[medearis]

Infant mortality rates are not a fair metric for comparison because the point of viability is significantly earlier in the US that in most other countries in the world. When adjusted, US infant mortality rates are some of the best in the world. The US is also one of the best in terms of experimental treatments, emergency room care, cutting edge surgery techniques and specialty care for diseases such as cancer. The downside is that care is generally more costly in the US, but there is a reason why the wealthy individuals in many other countries come to the US when they need heart surgery etc. The challenge of reform will by to preserve the really innovative and successful aspects of the US health care system, while expanding coverage affordably.

[patio11]

Infant mortality rates are not a fair metric for comparison because the point of viability is significantly earlier in the US that in most other countries in the world.

People may not know what this means so I'll spell it out for you: a baby born three months premature to a drug-addled mother is very unlikely to survive. In the U.S., that baby will be treated and damn the cost. In most other countries, that baby will be scored as a miscarriage (i.e. not the hospital's fault) if it dies. It receives care accordingly.

You know the saying "We only improve what we measure?" Many countries do not measure the healthcare of severely premature infants.

This is a good thing to keep in mind the next time you hear about "rationing", because this difference is the rationing that dare not speak its name. After all, if they're not acknowledged to be human quite yet, then if you withhold care to them it isn't rationing.

[david927]

While that's a very interesting point, and I haven't heard it before so I'll look it up, my main point remains. Because of socialized health care, other countries can focus on prevention, which is much cheaper and effective then dumping money and effort at the point of crisis.

A quick anecdote: my friend and I here were laughing because in both cases our pregnant wives went to the doctor about a small concern and were put in the hospital for a week for testing. But I thought about it later, and that wouldn't happen in America. You're churned out as fast as possible. The great side effect, and I think you'll see this on infant mortality rates as well, despite what you've said, is that if health care is free, people use it earlier than the crisis point. And that's cheaper and better for everyone.

[DanielBMarkham]

Prevention does not save money.

Or rather, it saves money for the individual who has something worthy of being prevented. For that person, it's much easier to find something and/or prevent it early rather than wait until it gets serious. This is why prevention seems like such a common sense thing.

For society at large, however, testing and servicing all of the other people -- the people who never will get the thing you're trying to prevent -- ends up spending more than the treating person who got it later.

It's one of those things that sounds good when you say it, but the statistics don't back it up.

[david927]

That's a horribly spurious statement. What statistics? What the hell kind of statistics can you have that would back up something like that? 1) It depends on how you do the prevention, and how you handle the event itself. 2) A lot of people would probably die without preventative measures, making it very cheap indeed. 3) What is the point of medicine if we afraid it's going to cost more? Medicine is about preventing.

But it's not more expensive. Most European countries spend much less on health care, but much more on prevention. It's very effective, and at the end of the day, it's really what medicine is about.

[DanielBMarkham]

Here's an article written before the current debate

http://www.medscape.com/viewarticle/540199

...After all the consequences are accounted for, very few services of any kind save more money than the cost incurred. Childhood vaccines are among the rare examples that actually are cost-saving...

Of course, there's more to universal health care than just saving money. Once you politicize it, it's more about doing and saying things to keep those votes coming in.