U.S. medicine compares well on COVID

The number of U.S. deaths from COVID-19 is truly horrific. As of Feb. 7, 462,169 people had succumbed to the disease, nearly eight times the number of American lives lost in the Vietnam War.

This is the well-publicized bad news. But there is good news too. While we mourn the loss of many lives, we can be thankful that our health care providers and hospitals have saved many lives.

How many? If the U.S. health care system had performed equally to those of Canada, the United Kingdom, Italy, Germany and France, another 292,000 Americans would be dead.

Canada, France, Italy, the United Kingdom and Germany all consider health care to be a right and their governments are substantially more involved in financing and providing health care than the U.S. All are large, affluent, democratic countries, arguably most comparable to the United States. These similarities presumably produce similar testing and reporting procedures for COVID-19.

Relying on data from Johns Hopkins University (coronavirus.jhu.edu), the U.S. death rate from confirmed COVID cases is 1.72%. In Europe's big four and Canada the death rate is 2.8%.

If the U.S. had matched the record of these five other countries, an additional 1.08% of people with confirmed cases would have died, for an additional 292,000 U.S. deaths (1.08% of 26.9 million confirmed COVID-19 cases).

To put it another way, America's health care system reduced deaths of confirmed COVID-19 cases by 39% compared with the other five countries.

The comparative U.S. success in saving COVID-19 patients comes despite a much higher infection rate, which has placed extra burdens on its health care providers. The U.S. rate of confirmed COVID-19 cases as a percent of population is almost double that for the big four and Canada: 8.13% vs. 4.14% by my calculation from Johns Hopkins data. Infection rates comparable to the United States would have more than overwhelmed the other health care systems.

As one example of its readiness to fight the pandemic, the U.S. leads the six countries in the number of critical care beds per 100,000 population. The U.S. has 34.7, Germany 29.2, Italy 12.5, France 11.6 and the United Kingdom 6.8. (Source: Society of Critical Care Medicine.)

The U.S.'s success in saving patients also comes despite its leading the six countries in the percent of population with obesity, diabetes and sickle cell disease, three underlying causes of increased risk of severe illness associated with COVID-19.

Despite the adversity, American hospitals and medical teams rose to the challenge providing the services needed to save lives.

We have heard Vermont Sen. Bernie Sanders note that the United States is the only developed country where free public health care is not a right. He bemoans America's health care system as the costliest in the world. But perhaps this ranking is due to other comparable countries underfunding health care through their political processes.

How exactly does he intend to lower costs without wage and price controls or rationing of services? Sanders probably knows the answer from his experiences as past chair of the Senate's Committee on Veterans' Affairs. VA medical services were rationed, and veterans joined long queues to receive specialist care. That a single-payer government system will have efficiencies to substantially lower costs without lowering quality is a claim lacking in evidence.

Among the large countries, the U.S. health care system is the best and its hospitals and medical professionals are deservedly celebrated. The system, however, can be improved. As one example, the United States pays more for prescription drugs than Europe. The solution to this inequity does not need Medicare for All to find a solution. As the adage goes, if it ain't broke don't fix it.

America's health care system is not broken. How we attempt to improve it will matter.

Burton A. Abrams of Bovey, Minn., is professor emeritus of economics at the University of Delaware.