by Michael D. TannerFew things in life are as terrifying as a diagnosis of cancer. But for millions in the United States, the news just got a little bit better. Death rates for those suffering from cancer are actually beginning to drop. In particular, death rates have declined for the four most common forms of cancer: lung, colorectal, prostate and female breast cancers. Overall, fewer U.S. citizens died of cancer than at anytime in the past 70 years.
While there are many reasons for this welcome trend, one reason is the much-maligned U.S. free-market health care system.
The one common characteristic of all national health care systems, including Canada’s, is that they ration care. Sometimes, they ration it explicitly, denying certain types of treatment altogether. More often, they ration indirectly, imposing global budgets that limit the availability of high-tech medical equipment, or which require long waits for patients seeking treatment.
In the United States, by contrast, there are no such limits, meaning that the most advanced treatment options are far more available. This translates directly into saved lives.
Take prostate cancer, for example. Even though U.S. men are more likely to be diagnosed with prostate cancer than their counterparts in other countries, they are less likely to die from the disease. Less than one out of five American men with prostate cancer will die from it, but 57% of British men and nearly half of French and German men will. Even in Canada, a quarter of men diagnosed with prostate cancer, die from the disease.
That is, in part, because in most countries with national health insurance, the preferred treatment for prostate cancer is … to do nothing. Prostate cancer is a slow disease. Most patients are older and will live for several years after diagnosis. Therefore, it is not cost-effective in a world of socialized medicine to treat the disease aggressively. The approach saves money, but comes at a human cost.
Similar results can be found for other forms of cancer. For instance, just 30% of U.S. citizens diagnosed with colon cancer die from it, compared to 74% in Britain, 62% in New Zealand, 58% in France, 57% in Germany, 53% in Australia, and 36% in Canada.
Even when there is a desire to provide treatment, national health care systems often lack the resources to provide it. In Britain, for example, roughly 40% of cancer patients never get to see an oncology specialist. Delays in receiving treatment under Britain’s national health service are often so long that nearly 20% of colon cancer cases considered treatable when first diagnosed are incurable by the time treatment is finally offered.
Canada has its own problems. For example, the Canadian Society of Surgical Oncology recommends that cancer surgery take place within two weeks of preoperative tests. Yet one study indicates that median waiting time for cancer surgery in Canada ranged from 29 days for colorectal cancer to more than two months for urinary cancers. Radiation treatment and new therapies, such as brachytherapy, are also less available than in the United States. Consider this: Seven out of ten Canadian provinces report sending prostate cancer patients to the United States for radiation treatment
But the advantages of free-market health care go beyond an absence of rationing. With no price controls, free-market U.S. medicine provides the incentives that lead to innovation breakthroughs in new drugs and other medical technologies. U.S. companies have developed half of all the major new medicines introduced worldwide over the past 20 years. In fact, Americans played a key role in 80% of the most important medical advances of the past 30 years. Eighteen of the last 25 winners of the Nobel Prize in Medicine either are U.S. citizens or work here.
Obviously, there are problems with the U.S health care system. Too many Americans lack health insurance, or are unable to afford the type of care they want. But it is important to understand that, for all its faults and all the criticism that it has received, the United States’ free market health care system has made it the place you want to be if you have a serious illness. Millions of cancer patients have discovered that. And much of the rest of the world might be able to learn something from it as well.
This article appeared in the National Post on March 16, 2006.