In recent weeks, some have been quick to criticize health policy decisions in the U.S. by pointing to decisions made in other countries. For example, the U.S. has a broad recommendation for the fall Covid-19 vaccine, while the U.K. has a more targeted policy
One of the most concise and honestly damning pieces I have seen written about the US Health care system compared to other 1st world nations.
Absolutely spot-on. Excellent documentation of some of the myriad problems our healthcare system has evolved over time. And thanks for the OECD statistics. I need to put together a lecture on this topic, and you've raised points my notes didn't cover yet. I'd not considered the number of beds per capita, obviously a sign I needed more time on the topic, but your summary is very appropriate.
Thank you. That’s a brilliant explanation. Quite easy some to interpret the UK recommendations as “the vaccine is so dangerous for younger people that’s it been banned for those under 65”.
Dr. Jetelina’s compilation of information here is a huge public service that I hope will be widely read and considered. Add to this that, in a cross country comparison, we in the US pay a whole lot more than other countries for this miserable state of affairs. https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/
So clear. So accurate. So damning. I believe we can judge the intentions from the result. Our nation as a group does not want humane, compassionate, effective healthcare--in fact, it does not want health. My career in medicine has given me firsthand experiences which jibe really well with this column. As Bugs Bunny might say, our country is a moroon.
I agree with everything in the article. But I think the primary reason, the overwhelming reason, that the US and UK recommendations are different is because of funding. The UK health system was deciding who it would pay to vaccinate. And when you add up all the at risk people and the people they interact with (at home, in shops, etc.) they are actually paying for a lot of jabs. But not for everyone. The US CDC was deciding who would be allowed to get the vaccine, and whether other entities (mostly health insurers) would have to pick up the cost. But the people who decided for the US had no responsibility for the funding.
Not only "subpar", but also not a "system".
Really helpful piece, but fyi, the ILF graph under the point about our terrible safety net and the US having zero paid sick leave doesn’t show sick leave; it’s about paid maternity leave (of which we also have zero, of course).
Well written assembly of data that I wish more of the US public understood - for this conversation and many others in healthcare.
(Cross post of my comment on Dr Paul Offits Substack from yesterday who argued for targeted protection)
I put together a spreadsheet tracking recommendations by country here:
US, Canada outliers at 6 mo+
Austria at 12+ is outlier in EU.
New Zealand at 30+ is lowest after Austria and US/CAN.
After that 60-65+ is standard recommendation.
Considering that only 2.1% of the EU bothered with 3rd booster, I suspect only a handful will go for the 4th anyway. The public is treating CDC/PH like Catholics regard Vatican recommendations not to use birth control.
I love this article for so many reasons -- the clear and concise articulation of so many elements of the ecosystem in which we live (and how and why decisions are made as a result) and a general primer on why context matters. Thank you!
Considering that currently 88% of hospitalization and death is occurring with at risk population, there is a need to really target them in messaging. As for the rest, durable immunity still seems to be working well. I also think the HCW will/should be targeted.
Additionally, for reasons that are unfounded, PCP seems to be slow in using antivirals like Paxlovid and Remdesivir. Both show 90% reduction used within the first 5 and 10 days respectively. Remdesivir seems to be getting harder to obtain. So, what's up with the FDA and VV116?
Of course, I've some things heard/seen/read, "its mild", "let's wait and see", "rebound" and "take when your temp is 102". When you test positive, this is when you need this in high risk populations. Psst, SARS-CoV-2 is biphasic and 2nd stage inflammatory response (so called rebound) is the natural history of COVID-19. This happens WITH or WITHOUT antivirals. We should be targeting this message!
Incredible explanation and sure wish this post would get "out" and "about"! Thank you very much.
Outstanding. Depressing, but valuable information.
To be fair, we should criticize health policy not for COVID but for all those other reasons as to why our country's healthcare is behind.
This is a stark, and discouraging, analysis of what we “kind of knew.” Thanks.