1: Americans have better survival rates than Europeans for common cancers.
2: Americans have lower cancer mortality rates than Canadians.
3: Americans have better access to treatment for chronic diseases than patients in other developed countries.
4: Americans have better access to preventive cancer screening than Canadians.
5: Lower income Americans are in better health than comparable Canadians.
6: Americans spend less time waiting for care than patients in Canada and the U.K.
7: People in countries with more government control of health care are highly dissatisfied and believe reform is needed.
8: Americans are more satisfied with the care they receive than Canadians.
9: Americans have much better access to important new technologies like medical imaging than patients in Canada or the U.K.
10: Americans are responsible for the vast majority of all health care innovations.
Details and references at ncpa.org.
this list might be true, but without an explanation of the epidemiologic issues surrounding some of them, its really kind of misleading. thank god im here to explain! ;)
just to address the most glaring problem…
#1, #2 and #4 are highly correlated and not because screening necessarily improves treatment or the course of cancers. screening often picks up small and slow growing cancerous growths which are not actually all that dangerous – this is especially true of prostate cancer. many of these cancers would not cause mortality or mordibidity at all if untreated. because of this, in the US the diagnosis rate for nonlethal cancers is much higher than in countries with less aggressive screening programs, and thus the apparent mortality rate is lower. (this is called length-biased sampling)
screening also presents the problem of lead-time bias – which means that since cancers are caught earlier, people tend to appear to survive longer with it, regardless of whether or not treatment has actually prolonged their life. Im confused about whether #1 is addressing survival rates (as the headline says), or mortality rates (as the text says) – mortality rates are much more useful when evaluating the effects of screening programs.
Can’t touch that. Thanks esoteridactyl.
and of course, screens like mammograms and colonoscopies and the possible unnecessary treatments that can result, drive costs up tremendously, and have risks themselves. not that they shouldnt be done at all, but we probably dont need to be doing them across the board.