I'm grateful to Dr. Eidus for going through this experiment and reporting the results. For U.S. docs who are only partly run by the government it's hard to imagine the horrors of what it would be like to be under its full control. It's Medicare for All not just as a thought experiment but in the flesh.
The problem in comparing the US as a whole with NZ is the size and diversity of cities. Miami vs Minneapolis have different production frontiers and functions. I asked AI for an apt comparison, and Portland and Salt Lake most closely resemble NZ, despite their different systems. There are different ways to crack an egg: different inputs but similar outputs.
Keep up your occasional reports from NZ. This is interesting to read!
Other issues that will be notable to most American readers include the different level of professionalization. Non-physicians generally do not have doctoral degrees (whereas we have doctors of pharmacy, physical therapy, psychology, etc.). Residency training is longer, and salaries are actually a bit higher during residency but lower for full attending physicians.
NZ is well known for its malpractice system, which includes government-run no-fault compensation for many iatrogenic harms, theoretically saving malpractice suits and board investigations for the most egregious conduct.
A thoughtful piece that resonates (I’m a Canadian family physician). How much would access to medical care improve for sick people if a primary care doctor delegated the work of disability forms and health screening to organized programs?
As long as healthcare allows big pharmaceutical companies, lawyers, insurance companies, and healthcare administrators to keep doing business as usual; US healthcare will not change.
It would be interesting to see how much drugs would cost if we had a free market. Which we never will. But drug discovery costs billions and the US is subsidizing the rest of the world. If we stop doing that, other countries either will have to pay more or we will have fewer new drugs (which might be fine?).
Did you notice that, even with strict controls on drugs, NZ is only “saving” 2% of total costs? That’s peanuts.
And this is a PC writing--what specialty drugs is NZ not allowing? Targeted cancer drugs? New, more effective drugs for MS? Etc.
He also fails to note that US life expectancy is lower due to our homicide and MVA rates. If you can avoid getting shot or dying in a crash, your life expectancy is pretty close to NZ’s.
NZ optimizes the macros--while pts like his with chronic pain from back injuries or endometriosis suffer.
There is a lot of apples to oranges comps here, unfortunately. On the uninsured aspect, for example, how many US-uninsured are young, healthy folks? The daughter identities other “issues”.
I'm grateful to Dr. Eidus for going through this experiment and reporting the results. For U.S. docs who are only partly run by the government it's hard to imagine the horrors of what it would be like to be under its full control. It's Medicare for All not just as a thought experiment but in the flesh.
Excellent thank you for this information.
The problem in comparing the US as a whole with NZ is the size and diversity of cities. Miami vs Minneapolis have different production frontiers and functions. I asked AI for an apt comparison, and Portland and Salt Lake most closely resemble NZ, despite their different systems. There are different ways to crack an egg: different inputs but similar outputs.
Keep up your occasional reports from NZ. This is interesting to read!
Other issues that will be notable to most American readers include the different level of professionalization. Non-physicians generally do not have doctoral degrees (whereas we have doctors of pharmacy, physical therapy, psychology, etc.). Residency training is longer, and salaries are actually a bit higher during residency but lower for full attending physicians.
NZ is well known for its malpractice system, which includes government-run no-fault compensation for many iatrogenic harms, theoretically saving malpractice suits and board investigations for the most egregious conduct.
A thoughtful piece that resonates (I’m a Canadian family physician). How much would access to medical care improve for sick people if a primary care doctor delegated the work of disability forms and health screening to organized programs?
As long as healthcare allows big pharmaceutical companies, lawyers, insurance companies, and healthcare administrators to keep doing business as usual; US healthcare will not change.
It would be interesting to see how much drugs would cost if we had a free market. Which we never will. But drug discovery costs billions and the US is subsidizing the rest of the world. If we stop doing that, other countries either will have to pay more or we will have fewer new drugs (which might be fine?).
Did you notice that, even with strict controls on drugs, NZ is only “saving” 2% of total costs? That’s peanuts.
And this is a PC writing--what specialty drugs is NZ not allowing? Targeted cancer drugs? New, more effective drugs for MS? Etc.
He also fails to note that US life expectancy is lower due to our homicide and MVA rates. If you can avoid getting shot or dying in a crash, your life expectancy is pretty close to NZ’s.
NZ optimizes the macros--while pts like his with chronic pain from back injuries or endometriosis suffer.
There is a lot of apples to oranges comps here, unfortunately. On the uninsured aspect, for example, how many US-uninsured are young, healthy folks? The daughter identities other “issues”.
I thought overdoses were more prevalent as cause of death than homicide and MVA combined