The Magazine

An Unnecessary Operation

Obamacare threatens what's right with American health care.

Sep 21, 2009, Vol. 15, No. 01 • By FRED BARNES
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This is the poll number that drives supporters of Obamacare crazy: Eighty-nine percent of Americans in a June 2008 ABC News/USA Today/Kaiser Family Foundation survey said they were satisfied with their health care. Put another way, more than 270 million Americans (I'm including kids) are reasonably happy with the system of medical care in this country. Other polls have found the same level of satisfaction.

One reason is the availability of first-rate care almost everywhere, day or night. But there's a more important reason: If you have a serious ailment, your chances of survival are better when treated in America than anywhere else in the world. Sure, the system has flaws, shortcomings, and inefficiencies. It probably costs too much. But if your goal is to live longer, then American doctors and American hospitals are your best bet.

Americans appear to understand this. So do the 400,000 foreign patients who come here every year for medical care. "Not too many people get on a plane and fly to Cuba or to France" to see a doctor, says Dr. Stanley Goldfarb, associate dean of clinical education at the University of Pennsylvania School of Medicine and an expert on worldwide health care systems.

Why would they go anywhere but here? America provides timely access--and not just for the wealthy--to the latest and most innovative technology, a full array of breakthrough drugs, and the top medical specialists. "If you have an acute illness, this is the country to get your care," Goldfarb says. "If you're not that ill, other countries are great."

Even if you're not seriously ill, American doctors have more to offer. The two most significant innovations for patient care in the past decade are magnetic resonance imaging (MRI) and computerized tomography (CT), according to Dr. Scott Atlas, chief of neuroradiology at Stanford University Medical School. The United States has 27 MRI machines per million Americans. Canada and Britain have 6 per million. The United States has 34 CT scanners per million. Canada has 12 per million, Britain 8.

And utilization of MRI and CT technology has become routine in America. My wife had an X-ray after injuring her ankle last spring and the diagnosis was she'd broken a bone. When it was slow to heal, she had an MRI, which revealed she'd actually torn a tendon. Now her ankle is healing.

Our share of the cost was minimal. Health insurance pays for tests, and you don't need a Cadillac policy to be covered. A little-known fact: Out-of-pocket expenses by American patients amounted to 12.6 percent of total national health spending ($2.24 trillion) in 2007.

That's one of the lowest percentages of private out-of-pocket spending among the world's advanced countries--lower than Germany, Japan, Canada, and most countries in Europe, including those with government-run health care systems. Why do Americans get more and pay less? Because their insurance policies provide broader coverage than most government plans, says Tom Miller of the American Enterprise Institute.

Private insurance, Medicare, and Medicaid cover most of the high cost of treating critical illnesses such as cancer and heart disease. And those are the ones in which the survival rates in the United States are significantly higher than in Europe or other countries. There are clinical data substantiating this. Two major studies (EUROCARE-4 and a study by the National Center for Epidemiology, Health Surveillance, and Promotion, in Rome, both published in the September 2007 issue of Lancet Oncology) were used to compare five-year survival rates for Americans and Europeans diagnosed with cancer.

For all cancers, 66.3 percent of American men and 63.9 percent of women survived. In Europe, 47.3 percent of men and 55.8 percent of women survived five years. Those are statistically important gaps.

And the survival rates were higher in the United States for the most common cancers as well. More than 99 percent of men with prostate cancer had survived in the United States after five years, 77.5 percent in Europe. Those with colon or rectal cancer survived at a 65.5 percent rate here and 56.2 percent in Europe. The rates for breast cancer showed a similar difference, 90.1 percent for Americans, 79 percent for Europeans.

Dr. Atlas cites a different set of results that underscore the same point: Your chances of living longer are better with treatment here. "Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom," he reports (see "Here's a Second Opinion," Hoover Digest online). "Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher."