Summary of overall performance:
Before looking at the tables, here are some facts:- All leading healthcare systems (top 4 in the table) have separated provider of services (mixed models of private, publicly-owned but independent, locally-owned & non-profit) from payee (state) for services.
- Of top 10 performers, 5 have fully separate functions of service providers and payees for service, 3 others have a mixed system. In contrast, Ireland has not even a mixed system, with all primary, emergency and non-elective medical service providers being captured by the state.
- Ireland is ranked a lowly 14th this year, although it is a marked improvement on the past years performance (see below).
- Fully nationalized system of healthcare practiced in Canada scores marginally worse than Ireland in patients rights and access to information. Only Latvia, Portugal, Romania and Spain score worse or equally poorly as Canada in this area.
- Canada scores worse than Ireland in waiting times for treatment. The only other country that scores as poorly as Canada in this area is Latvia.
- In terms of healthcare system outcomes (designed to gauge basic treatments effectiveness), Canada scores as highly as Ireland, with both countries ranked between the 4th and 8th places.
- In terms of range and reach of health services provided within the system, Canada (100) scores marginally above Ireland (92), with Canada ranked between 12th and 14th places, while Ireland ranks between 15th and 22nd places.
- In terms of access and quality of pharmaceuticals within the system, Canada ranks between 26th and 27th. Ireland ranks between 2nd and 8th.
- Thus, contrary to the noise about 'socialised medicine for Ireland's future' movement within Irish Left, global data shows year after year, that using objective criteria, socialised medicine is bad for your health.
I'm not sure your conclusion is supported by the study, and certainly not by the facts that you highlight. The study simply says that the Beveridge model based health care systems have a lower score on this scale, in general, than those based on the Bismark model. It says nothing about "socialised medicine", unless, being generous, that is your short-hand for Beveridge, though I'd hardly say that is what the "Irish left" rants about. The Irish left rants about keeping the status quo where the system is intentionally run for the benefit of those working in it, not for patients.
ReplyDeleteBut more importantly, this study does not say Beveridge systems are bad for your health. The study was designed to measure how consumer friendly the system is, not how effective it is except in as much as this affects consumer friendliness. I haven't looked at the weighting of the various factors in the score, but I think it allows for a system to score well where the patient dies, so long as he got to read a bill of rights first, and only had to wait a short time to receive the treatment that killed him. I'm sure you'll correct me if I'm far off on that, but in my world view, outcomes are the only consumer friendliness factor that should really matter. Unless the scores are weighted very heavily on the outcome axis, I don't consider these results useful.
Finally, the examples you called out do not make your point, and this is where I take the most exception, but only because I don't want the looneys in the current US debate to gain succour from your analysis (or succor as they would take it). You're sounding like Fox News here!
Outcomes are better in Canada than in most places in Europe. Certainly you are better off in Canada's system than in Ireland's, if by better off you are concerned with health care outcomes rather than dross like patient's bills of rights.
For a more detailed examination of 5 year cancer survival rates, see the CONCORD study published in the Lancet last year, and summarized here (for Canada) http://www.canada.com/montrealgazette/news/story.html?id=d18a477c-2d4b-4d33-90c2-25f9f838c6c9, and here (for Ireland): http://www.independent.ie/national-news/ireland-trails-world-in-cancer-survival-1435051.html. To repeat the headlines from those linked articles: "Canada's cancer survival rates among best in world: study" and "Ireland trails world in cancer survival"