Health Care: The U.S. versus Canada, France, Britain, Germany, and the VHA

Two on health care from Ezra Klein. The first looks at how well the U.S. stacks up against other countries:

The Health of Nations, by Ezra Klein, The American Prospect Magazine: Here's how Canada, France, Britain, Germany, and our own Veterans Health Administration manage to cover everybody at less cost and with better care than we do...

And the second, which came out after he wrote the above, is a comparison of Canada, which is "often considered a fairly mediocre system," to the U.S.:

Canada vs. America, by Ezra Klein: ...[A] new study was released today comparing care outcomes in the US and Canada. ... [O]f the 38 studies examined, 14 showed clear advantaged for Canadian patients, five suggested US care was superior, and the remainder were mixed. The studies showing the Canadian systems superiority found effects both on income -- low-income Americans with breast or prostate cancer do much worse than low-income Canadians with the same conditions -- and care effectiveness. For conditions like kidney failure or cystic fibrosis, Canadian care was simply better. You can pick through the tables with all the results here.

It's not that the data shows unbelievable advantages for Canada, to be sure. As the authors conclude, "although Canadian outcomes were more often superior to US outcomes than the reverse, neither the United States nor Canada can claim hegemony in terms of quality of medical care and the resultant patient-important outcomes." The question raised is slightly different: How can we possibly countenance a system that costs twice as much as the Canadian system but delivers slightly worse care? Even assuming diminishing returns, our expenditures should result in care outcomes at least 20% or 30% better than Canada's. Instead, they're about 5% worse, but cost around 187%. Does it sound like we're getting a good deal?