In the debate over health care in America, one common theme is that care in this country costs too much.  Indeed, we spend roughly 16% of our GDP on health care.  (This is similar to the percentage that we spend on Information Technology.)  Another common theme in the health care debate is that “quality of care” is low.  Critics charge that we pay a lot for health care, but that Americans are sick, and getting sicker.  Our investments in our health aren’t reaping the benefits that they should.  Many other western countries, such as the United Kingdom, care for their citizens at much lower cost and achieve similar or better “quality”, or so goes the refrain.

But what do regular people consider to be “quality” health care?  In all likelihood, people thinking about the quality of their health care might think about how good their doctor is, and whether or not they expect to receive competent and compassionate treatment should they become ill.  One of the most devastating illnesses, and one of the most frightening for many people, is cancer.  When diagnosed with cancer, the paramount question for most people is, “How long will I live?”  Cancer is a scary and life-changing diagnosis, and many patients will travel far, consult with specialists, pay huge sums, and try almost anything to increase their chances of survival.  Surely, a health care system that helps people survive cancer is a higher “quality” system than one that lets people die of their disease.

 If you are unfortunate enough to be diagnosed with cancer, what are your chances of survival, and how is your survival affected by where you live and your health care system?  To address this question, it is helpful but sobering to compare the survival rates for various cancers in the U.S. and in the United Kingdom.  Data provided by the National Cancer Institute in the US, and by the Office of National Statistics in the UK, show large differences in your likelihood of survival at 5 years if you are diagnosed with cancer in either country: 

Should you develop lung or pancreatic cancer, your chances of surviving 5 years, though low, are doubled if you are lucky enough to receive your care in the US rather than the UK.  Should you develop prostate cancer, your chances of surviving for 5 years in the US are nearly 100%, while you only have a 77% chance of being alive at 5 years if you are treated in the UK.  Similarly, you’re substantially more likely to be alive 5 years after a diagnosis of either breast or colon cancer in the US as compared to the UK.

By any reasonable standard, health care that helps people survive their cancers is “higher quality” than care that doesn’t.  But taking care of cancer patients is an expensive business.  Chemotherapy, radiation, surgery, advanced pain-relieving drugs, etc., all cost money.  Indeed, cancer is an expensive diagnosis – more expensive than heart disease, stroke, and many other devastating illnesses.  In the US, medical science has developed many new treatments that have substantially increased survival for almost every type of cancer there is.  These advances in health care have saved hundreds of thousands of lives.  These advances cost money.

 In the next several articles, I will examine the “quality” issue of health care in America.  What are we really getting for our 16% of GDP?  Have we benefited sufficiently from our investment?  How good is care in this country, relative to other western countries that spend substantially less on the health of their citizens?  By looking closely at the facts, we can build a more reasoned debate on the question of “quality” of health care in America.