My argument for reforms that would help American healthcare are detailed here:
The Myth of "Best in the World"
I wanted to also address some things that were said directly:
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And have you ever went to a VA hospital, or known someone who has dealt with them? That is what our health Care system will be like. And it sucks.
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The VHA has a history of poor performance, but it was overhauled in 1994 with a reorganization of management from centralized to regional, which lends credance to the idea that state-based healthcare with federal help may work. This was accompanied by the hiring of more primary care physicians, and shutting down extraneous acute care facilities. This shifted the emphasis to preventive care. They also developed a medical records program called VistA, and developed a drug formulary based upon available evidence with a shift towards evidence-based medicine unparalleled elsewhere in America.
Between 97 and 99, the VHA outperformed fee-for-service Medicare on 11 of 11 measures of quality and this trend has continued. With the help of VistA software, the VHA's accuracy in drug administration is 99.997%, compared to 92-97% in the rest of America. They also give recommended care 67% of the time compared to 50% in the rest of the country. Amazingly, they even spend less per person than the rest of the country, despite the fact that the population they serve has more problems with obesity, substance abuse, diabetes, etc.
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Germany, France, Canada and the UK all have higher Cancer mortality rates than the US.
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Yes, but all of those nations do better than America overall on health and have higher life expectancies. Out of industrialized nations, America is roughly in the middle of the pack on cancer mortality while it is at the bottom on other measures. Australia, Japan, Sweden, Finland, Austria, and even Cuba (which all have life expectancies equal to or better than the U.S) do better in cancer mortality.
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Why not let the free market work? It is working in some sections of health care.ABC News: Healthy Competition in Health Care
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Overall, the free market cannot work well for healthcare, and just because it can work for plastic surgery and vision correction doesn't mean it can work for the rest of it. Why?
Health is maximized when intervention-based care is a last resort and prevention is vigorously pursued. Unfortunately, invasive intervention is more profitable than preventive care, so in a market economy, health comes second to profit. And since the "demand" is set by the supplier (the doctor usually tells you what you need, not vice-versa, except in cases like plastic surgery), the market leads to ever-escalating costs.
On a related note, when about a third of Americans are uninsured or underinsured, they cannot pay for catastrophic care that results partly from our lack of preventive care. Healthcare bills are the number one reason for personal bankruptcy in America. But as a result, emergency rooms lose a lot of money, and the hospitals must make up for it elsewhere, usually in oncology or cardiology. This leads hospitals to pressure doctors to give unnecessary care, which is inefficient at best, and dangerous at worst. Due to asymmetry of knowledge between doctor and patient, the patient is usually in no position to refuse this inefficient or dangerous extra care.