September 14, 2007

Does universal health insurance automatically equal better cancer care? In the Wall Street Journal today, Betsy McCaughey argues that it doesn't. McCaughey notes that while the U.S. doesn't have universal health insurance, it still leads the world in cancer survival rates.

Last month, the largest ever international survey of cancer survival rates showed that in the U.S., women have a 63% chance of living at least five years after diagnosis, and men have a 66% chance -- the highest survival rates in the world. These figures reflect the care available to all Americans, not just those with private health coverage. In Great Britain, which has had a government-run universal health-care system for half a century, the figures were 53% for women and 45% for men, near the bottom of the 23 countries surveyed.

A 2006 study in the journal Respiratory Medicine showed that lung cancer patients in the U.S. have the best chance of surviving five years -- about 16%. Patients in Austria and France fare almost as well, and patients in the United Kingdom do much worse with only 5% living five years. A report released in May from the Commonwealth Fund showed that women in the U.S. are more likely to get a PAP test every two years than women in Australia, Canada, New Zealand and the U.K., where health insurance is guaranteed by the government. In the U.S. 85% of women ages 25-64 have regular PAP smears, compared with 58% in the U.K.

Critics argue that universal health insurance would mean that more Americans would get routine preventative care that would help reduce cancer mortality. But it is more likely that efforts to ration expensive diagnostics and drugs would leave many cancer patients worse, not better off under a universal health care program.

It is also difficult to compare the U.S. to small, high performing countries like Austria or Sweden, which are less economically and racially diverse, and thus present a different disease mix.

All told, the U.S. does extraordinarily well in cancer care, and while we should work to make health insurance more affordable and accessible, we shouldn't move to any system that jeopardizes the U.S.'s commitment to cancer innovation.

Posted by Paul Howard at September 14, 2007 11:34 AM

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