Interesting thread. One thing I wonder about is cause and effect. When people say the US healthcare system doesn’t have good outcomes, longevity is one of the key metrics I’ve seen used to substantiate “poor outcomes.” The US has very high rates of obesity and obesity-related illnesses and deaths. But is that because of the healthcare system?
I think it’s more related to US culture vs foreign cultures with regard to physical fitness, portion sizes and fast food. In the US, kids and adults ride in cars, while in many countries people walk and/or bike as a part of daily life. Very few Americans commute to work on a bike, but lots of people in Amsterdam do, as one example. Anyone who’s traveled abroad knows the portion sizes in the US are HUGE. When we were in Greece for 6 weeks, we saw almost no fast food chains. If the countries with socialized medicine had the same cultural factors as the US - ie drive everywhere vs walk or bike and eat huge portions of unhealthy fast food - would their care really deliver better results? And is the reason these other countries don’t behave like the US driven by their preventative healthcare systems? Maybe partly, but it seems to me it’s more culturally driven.
While it may be true that more Americans go elsewhere for medical procedures than foreigners come here, I think it’s also true that Americans go abroad to try to save money, not get better quality. People who can afford it come to the US from other countries, not to save money but to get the best possible quality of care on demand, with no wait. To me, there is a big difference in the motivation.