do not know enough to do so), I suspect this one's not as easy to hand-wave.

The results of the study carried out in [2] say:

  The U.S. has a relative undersupply of maternity care providers, especially midwives, and lacks comprehensive postpartum supports.

American healthcare is acceptable if you can afford it and a death sentence if you can't.

[1] https://www.npr.org/series/543928389/lost-mothers

[2] https://www.commonwealthfund.org/publications/issue-briefs/2...