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Critical Condition

NRO’s health-care blog.

Misguided Hit at U.S. Health Care



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The Commonwealth Fund has produced yet another headline-grabbing survey, this one putting the United States dead last in its ranking of seven countries’ health systems. Besides the U.S. and Canada, other countries surveyed were Australia, Germany, the Netherlands, New Zealand, and the United Kingdom.

Commonwealth takes a decidedly statist view of public policy and regularly produces studies that put the U.S. in the worst light. The bottom line of this one: Only Canada has lower-quality health care than we do; the U.S. is the most unsafe, the least efficient, the least equitable, and the worst at keeping people alive and healthy. Oh, and we spend way too much.

And, of course, Commonwealth reminds us that the U.S. placed 37th in a much larger (though largely discredited) 10-year-old survey by the World Health Organization.

So why would it be, then, that when people are sick and want the best medical care, they want to come here? The Commonwealth study didn’t discuss, for example, survival after being diagnosed with cancer, access to specialists, or investment in research to improve medical care for the entire planet, categories where we would surely be on top.

Is there an agenda here? Of course. “The comprehensive health reform legislation signed into law in the United States will undoubtedly ameliorate some of these problems,” Commonwealth writes.

Do we have problems in our health sector? Absolutely. Is Obamacare going to fix them? Absolutely not. In fact, access to timely, good-quality care and many other measures, including cost, are going to get much worse as a result of the health-overhaul law.

Here’s why the Commonwealth survey is so misleading: It’s not based on actual data about the effectiveness of care, but on “patient and primary care physician perceptions of the care they received and administered.” For proof that this study should not be used as a guide, consider this: It concludes that the U.K. was second in overall rankings, and first in efficiency and in providing effective care.

Commonwealth might want to rethink its criteria before we are hit with the full force of Obamacare. And the White House might want to rethink its choice of Dr. Don Berwick to implement Obamacare in the Medicare and Medicaid programs.

Robert Pear had an article this week in the New York Times that explains why many of us believe the selection of Dr. Don Berwick is so politically tone-deaf, especially among seniors concerned about big government blocking their access to health care. Pear writes:

Long before the uproar over “death panels” last year, Dr. Berwick was urging health care providers to “reduce the use of unwanted and ineffective medical procedures at the end of life.”

. . . In speeches and articles celebrating the 60th anniversary of Britain’s National Health Service in 2008, Dr. Berwick said he was “in love with the N.H.S.” and explained why it was “such a seductress.”

“The N.H.S. is not just a national treasure,” he wrote; “it is a global treasure.”

. . . Dr. Berwick offered a suggestion to the British: “Please don’t put your faith in market forces.”

Even a columnist with Dr. Berwick’s hometown newspaper, the Boston Globe, took direct aim:

No one can deny that America’s health care system is flawed in many ways. But when it comes to the standard that matters most — the quality of health care provided — our haphazard, expensive, insurance-based system towers above the NHS.

“In Britain 36 percent of patients have to wait more than four months for non-emergency surgery,” wrote journalist James Bartholomew in The Spectator. “In the US, a mere five percent do.”

By one metric after another — cancer survival rates, performance of diagnostic tests, availability of CT and MRI scanners, consultation with specialists — U.S. health care is superior. “British state-run health care,” Bartholomew concluded, “is so amazingly, achingly, miserably, and mortally incompetent.”

That’s the system that leaves Berwick feeling “romantic” — the system he proclaims an “example” for the United States. And Obama wants him to run Medicare and Medicaid? Let us hope 51 senators say no.

Maybe someone should also tell this to the Commonwealth Fund. Major central planning for the entire health sector isn’t working in the U.K., and it won’t work in the U.S.

Even if he is confirmed, Berwick will become the poster person for the complaints that seniors inevitably will have with the huge problems to come with Obamacare. Maybe someone at the White House should reconsider.



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