Why We Are Less Healthy than the Brits
By Alan Stewart Carl | Related entries in Health CareA recent study has shown that the British are much healthier than we Americans. Across the board and across socio-economic lines, the Brits suffer from fewer diseases and live longer�despite smoking as much as we do, drinking more than we do and paying half of what we pay per-person for healthcare.
Even their fat people are healthier, so it’s not just our weight problem. And it’s not our larger numbers of racial minorities who generally have worse health�the study only used white people.
The English are simply healthier. And this bears repeating: they pay half of what we pay per-person for healthcare.
We have better doctors. We have better technology. But we pay more for worse health.
The recent study could not isolate any specific cause for our lower level of health but I have a layman’s theory: it’s about access. Our much more expensive system is much harder to access. If you don’t have health insurance, you’re probably not going to see the doctor until there is an emergency. And emergencies, in turn, add a lot more cost to the system.
The British, on the other hand, have free access to primary care. Health issues get caught sooner and the British people are healthier for it. Too simple? Probably. But it makes sense. Better access to healthcare=better health.
We can, of course, keep trying to improve our healthcare system by adding new layers of duct tape (and red tape). Or we can step back and recognize that the system we have built is not merely broken�it will never work. Never. What we need is free or at least incredibly affordable primary care for all citizens. That doesn’t mean we need to socialize medicine, but we need to subsidize primary care.
Until we make going to the doctor an affordable choice, too many Americans will simply wait until a health problem becomes a crisis.
I’m not recommending a specific method of providing subsidies�that is a post for another day. And I’m not talking about how we reform the critical care areas of the system. I’m just advocating making primary care an easily affordable option for all those who want it. I’m willing to bet we’d save trillions on healthcare if we caught more health problems earlier. It’s an idea whose time has come.
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May 3rd, 2006 at 3:39 pm
While access is almost certainly a part of the explanation for the disparity, it can’t explain all of it. As many people have pointed out, access issues can’t explain why rich British people are healthier than rich Americans, who presumably don’t have medical care access issues.
May 3rd, 2006 at 3:58 pm
Can I point out that some very simple preventative measures would probably reduce health access problems and subsidies by at least 50%.
Diet change from high fat high processed foods to using basic meat and vegetables. Oh, that means more time spent in preparation and cooking, huh! You should try my wife’s 10 hour stew – it cooks while she is at work in a very slow pot.
Less time spent in sedentary pasttimes, particularly for the kids. But then if you are taking the kids to football or swimming or cycling then you are going to miss the afternoon game, huh!
Walk or bike the kids to school instead of drive. Oh, I forgot about the baddies with guns – won’t go there.
I guess that cultural change along those lines would be just plain too hard…
May 3rd, 2006 at 5:54 pm
I’m a little suprised at the conclusion you drew Alan. In the interview I heard with them, on of the leading candidates for possible causes was stress (we have much more than the Brits… most of it self-induced). No one mentioned the healthcare system.
May 3rd, 2006 at 7:56 pm
The real cause for differences in self-reported incidences of diseases is that in the socialized medicine ‘paradise’ that is the UK, patients never see the specialists who would diagnose the diseases in the first place.
Instead they are told to do the sensible lifestyle changes that everyone should do anyway, take two aspirin, and go home.
The lower rates of self-reported illnesses aren’t de facto an actual lower rate of illnesses, chalk it up to observational bias.
In the US folks with means are more likely to get every possible complaint diagnosed by a specialist who has an incentive to find that illness as soon as possible, in the UK you have overworked GPs who know that there are no specialists to refer borderline patients to, even if they suspect that there is an undiagnosed illness, so instead just tell them to eat better, exercise more, et cetera.
The study cited says nothing about life expectancy (which is rising in the US, despite all the talk about obesity, and the UK numbers are , not vastly better), you’ve made an inference that’s not supported by the facts of the study (an understandable error though, as that is how this study is being spun).
The only way to really determine if comparable Brits are healthier than comparable Yanks would be to pull a random sample of 5000 folks from similar socioeconomic strata and give them a full check up, that’s not what this study did, it just asked people what’s wrong with them. My contention is that in the UK folks are likely to know less about their own health complaints then in the US given the vast differences in how care is administered.
(and if you think folks are happy with the NHS, read any British paper for a week)
May 3rd, 2006 at 8:03 pm
Doh! I hate messing up tags (where’s the trash can?)
May 3rd, 2006 at 11:58 pm
Well, as I said, it’s a layman’s theory.
Here’s another one: what if it’s partly cultural? What if our rugged individualism leads us to live riskier lives and avoid seeking out medical help until a problem is a crisis?
That problem would then be compounded by access issues. If we as a people are already predisposed to avoid check ups, making healthcare less available would only make the problem worse.
Yes, it’s true I don’t have data to back this access theory up. But I do think a certain amount of logic is on my side.
May 4th, 2006 at 4:16 am
Such a shocking news.
’cause I thought we, Americans, care a big deal about our health…
Well, that’s such a big homework for everybody…
May 4th, 2006 at 6:11 am
I think Bradley may be on to something regarding stress. I am an American who has been living and working in southern European country for several years. Ok, its not the UK but I think the comparison can be made fairly. The amount of stress that americans suffer (many of self-induced) is much more significant than it is over here. There is less stress in the office because jobs are more secure and there is frankly less pressure to “produce” and perform. Families are less stressed because they seem to put less pressure on their kids and they have the advantage (more so than american at least) of having built in baby-sitter in the form of grand-parents that live with the rest of the family or at least very near. I could go on and on with the reasons why I believe European are lessed stress generally than Americans but I think you may get the point. After all, stress kills.
