If I can cut through the static it appears you're saying that the US system overservices and the NHS (I'm not British) is :
- Overloaded, to its own detriment
and
- Conservative about treatment and therefore dependent on the US/Japan for medical advances.
Perhaps you're right on both counts. I have no idea.
But .. how does it relate to this report?
OB
The report measured Care Process, Access, Administrative Efficiency, Equity, and Health Care Outcomes.
A system with excessive procedures and safeguards will by nature have:
1.More bureaucratic hassles, thus decreased Administrative Efficiency.
2. Will extend hospital stays and various departmentments visited during an admission, limiting Access to others for those beds or services.
3. More procedures means more chance for adverse events, thus impacting health care outcomes.
The US system is profit driven, privatised by nature, so of course equity will be strained. Procedures will be determined by the market.
Care process is a weird variable. I do not know how they determine it. It seems a mix of clinical outcomes, screening and patient satisfaction, so has a lot of overlap with the others.
Regardless, my point is that the US system has serious flaws, but these are inherently those of their medical model. The state-run health care systems also have serious flaws, but more profit-driven systems prop them up to a lesser or greater extent. It is a mixed bag, there is no really acceptable medical system.
Poor countries stress preventative medicine - trying to stop illness before their expensive consequences arise. They thus stress breast-feeding initiatives, immunisations, lifestyle modification in chronic illnesses like Diabetes or Hypertension, etc. This is cost effective, but fairly ineffectual as it requires people to take responsibility for their own health. The US seems to also employ preventative medicine in a much more systematic manner than the others, based on that report, with better mammography screening and so forth. This is then offset by excessive interventions later, but negative outcomes that are prevented before admission, seldom end up in medical statistics. The US life expectancy is not that far off those of these other countries, especcially when we take the US deleterious diet and obesity epidemic into account.
The US system, as it is propped up by money, is also far more robust, than the fragile state-run services - dependant on the vagaries of state expenditure.
One must keep a nuanced understanding. Both systems of health care have strengths and weaknesses, that are often complementary to one another. Government systems try and cut waste, so invest in studies of the effect of minimal intervention. To take an example, in Orthopaedics, the US operates excessively, trying to correct angulation of fractures that would be deemed acceptable elsewhere. By doing so, they created better systems of locking screws and often outcomes than was deemed possible. On the other hand, this knowledge came from more invasive and quantifiably more operations than other countries' would have performed. This then acts as a feedback to both, based on medical literature, with the US exhuberence being reined in over time and the others' reticence being overcome somewhat.
The lack of full medical coverage in the US is a bit of a worrying matter, though, but often State run systems get overutilised and have constant money woes - such as the UK's NHS. More patients strengthen the US system by pumping money into it, but it merely weakens the state-run ones in the long run. Unfortunately, the world population seems to be climbing and populations are ageing rapidly, which is already making state-run systems struggle - as even Medicaid and Medicare is in the US. Either we need massive public investment in health care, which I don't expect nor think affordable quite frankly, or some mixed public/private system is required.
