Readers Write: Americans overpaying for inferior health system

The Island Now

I’ve been listening to a BBC podcast, Inside Health, and it is a fascinating window into a parallel universe in health care, compared to how our country manages it.

With their NHS in place, there is a whole different culture than what we’re used to. The podcast features GP Margaret McCartney, whose Glaswegian accent I find a bit hard to parse. Perhaps someone will translate it into a local Canarsie dialect for me.

 A recent show dealt with celebrities “coming forward” about their afflictions, in order to, as they say, “build awareness.”

One example was actor Stephen Fry, who went public about his prostate cancer. What it led to was the NHS becoming immediately overwhelmed with a surge in referrals for testing.

Because of that, treatment rates actually went down. And the reason is, oftentimes all these “awareness building” exercises do is scare the hell out of everyone.

 What was also of interest was that sometimes the value of the testing is suspect.

For prostate cancer, Dr. McCartney noted that autopsies show 40 percent of men over 60, and 60 percent of men over 80 will die with the disease. But they didn’t die from it.

While a PSA test is certainly advisable, by itself, it can’t tell you if the protein is “indolent” or aggressive, and men need to have better information about their choices before flying into a panic.

Dr. McCartney noted the same phenomenon when singer Kylie Minogue went public with her breast cancer. The NHS was swamped with a surge for testing, but then as now, there was no increase in the detection rate.

So while NHS chiefs congratulated Mr. Fry for his “courage” in disclosing his surgery, Dr. McCartney had her doubts as to whether this was of any genuine benefit to the public. And she hit on something that separates a national health system from a for-profit one.

And it explains why Americans are preposterously overmedicated, overtested, and completely obsessed with funding for cures.

 In America, we’re told a patient can “beat” cancer by simply yelling at it, or in some commercials, belittling it. Every “battle” against it is “courageous” and can be “fought,” as if invoking a string of brave metaphors could change patient outcomes.

This takes odd forms politically. Some years ago, it appeared that the incidence of breast cancer was higher here than in other parts of the country.

Statistically, that’s not really true, but Long Islanders are made to live in constant fear of breast cancer, and mammogram trucks offering tests roam the Counties. But the incidence rate is barely different than in other parts of the country.

 These podcasts demonstrate a different way of thinking, liberated from the obsession of American “practice management” and the profession’s endless need for promotion, self-enrichment and self-glorification. And the result is it costs them far less, and they get better outcomes than we do.

Recently, the pharmaceutical company AbbVie was able to arbitrage our country’s patent laws into keeping the price of its Humira product at stratospheric prices.

Americans will pay an estimated $4.4 billion more for the anti-inflammatory than they would be in any other OECD nation. That’s for one drug. We’re told we can’t afford a national health care system like every other industrialized nation. I disagree.

We can’t afford not to. And if we did, the health insurance cost inputs removed from the production of goods and civil service payrolls would liberate the American economy and its taxpayers. Markets do a very poor job of allocating health care, and aside from that, it’s not even a “market,” insofar as the industry itself allows it to be.  

Only an American can be paper trained to think that handing over $12,000 a year to an insurance provider is superior to paying a fraction of that for better care in a nationally structured system.

Long Islanders are unquestioningly convinced their school system must be superior to all others because of the funding they lavish on it, when the main reason for their outsized tax bill is merely the cost of employee benefits paid out.

There’s a good reason we’re the only outlier when it comes to health care. It has nothing to do with any controversy regarding “socialized medicine.”

We do it the way we do because it makes it easier for the entire health delivery system, and those who exploit it for their own comfort, to exploit us. And that’s the whole game here. Pity so many Americans willfully succumb to playing it.

Donald Davret 


Share this Article