Reader Response – (Not) the best health care system in the world.

A reader writes:

We Canadians like to brag about our health care system but we often forget that while we look good compared to the US, compared to the rest of the world we’re not quite so good.  The chart on your June 23 post seems to confirm that, with Canada placing last (7th) in several categories including timeliness of care, effective care, and quality care (overall.)  Even in most of the other categories we place well down the list with lots of 5’s and 6’s, including a 6th place standing for Overall Ranking.

Yet on Long, Healthy, Productive lives (which I would argue is truly the best metric) we place 2nd!  Given our dismal performance in so many of the other categories, this seems particularly out of place.  Can you shed some light on this apparent contradiction?

(Don’t get me wrong, I’m quite happy with my health care.  I’m just very confused by the chart.)

Lots of good stuff in here.  The simplest explanation is that “long, healthy, productive lives” are due to much more than just the health care system.  I can think of any number of public (or private) things that could improve this metric that have nothing to do with the health care system.

This illustrates a larger point.  We shouldn’t focus on any one metric to measure anything.  It’s very easy to cherry pick one statistic and then claim victory.  For instance, I bet we do more pancreas transplants in the United States than anywhere else in the world.  If we use that as the only metric, then we can hold a parade today; we’re number one!  Similarly, if you use only “long, healthy, productive lives”, then Canada is number 2.  Go celebrate.

This is why whenever you hear me talk about the quality of the US health care system, I rattle of a host of different metrics.  You can’t pick any one.  They are all flawed in some way.  But, when together they paint a pretty consistent picture (as they do in the chart I posted), you have to start believing that picture is true.  To quote myself about the US:

Last in efficiency.  Last in equity.  Last in long, healthy, productive lives.  Last overall.

Next to last in quality care.  Tied for last in access.

So I repeat.  Tell me where the good news is in there.

Here’s another point that’s often overlooked.  It’s not by chance that people who want to demonize health care reform in the US always pick on Canada.  It’s because you’re not the best in the world, either.  You’re #6 to our #7 in this case.  If they want to look for someone to pick on, they are certainly not going to turn to #1 or #2.

This isn’t to say your system isn’t better than ours in many respects.  It’s just got room for improvement, too.

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