Cancer Around the World

CANCER AROUND THE WORLD….Over at TNR, Jon Cohn provides us with the latest dope from the Annals of Oncology. Exciting! The question at hand is whether the United States, with its awesome private healthcare system, is better at delivering new cancer drugs to patients than Europe, with its array of feeble and feckless public healthcare systems. At first, it looks like the United States is the winner, but when you dig a little deeper it turns out that this has a lot to do with the fact that the study includes lots of countries that have very low healthcare spending, like Great Britain and Eastern Europe. So what happens when you do an apples-to-apples comparison?

If you really want to know how universal health insurance per se affects the diffusion of cancer drugs, a much more logical comparison would be between the U.S. and some of the countries that more closely resemble us in terms of economic development — and that don’t spent quite so little money on their own medical care systems. And guess what happens if you do that? A very different picture emerges: We may be atop the world when it comes to getting new cancer drugs to our patients, but we’re hardly alone on that perch. Three other countries — Austria, France, and Switzerland — are right there with us.

….Admittedly, the paper is vague on one key point: It doesn’t indicate whether, among those four world leaders, the U.S. stands out as the best. If it did, the argument against universal health care might still have some small merit. Fortunately, Jonsson and Wilking have e-mail addresses. And they were kind enough to respond when I contacted them. “Overall,” I asked, “was one country significantly and consistently better than the other three?” Wilking’s response: “Not really.”

I suppose you’re all getting tired of hearing this, but the conclusion here is pretty much the same as it is every time you look at the U.S. vs. Europe: the differences are almost entirely about money. If you have a national healthcare system but you spend way less than the United States (as Great Britain does), you can provide good but not great service. If you spend modestly less than the United States (as France does) you can provide healthcare every bit as good as ours — and cover every single citizen in the bargain.

And what if you actually spend as much as the United States — but you have to put up with our ragtag private delivery system? Then you get healthcare about as good as France’s, except that it doesn’t cover everyone, it bankrupts large companies, and it goes away anytime you get laid off. And all for only about 40% more than anyone else in the world pays. Pretty good system, eh?