Health Care Reform

[halplm]

We pay more because we get more. Better drugs, better equipment, longer life (although the fact that accidental and criminal deaths are rolled into the figures makes this not seem true) which results in more treatement as is necessary the older you get.

The USA is in position 38 in the UN statistics concerning life expectancy. Do you want to tell that the UD drops 37 positions because of crimes and accidents?

Also, assuming everyone gets their crime and accident statistics mixed in, why are Americans so prone to getting killed in crimes and accidents?

Because those are some of the risks that we have for some of the freedoms we enjoy.

[Ellienor]

There is no doubt (in my mind, at least) that if you have good health insurance, or are very wealthy, you will get top of the line care in the U.S. Which isn't surprising, because in the U.S. is where you have a tremendous amount of medical innovation going on. Drug research, device research, surgeon-inventors.....I am a patent attorney, I see it!

But we are talking about populations as a whole.

It's a difficult problem. In the U.S. there is a very strong sense of if you want something, you have to earn it, and that people are poor by their own fault. Whereas I think there is a little more noblesse oblige in Europe, or the poor aren't quite blamed so much for their own misfortune. So the fact that health care is meted out by income (or working for the government or union job) in the U.S. just seems to make more sense somehow here. I was born and raised here, and even though I am a Democrat, somehow I have a little bit of that attitude as well.

[Ellienor]

hal, are you just implying that accidents and crime are so much higher here that it skews the statistics with no facts, or do you have facts to show that it accidents/crime were taken out, that we would be #1, or much closer to #1?

[halplm]

hal, are you just implying that accidents and crime are so much higher here that it skews the statistics with no facts, or do you have facts to show that it accidents/crime were taken out, that we would be #1, or much closer to #1?

I looked for that, but found the article first, and it's a better explanation that just taking out accidents/crime. I'll see what I can find.

[River]

The USA is in position 38 in the UN statistics concerning life expectancy. Do you want to tell that the UD drops 37 positions because of crimes and accidents?

Also, assuming everyone gets their crime and accident statistics mixed in, why are Americans so prone to getting killed in crimes and accidents?

Because those are some of the risks that we have for some of the freedoms we enjoy.

Which freedoms in particular? The accidents thing is what really befuddles me. I've been to Europe. They're a bunch of maniacs behind the wheel and I won't even go into all the weird **** the climbers get into. If you ever explore an old castle in Serbia you will also quickly discover that in some parts, the concept of "safety railing" hasn't really taken hold. Nor do all places recognize the rights of pedestrians, or all pedestrians the rights of drivers. Yet you're telling me that the US has a higher accident death rate?? That suggests, to me, that either the Euros know how to calculate a risk better than we do OR we need to rethink how we handle trauma.

[halplm]

as a total guess, I would say a higher accident rate would be more likely due to a higher percentage of people driving cars.

[halplm]

hal, are you just implying that accidents and crime are so much higher here that it skews the statistics with no facts, or do you have facts to show that it accidents/crime were taken out, that we would be #1, or much closer to #1?

I looked for that, but found the article first, and it's a better explanation that just taking out accidents/crime. I'll see what I can find.

Apparenlty it's not as easy a number to figure out as you would expect. Some guys wrote a book a few years ago that is usually sited as a source for the idea. They used a regression rather than raw data, so it's not perfect, but it did result in the US being number 1.

Here's an article talking about it:
http://blogs.wsj.com/numbersguy/does-th ... b/article/

I'm surprised it's not something someone has done, but it's probably simpler to move on the all the other reasons life expectancy is a bad indicator of health care as was discussed in the article I linked on the last page.

[ToshoftheWuffingas]

You all know what my salary and contributions are already.

Of course it doesn't ENSURE it. But it makes it much more likely. As Yov said, cancer screenings alone. May I add to that? Mammograms. Colonoscopy. Blood pressure. Blood sugar. Pap test. Prostate tests. Thyroid exam.

Mammograms? My wife has had several. No extra charge

Coloscopy? When I turned 60 I got a bowel cancer screening package from the NHS out of the blue. I didn't know they existed and didn't ask for one. I sent off my second screening this autumn. No extra charge.

Blood pressure? Taken several times. My wife gets it done every month or two at her local clinic. No extra charge.

Pap test? Pass on that one. I don't know what it is without checking Google though I've heard the term used.

Prostate tests? No I haven't had one. All I need to do is to go to my doctor and ask for one. I know without question that I would get one.

Thyroid exam? I took my wife to the local hospital 3 days ago for a final checkup following some questions about thyroid function. She has been given the all clear but the consultant suggested a bone density scan as a follow up. (and a thyroid check in a years time -appointment already made for her) Two days later the appointment arrived in the post. It is to be in 10 days time. This is for a non emergency condition. No charge at all.
And that is just from Jewelsong's list

[halplm]

Do you really want to claim single examples of it working should convince anyone?

You do know that single examples can be found and presented for colossal failures of the system right?

I have not done so because I don't think it proves anything, and don't think it actually helps discussion of the theory.

For that matter, I could offer up any number of people that the US system works perfectly for, which doesn't really mean anything either.

[Ellienor]

For that matter, I could offer up any number of people that the US system works perfectly for, which doesn't really mean anything either.

Who are those people, Hal? Government employees? Mine has worked pretty well....when I've managed to be employed. Gotten laid off three times in my career. My husband's gotten laid off several times, most recently in August. So we lost that health insurance, and had to switch on to mine. I've changed insurance, let's see, since 2005....four times. Involuntarily. And my co-pays are high. My "share" is high. My husband had a colonoscopy at 55 because of his family history. I paid hundreds out of pocket for that one. And we have "good insurance." And are in a high income bracket.