May 4th, 2006 at 6:28 am
I’m not sure stress kills. If it did Japan would be depopulated.
My guess is we’re unhealthy because we drive rather than walk, which is a consequence of living in suburbs rather than walkable cities or villages. When I’m in Paris or New York I walk miles a day — and lose weight. Here in North Carolina I walk to the car. We built a society around the car, and, since we spend our lives in our cars we tend to eat in them as well, and Hardees is not the place to get a nice salad.
May 4th, 2006 at 7:02 am
Word, Michael. I was going to say “I bet they walk more.”
May 4th, 2006 at 9:59 am
And have you ever tried to eat a salad while driving? — now that kills.
May 4th, 2006 at 1:08 pm
At the risk of tooting my own horn as a physician trained in both psychiatry and internal medicine, I think that a big part of the healthcare cost problem is the separation between payors for physical and mental health care. Well funded and delivered mental health care drives up mental health costs, as expected, but drives down primary care costs for a net savings.
As long as the payors are separated, there’s no incentive for a mental health ‘carve out’ insurance company to improve access and quality to care in order to allow another insurance company to reap the rewards.
November 30th, 2006 at 4:29 am
Its not the UK but I think the comparison can be made fairly. The amount of stress that americans suffer (many of self-induced) is much more significant than it is over here. There is less stress in the office because jobs are more secure and there is frankly less pressure to “produce� and perform. Families are less stressed because they seem to put less pressure on their kids and they have the advantage (more so than american at least) of having built in baby-sitter in the form of grand-parents that live with the rest of the family or at least very near
March 12th, 2007 at 4:49 pm
I think I have some authority here as I was trained in medicine (OSU Medical School), have family members who are doctors, left the US of A and moved to the UK (to become a citizen) for years and have lived and learned from both systems.
Alan, I feel sorry for your logic, and it does quite upset me. I can give you studies that say we are all aliens living on another planet. A study is only as good as the person responsible for it. The scientific method has often been manipulated by people who don’t understand it.
Your quote: ‘The British, on the other hand, have free access to primary care. Health issues get caught sooner and the British people are healthier for it. Too simple? Probably. But it makes sense. Better access to healthcare=better health.’
Free primary health care? I’m an xpatt and I can tell you that your statment is simply not true. There are many, many, many people around me who have died as a result of a significant lack of health care, including my next door neighbor who died just a few weeks ago in her early 30’s. Issues get caught sooner? That couldn’t be further from the truth. Issues don’t get dealt with is more like it. The NHS (if you know what that is) is in a HUGE crisis. Not everyone has access to free health care. In fact, more and more often a lottery system has been employed to select who gets it and who doesn’t.
I’ll give 2 examples. Firstly, me. My knees have been having fairly significant trouble in the UK from years of hard work and predisposing factors (such as flat feet). I went to my primary care physician to get a simple knee brace. One and a half years later (and I’m not exxagerating here) I’m waiting to receive a letter telling me when I can go to a clinic to have my knee brace fitted. I’m on a never-ending waiting list.
Secondly, my wife. My wife was diagnosed in America as having a rare bowel disorder, Pneumatosis Intestinalis Cytosis, while we were on holiday a few years ago. Due to her symptoms and diagnosis of free-air on an x-ray, my wife received basic care and follow-up treatment within 2 weeks that could have saved her life as she could have burst her abdomen had she gotten on a plane to go back home to the UK. I gave our local hospital instructions for follow-up care which included a highly suggested CT scan for follow-up to clarify the condition after air travel. No investigation followed. Instead a long battle ensued in which doctors denied anything wrong. After dealing with management within the NHS, they finally admitted to wrongdoing but still have not offered additional treatment (we are talking years now). The solution has been made through my own diagnosis and treatment of my wife at our own expense and herbal treatments such as Oxipowder- which seem to have greatly helped.
What is my point? I am very concerned for America. Americans need to be careful before they act like experts on issues they know nothing about. George Bush has been guilty of this, and I’m hoping democrats don’t go down the same path. Health care in America is a big problem, and people need to have coverage. But Americans without doubt have the most advanced health care in the world. Its sad and worrying that some Americans don’t have access to it. But lets not be drastic and change the system to something Americans know nothing about. Americans health is determined by their own actions. Brits can’t afford to eat out, eat fat, and watch as much entertainment as Americans. If they did, I think you would find brits would not live nearly as long as Americans, unless their genetic predisposition was more beneficial in the first place.
I agree with most of the responses earlier from Thomas, Amba, Michael, Pete, and especially XWL who I believe is right on the mark.
XWL, maybe you should run for office. We need more people to be more globally aware like you are.
Oh, and by the way we are planning to move back to America primarily for many reasons, one of which is decent health care, freedom, capitalism, and.. krispy kreme.
March 12th, 2007 at 5:07 pm
One quick follow up. If you want to learn more about why American shouldn’t go toward European social health care (to be more exact- the UK NHS), go to google.co.uk (not google.com) and look up nhs problems. I could post a story a day. For instance, just looking today..
http://society.guardian.co.uk/health/news/0,,2031604,00.html
America’s healthcare is looking good compared to the UK, even in terms of people receiving basic healthcare.