With Apple recently surpassing Exxon for the world’s most valuable company, and Bloomberg reporting this week that Apple has just surpassed Coca-Cola as the world’s most valuable brand, it should come as no surprise that Steve Job’s death impacted so many in the U.S. and around the world. While his death was untimely, at age 56, what often goes unmentioned is how long his life was extended thanks to a medical system that doesn’t exist in any other country.
In 2004 Steve Jobs was diagnosed with a rare form of pancreatic cancer affecting the islet cells. This affects only 1.3 percent of pancreatic cancer patients. In 2009 he received a liver transplant because the disease had spread, which happens in about 10 percent of islet cell cases. He died last Wednesday from the condition.
The time added to his life by his medical treatment dramatically influenced the world in which we live. From the time he received a transplant alone, Apple stock grew about 350 percent. He was so influential in the company that Apple released a memo upon his passing stating that Jobs had outlined four years of ideas prior to his death. However, his chances of surviving cancer for five years prior to his transplant would not be so high anywhere else in the world. Likewise, nowhere else in the world would a pancreatic cancer victim receive a liver transplant.
President Obama’s appointee to run Medicare and Medicaid, Dr. Donald Berwick, has praised the British National Healthcare System (NHS), saying in 2008, “I fell in love with the NHS.”Former Senator, Tom Daschle wrote a book, regarded as the blueprint for Obama’s healthcare reforms, praising NHS and recommended we follow a similar approach in the United States.
But it is this same system that sets a limit on care at £20,000 (about $31,000) per quality-adjusted life year of health care. Job’s treatment would likely not be covered, as would his transplant. Even worse, in Britain, liver transplants are a monopoly of the NHS – so if you can’t get one through the NHS, you are given a death sentence.
Some may argue that this is alright, as the goal of medicine should be to combat inequality. After all, Jobs was wealthy, so of course he received adequate treatment in America, whereas others wouldn’t be as well off. This is true to an extent as inequality does exist, but to act as if a single-payer system like the NHS is a cure for inequality is to deny reality.
Putting medical funding in the hands of bureaucracies institutionalizes both implicit and explicit inequalities. The best performing hospitals in Britain are the ones in wealthy areas, whereas the worst hospitals are the ones in poor areas. Even the British newspaper, the UK Guardian, which staunchly supports NHS, concedes that in Britain, “the poorer you are and the more socially deprived your area, the worse your care and access is likely to be.” In fact, one study shows that if the mortality rate of cancer-related illness in Britain’s lowest socioeconomic groups were equal to that of the most affluent, there would be 16,600 fewer deaths from cancer each year – this is with a National single-payer system.
But, while there is still inequality after instituting the NHS in Britain, the access to health resources is less and outcomes are worse. Breast cancer and colon cancer mortality ratios in Britain are double what they are here. Prostate cancer is triple. CT scanners and MRI units per capita are more than double what they are in Britain.
When medical expenditures are placed in the hands of politicians, they are allocated on a very political basis. The incentives are such that they give small benefits to many people (those who are not ill) while detracting great benefits from those who are sick. If you believe, as I do, that the measure of quality in a healthcare system is what can be done for the ill, like Steve Jobs or the thousands of others, a single-payer healthcare system is not the answer but is a catastrophic problem.