I recently read an article by Michael Tanner, director of health and welfare studies, at the Cato Institute that outlined his concerns about treatment of cancer patients under national health plans of foreign countries. The Cato Institute is a well known conservative think tank, and thus one must cautiously assess the accuracy of their findings. Nevertheless, I feel compelled to summarize Mr. Tanner’s arguments, because I have personally benefited from outstanding medical services and therefore believe that despite its faults, America’s medical system at the top tier is the finest in the world.
While I am reluctant to write up articles from people with known biases, especially where I cannot verify independently the data, I was so disturbed by Mr. Tanner’s finding that I felt compelled to outline his thoughts, especially in view of the heavy emphasis placed by leading Democratic presidential candidates on providing on a national basis some medical services for all Americans.
While expensive, the financial incentives offered in the United States have encouraged medical innovation. United States companies have developed half of all major new medicines introduced worldwide over the last 20 years. 18 out of 25 of the Nobel Prize winners either have been U.S. citizens or worked here. Thus, in reforming our medical system, we cannot afford to throw out the baby with the bath water.
My concerns like most Americans is maintaining the excellence of our medical system while providing comprehensive care for some 40 million Americans who currently are medically uninsured. These twin goals until now have been incompatible, and thus there exists mounting pressure to reform, possibly radically, our medical system. Moreover, given the very high cancer rate in the United States, we all have a vital stake in deciding the best system for treating this disease. From a broader perspective, America remains the best place for treatment for many serious illnesses, despite current faults in our medical system.
In essence, Mr. Tanner argues that the national health systems of most foreign countries ration care. That is, they impose global budgets or other cost constraints that limit the availability of high-tech medical equipment or impose long waits on patients seeking treatment.
Tanner cites a terrible statistic on prostate cancer. Fewer than 20% of Americans men with prostate cancer will die from it, against 57% of British men and nearly 50% of French and German men. A big part of this reason is that frequently in Britain, France, and Germany, the prevalent medical practice is to do nothing because prostate cancer is slow- moving disease. That is, from a cost-effective perspective, doing nothing is preferable.
Similar results can be found in other forms of cancer. For instance, only 30% of U.S. citizens diagnosed with colon cancer die from it, compared to 74% in Great Britain, 62 % in New Zealand, 57% in Germany 53% in Australia, and 36% in Canada.
Less than 25% of U.S. women die from breast cancer. In Britain, it is 46%, France 35%, Germany 31%, and Canada 28%.
In Britain, less than 40% of cancer patients never get to see an oncology specialist. The delays in Britain are so long, that nearly 20% of colon cancer cases considered treatable when first diagnosed are incurable by the time treatment is finally offered.
Seven out of ten Canadian provinces report sending prostate-cancer patients to the United States for radiation treatment.
In summary, Americans need to be very cautious about introducing major changes in our medical system. That is, every one of us worries about the high costs of medical care and the attendant costs on medical insurance, but we want to maintain the best elements of our medical system.
Originally published in the Sarasota Herald-Tribune