[halplm]

Anyone who's not sick arguably has no problems with the health care system.

I was just pointing out that all sides of the issue can present examples that support their point of view, but that doesn't add to the discussion of the roots of the issues.

[ToshoftheWuffingas]

But I didn't cherry pick something hal to prove a point. I used my own personal example.
You want more? My mother in law is 96. A couple of weekends ago she took a tumble at night and got bad bruises and cuts. A paramedic team came and patched her up and checked her over. The distict nurse followed and checked her and her dressings again. She has been back three times to her house, A falls team will come to check her house for safety.
No charge. No cherry picking to find the best or the worst experience to prove a point, just everyday health care under socialism for one of the members of this board.

Freedoms? I pick my own doctor and can change him or her if I wish. I have plenty of choice. I live in a largish village of around 4,000. It has its own clinic with several doctors and nurses. A pharmacy is close enough to my front door that I could hit it with a stone. But I could get a prescription routed from my doctors to many more pharmacies in the nearby town 5 miles away if I wanted. My medicines cost me nothing now I am over 60. I no longer pay health contributions either.


Socialism is terrible isn't it?

[halplm]

But I didn't cherry pick something hal to prove a point. I used my own personal example.
You want more? My mother in law is 96. A couple of weekends ago she took a tumble at night and got bad bruises and cuts. A paramedic team came and patched her up and checked her over. The distict nurse followed and checked her and her dressings again. She has been back three times to her house, A falls team will come to check her house for safety.
No charge. No cherry picking to find the best or the worst experience to prove a point, just everyday health care under socialism for one of the members of this board.

Freedoms? I pick my own doctor and can change him or her if I wish. I have plenty of choice. I live in a largish village of around 4,000. It has its own clinic with several doctors and nurses. A pharmacy is close enough to my front door that I could hit it with a stone. But I could get a prescription routed from my doctors to many more pharmacies in the nearby town 5 miles away if I wanted. My medicines cost me nothing now I am over 60. I no longer pay health contributions either.


Socialism is terrible isn't it?

It is, although obviously not for everyone all the time. And of course, some people can recognize a lack of freedom and not care, as they don't want or need it. It's dangerous, though, because before you know it you can lose a freedom you take for granted, and then what?

anectdotal evidence is just dandy, but utterly irrelevant to a discussion of ideas.

[Primula Baggins]

What freedom does Tosh lack? Especially compared to an uninsured American?

[Inanna]

What kind of freedom would you lose?

[vison]

Anecdotes are not data. But data are data. Over 60 years of NHS, and the British are pretty satisfied with their system. Decades of the Canada Health Act, and we Canadians are good with ours.

In other words, halplm, you ignore or dismiss data that disturbs your worldview. That's your privilege, of course, but don't keep telling those of us with good public health systems that we are "anecdotes". Millions of people over decades comes to a lot of DATA.

We are just as "free" as you imagine yourself to be. Your SCOTUS has just sold your constitution down the river, so enjoy it while it lasts.

[Primula Baggins]

Yes, it's probably going to get pretty bad here, unless Congress grows a spine and does something to stop this.

Getting back to freedom, I just want to point out that Tosh actually has more freedom than most insured Americans, medically speaking; we only get affordable charges if we use an in-network doctor, so when we change plans, we often have to change doctors. We aren't free to get any test our doctors order, or any medicine they prescribe; on many plans, such as the one I was on for years, these things have to be preapproved, and it isn't unusual for the insurer to second-guess the doctor, insisting that a patient try a cheap and less effective generic before being allowed a prescription to a new drug that the doctor believes is more effective and/or safer.

These aren't anecdotes, by the way; they're policies of some insurance plans, including some I have been on.

I'm really seriously wondering what freedom we've got that Tosh does not—other than the freedom to die in an ER waiting room, of course.

[halplm]

Anecdotes are not data. But data is data. Over 60 years of NHS, and the British are pretty satisfied with their system. Decades of the Canada Health Act, and we Canadians are good with ours.

In other words, halplm, you ignore or dismiss data that disturbs your worldview. That's your privilege, of course, but don't keep telling those of us with good public health systems that we are "anecdotes". Millions of people over decades comes to a lot of DATA.

We are just as "free" as you imagine yourself to be. Your SCOTUS has just sold your constitution down the river, so enjoy it while it lasts.

HA, you mean restored the law to what it's supposed to mean.

I don't ignore or dismiss data. I just look at ALL of it, and actually think about what it means, rather than seeing the data I want and stopping there.

[ToshoftheWuffingas]

In “Measuring the Health of Nations: Up-dating an Earlier Analysis” (Health Affairs, Jan./Feb. 2008), Ellen Nolte, Ph.D., and C. Martin McKee, M.D., D.Sc., both of the London School of Hygiene and Tropi-cal Medicine, compared international rates of “amenable mortality”—that is, deaths from certain causes before age 75 that are potentially preventable with timely and ef-fective health care. In addition to the U.S., the study included 14 Western European countries, Canada, Australia, New Zealand, and Japan. According to the authors, if the U.S. had been able reduce amenable mortality to the average rate achieved by the three top-performing countries, there would have been 101,000 fewer deaths annually by the end of the study period.

No mention of deaths by gun crime or car accidents there. That's a red herring.
100,000 a year

[ToshoftheWuffingas]

Here you go: the list of disorders considered amenable to medical intervention.

http://www.ncbi.nlm.nih.gov/pmc/article ... able/tbl1/


that Americans die from at a greater rate than the rest of the OECD.

That's whatt paying twice as much per person or twice as much from GDP than the other countries buys you