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Commentary

Poor U.S. Scores in Health Care Don't Measure Nobels and Innovation
The New York Times, 10-5-06

While America's health care system may seem worse off than state–funded systems in Europe and Canada based on the U.S.'s higher costs and some public health measurements, Cowen warns that the reality is far more complicated because the U.S. leads the world in medical innovation, in effect underwriting global health gains.

Compared with Europe, the American system involves more tests, more procedures and more visits with specialists. Sick people receive more momentary comforts and also the sense that everything possible has been done. This feeling is of value to the family even when the patient does not improve. In contrast, European countries have not created comparably high expectations about the medical process. If we count "giving people what they would want, if they knew it was there" as one measure of medical value, the American system looks better.

American health care has many problems. Health insurance is linked too tightly to employment, and too many people cannot afford insurance. Insurance companies put too much energy into avoiding payments. Personal medical records are kept on paper rather than in accessible electronic fashion. Emergency rooms are not always well suited to serve as last–resort health care for the poor. Most fundamentally, the lack of good measures of health care quality makes it hard to identify and eliminate waste.

These problems should be addressed, but it would be hasty to conclude that the United States should move closer to European health care institutions. The American health care system, high expenditures and all, is driving innovation for the entire world.



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