I'm shocked that life expectancy is falling in the US - and infant mortality is crap, too

[McEdam]

The US comes in at no. 42 in international league tables of life expectancy - because so many people don't have health insurance, apparently. Perhaps we should be thankful we have an NHS, however much we like to complain.

Also scary stats re infant mortality - US really not where it should be. I gather birth in the US is quite medicalised - perhaps this shows that Hospital Knows Best approach/high C-section rates are actually not safer at all?

US tumbles down life expectancy ratings

There are people who would be denied health insurance for pre existing condiions. Who would insure a baby born with AIDS.

My son has got his money's worth out of the NHS. For our family £4500 a year is a bargain. My son's hearing aids would cost about that if we had to pay for them. He has also had physio, seen a community paediatian as well as our GP once in a blue moon.

Prehaps more importantly doctors only do operations like C-section if they feel it is necessary. I feel its great that health professionals get paid exactly the same amount of money whether they decide tests are necessary or not.

But surely we should add the additional cost of all the private treatments people and health insurance pay for in the UK?

I am lucky enough to have insurance through work so my dc's get their operations etc that way - there would be a significantly higher cost to the NHS (and longer waiting times) if I, and many others, did not.

Plus of course the prescription charge - I bet that adds up too.

So comparing what the NHS costs with US healthcare costs is not like for like if you ignore those factors?

I don't think foreigners get access to NHS treatment, unless they show up in an emergency. And they do get treatment in the us as well in the case of emergency.

I get treatment on the NHS because I'm a legal permanent resident. If my mum was visiting and needed a doctor, I don't think she'd get seen.

In order t oattribute these people's poor health to the medical care they receive I think you have to establish whether that medical care is in fact American. So if they are foreign it is relevant.

As for the source Domocratic campaign slogans printed in the pinko loving Guardian are hardly unbiased, which is why I question the validity of the statistics.

Anyone that is here on a visa is eligible for the full range of NHS services, as well as British citizens and EU nationals.

Yes, Carbonel, you should include all healthcare, public and private.

Just looked it up. For 2004, NHS spending was 7.5pc of GDP, and private spending was 1pc.

I've lived about half my life in America, and about half in London. Thankfully, my health (and dd's) has been good, so I have limited experience of either healthcare system.

But here are two observations about the system in America:

1. For about a year, I worked as a secretary for a doctor whose practice was in a poor part of town. The healthcare of most of his patients was funded by the State (a program called Medicaid - which just as it sounds, was there to help those with low income). The patients on that program came to the doctor whenever they needed/wanted completely free of charge and the doctor was then reimbursed by the State.

Perhaps because there was no cost to them, we had quite a few 'regulars' who appeared in the practice waiting room every few days. In many instances it seemed their lifestyles were literally making them ill, and they looked to the doctor for help. What he could do was limited because their bad habits (sedentary, poor diet, smokers, drinkers, etc) needed to change to make them feel better. I also think some of the patients were depressed/bored, and coming to the doctor was something to do - and again, they were looking for something to make them feel better because he could find no physical reason why they were feeling so poorly.

Anyway - long way of saying, these were people who were unable to pay, and their costs were completely covered by the local government.

2. As a pregnant woman, I was considered 'uninsurable' by private insurance companies in America. Even though I could pay, the pregnancy was considered a 'pre-existing condition'. I was advised by an insurance broker to apply for coverage with the local government agency set up to deal with 'uninsurable' people.

After an interview, and form filling and some considerable redtape, I was covered. I gave birth to dd in one of the best hospitals, in a private suite, and it didn't cost me a thing. The government paid for it all.

I know there are horror stories, but I have not seen/experienced that in America.

"I think it's clear that whatever the quibbles, the US spends far more than any other country in the world on healthcare (assuming non-OECD countries spend less). So the NHS does seem to be better value for money than the US system, given US life expectancy is shockingly low and falling."

I was sceptical about that comment before I read the link because it assumes that healthcare spending correlates directly with life expectancy and is the only factor that correlates.

I thought that obesity and lack of exercise in a car obsessed society would have a fair bit more to do with it. And upon clicking the link to read the original article, I see that obesity is listed as a factor as well.

Not, of course that the NHS isn't an absolute bargain . My personal encounters with the NHS have had all the qualities of my personal encounters with public lavatories. I am left with the resolution never to use it(them) unless I am unfortunate enough to have to.

Personally I don't think you can beat the NHS in an emergency situation. A serious road accident would get you highly trained paramedics, a serious and rapid worsening of your health in an NHS hospital would find someone on call who could deal with it. I'll never forget a case a few years ago where a woman who'd had routine surgery in a private hospital died after complications set in a few hours later (at night). Her husband's comment said it all "they had a wonderful wine list but they didn't have an anaesthetist to save my wife". In an NHS hospital that woman would probably have survived - okay so I don't know the exact circumstances in this case but having worked as a nurse in the NHS and private sector I can tell you I'd always opt for an NHS bed over a private one.
A private system will never pay anyone to be on site if the feeling is they don't need to be - the NHS would have them there just in case.

The NHS won't always, TCP -- look at what happened to bubble99's DTs, just because the NHS was trying to save money.

Finding a doctor who takes medicaid patients is like getting a NHS dentist. Treatment by zip code is common in the US too.

Treatment by zip code is common in the US? I've never encountered it.

I guess you didn't live in Southern Ohio (for example)

Nope. Never lived in Southern Ohio. I've lived in Illinois, Kansas, Texas, and very briefly in Southern California. Don't think I ever went to a doctor in Kansas or California.

Eleusis can you check your voicemail and call me

I don't think there is really a zip code lottery in the States. Things are really done more on a county level and those without health insurance usually all go to the same hospital within a county.

That's hospital, but what about primary care?

hey Eleusis, I 'fessed up when I originally got the wrong figures for the NHS budget. Are you ready to agree the US spends more than any other country in the world on health, yet?

That's what the OECD says. Plus the US's own Department of Health agrees (I checked). The life expectancy figures are also confirmed by the US Centers for Disease Control and Prevention (checked them, too).

Hardly pinko liberal sources.

Americans are also much less healthy than us British people, according to a study in the Journal of the American Medical Association - a peer reviewed journal so not a flakey source (Vol. 295 No. 17, May 3, 2006). That is despite the authors adjusting for behavioural risk factors. And it holds good across the socio-economic scale - rich people in America are less healthy than Britons, just as poor and middle class Americans are less healthy than poor or middle class Britons.

rich Americans less healthy than rich Britons, I mean.