It has been proven fact that we (Americans) pay more than every other developed country for healthcare with poorer outcomes. It’s a racket, plain and simple.
https://news.harvard.edu/gazette/story/2018/03/u-s-pays-more...
Women with insurance pay out of pocket an average of $3,400, according to a survey by Childbirth Connection, one of the groups behind the maternity costs report. Two decades ago, women typically paid nothing other than a small fee if they opted for a private hospital room or television.
But one must take into account the risk of complications; if something were to go really wrong, would you rather be in the US hospital or the UK one? I suspect the NHS is more affordable, but does not handle complications and individual patient cases as well as the US system.
The hospital charges my wife for her stay, my newborn son for his “stay”, her OB charged for the procedure, and the neonatologist charged. Whatever isn’t paid by insurance automatically becomes our responsibility, with no recourse to dispute.
We are actively working to leave this country.
Germany is, by all accounts, amazing. It's where my wife and I holiday and we've contemplated opening a B and B there a few years down the road. If I were coming to the EU fresh I'd be looking closely at Germany, Denmark, or the Netherlands.
http://www.bluecard-eu.de/eu-blue-card-germany/ is very relevant for a skilled migrant interested in Germany.
I can't comment on Colombia though.
There have been attempts made to correct for these discrepancies. They end up accounting for a large fraction (but not all) of the difference in infant mortality rates, if I recall correctly.
Most of the rest of the effect is that premature births that everyone considers "births" have a higher prevalence in the US (for various reasons, not all of which are clear). Premature births have higher mortality, obviously.
https://uk.reuters.com/article/us-health-infants-mortality/u... is actually trying to look at an apples-to-apples comparison, and a few things jump out at me:
1) Birth defects. I wonder how much of this has to do with differences in abortion availability and again differences in definition of "birth". Many other countries count a child that dies within some number of days after birth from birth defects as a stillbirth, not an infant mortality event.
2) SUID (aka SIDS) is a huge contributor in the US. In the US this is highly concentrated in ehthnic groups that are largely missing in the comparison countries. Why that is is a good question, but makes this comparison less apples-to-apples.
To know where you'd want to be you want to know the outcomes for your specific demographic in the different countries, which is not something that gets reported very much...
From your own source, literally doesn't help your case at all.
The bit you quoted does not negate my two points about the data in that article.
But just to be very clear, Connecticut is cited as having an infant mortality rate that is slightly above the comparison country rates. Note that those countries were picked for a comparison because they have the 6 lowest mortality rates in Europe. [1]
Anyway, Connecticut is maybe somewhat similar to the comparison countries in terms of ethnic group demographics (mostly negating my point (2)) and has a more expansive definition of "infant mortality" than those countries last I checked, which is part of my point (1).
Mississippi, at the other end of the spectrum, has a vastly different ethnic makeup, has much worse abortion availability (increasing the number of babies with birth defects carried to term). And still has the more expansive definition of "infant mortality".
Now I'm not saying that it's a good thing that Mississippi has higher rates of SUID/SIDS. And I'm not saying limited abortion availability for cases when the child wouldn't survive is good. But I am saying that drawing conclusions about US healthcare here, as opposed to other societal factors, requires apples-to-apples comparison. And drawing conclusions about outcomes for a specific case (specific family) requires understanding whether those societal factors apply to it.
Or to put it another way, families that are willing to do an abortion when told their child, if carried to term, would not live more than a few months will have a lower infant mortality rate than families that are not willing to do said abortion.
One other thing which _is_ mentioned in the study itself but not in the article: "survival rates among preterm infants in the US were found to be very similar to those of the same European countries". Please model that with the "the US just sucks" model.
[1] The numbers in the actual study: Connecticut has an estimated FTIMR of 1.29 with a 95% confidence interval of 1.08 - 1.53; note that they don't have an actual hard number for reasons I haven't figured out yet. The six European countries involved are Austria, Denmark, Finland, Norway, Sweden, and Switzerland. Their numbers range from 0.97 to 1.24 according to the study.
https://www.cia.gov/library/publications/the-world-factbook/...
I would love to see a good study that tries to disentangle the various correlations here...
> [You] must take into account ... the racial makeup of America
Oh? Are black people not really counted for the purposes of birth stats? Why? Poorer genetics? Poorer healthcare access? Again, how would poorer healthcare access jibe with your "best in world" medical care?
How about this? Would you rather be in the US, or Japan, for such an emergency? Japan costs half as much as the US per capita (with even lower out of pocket costs), and beats us by every other measure. I'd rather be in the Japanese system than the American one for anything.
edit: The Japanese system, structurally, is very similar to the American system. It's not socialized, by and large. Private insurance through employers to private providers. Yet it costs half as much and works better. This points to something broken in the US system at a deeper level. Expanding on this, every civilized nation in the world has health care more or less on par with the US (fuck exceptionalism), for more or less half our cost. To the chagrin of liberals, "socialized medicine" isn't the obvious solution, because a lot of systems no more socialist than ours work well. And to the chagrin of conservatives, a lot of highly socialized systems also work better. The American system is uniquely fucked up.
Back to Japan. The key difference I can see between the two systems is that Japan has strict price controls. A government commission sets the prices for all medical products and services covered by insurance, with an eye to controlling costs while maintaining profitability. Insurers and providers have to control their costs internally, rather than jacking prices or doing many-to-many negotiations. Is this the key?
But I digress.
At any rate, the Japanese system clearly works, while the American system is clearly broken. One is selling the same product for half the price of the other. Assuming I'm right about the key differentiator being the Japanese price controls (I could be wrong), then it really makes me wonder why we aren't trying that. Seems like a great way to get costs under control (even shrinking), while preserving much of the complex market and avoiding radical change to almost 20% of the economy.
I think "critical utility services" touches on the importance, but doesn't go far enough. I believe a health care system that denies care purely out of poverty is immoral. A health care system that is the primary cause of bankruptcy for the middle class is immoral. A system that traps employees in jobs they hate, for fear of losing (or even changing) their insurance is both immoral and un-American - what's more American than quitting your job to get a better one, or start your own business? So our system is not just an economic failure, it's a moral failure. It's a stain on our honor and an insult to our values.
In conclusion, I do not give a fuck about "free market" here. I am not putting economic ideology ahead of moral imperatives, and I'm not choosing ideology over observable facts. If I wanted to choose ideology over economic reality, I'd be a communist.
Again, if you've got great health cover you can probably do better in the US. If you haven't, then you might not.
As someone who has lived in the UK, Australia, and the US, probably not the US?
Also, "Infant Mortality Rates of Countries, deaths per 1,000 live births[1]":
* Australia - 4.7
* United Kingdom - 4.8
* United States - 6.2
Apparently the statistics say we're not as good at "[handling] complications and individual patient cases" as you believe we are.
[1] https://www.infoplease.com/world/health-and-social-statistic...
Provide evidence for this claim, or stop trying to disparage an entire nation's healthcare system.