Benefits of single payer systems

Edward Winslow edbjwinslow at GMAIL.COM
Sun May 21 00:03:37 UTC 2017

Probably a more reliable measure would be the kidney mortality rate (deaths
per 100,000/yr). This would account for diagnosis reliability and treatment
effects. If the renal cancer mortality rates were different then one could
try to dissect the reason for the differences. This, of course, depends on
the accuracy of death attribution, which I'd difficult without post mortem
Peggy, do you have these data?

Rob, I'm not sure the data you are requesting exist. Interesting to see
whether Mark, or Paul, among others, have any insight.
On Sat, May 20, 2017 at 1:15 PM Peggy Zuckerman <peggyzuckerman at>

> I can only comment on what I read from kidney cancer patients in the UK.
> Though it is a single payer system, the available resources vary
> dramatically within the UK.  Also getting a CT exam is far more difficult,
> which is critical in diagnosing many solid tumors.
> My extremely rough measure of improvement in kidney cancer in the US and
> the UK comes from the ratio of newly diagnosed and deaths in any one year.
> Though that ratio from about 15 years ago showed a 1 death for every 2
> diagnosed in  both countries (exp; US 30K diagnosed in 2003 with 14K
> deaths), with the ratio much improved in the US, about 1 death per 5
> diagnosed, and in the UK staying about 1 death to less than 3 diagnosed.
> Some of that is naturally attributed to their generally more limited
> medications, which are also varied, region to region, and by the assessment
> of the years of 'quality' life one drug might bring.  This measure is based
> on clinical trial data, which may or may not reflect real life patients.
> And the description of Quality of Life Year I read most recently required
> that a patient be considered "healthy" through out that year.  Not likely
> to happen with metastatic kidney cancer, but many good years given to
> patients who take the available drugs are pretty welcome years!
> Peggy
> Peggy Zuckerman
> On Sat, May 20, 2017 at 7:29 AM, Robert Bell <
> 0000000296e45ec4-dmarc-request at> wrote:
>> Is there any evidence that single payer systems such as the VA, Medicare,
>> and even those in other developed countries help reduce the prevalence of
>> errors in diagnosis?
>> Rob Bell, MD
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*Edward B, J. Winslow, MD, MBA*
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