U.S. Healthcare

Re: U.S. Healthcare

PostBy: Wood'nCoal On: Fri Feb 29, 2008 9:37 pm

gaw wrote:
Wood'nCoal wrote:
So it's basically a report about how efficiently a country uses it's health care resources, sort of a glorified price comparison, not really rating the quality of the healthcare.

Exactly like a Consumer Reports best buy recommendation.


Yup!
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Re: U.S. Healthcare

PostBy: Dallas On: Fri Feb 29, 2008 9:38 pm

Wood'nCoal wrote:You're missing the point. There's lots of options for one who isn't happy with things in the US


For the money spent on healthcare in the US, much more per capita than anyone else, the heathcare is sub standard. That's not right, is it?
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Re: U.S. Healthcare

PostBy: spc On: Fri Feb 29, 2008 9:41 pm

stockingfull wrote:So we're 45th in life expectancy by CIA data, behind Japan, France, Canada and the UK.
All the overweight dems are dragging us down.
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Re: U.S. Healthcare

PostBy: stockingfull On: Fri Feb 29, 2008 9:41 pm

Wood'nCoal wrote:
stockingfull wrote:So we're 45th in life expectancy by CIA data, behind Japan, France, Canada and the UK.

Next -- I can't wait -- will the CIA be an unreliable, Micheal Moore-influenced source? :lol:

And, when all else fails, just wave the flag and all will be well.


You're missing the point. There's lots of options for one who isn't happy with things in the US


No, YOU'RE missing the point. I'm as much of a citizen of this country as you are and, if I want to promote serious change to address serious problems, you can't force your "love it or leave it" BS on me. It's old, tired and lame.

Sorry.
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Re: U.S. Healthcare

PostBy: stockingfull On: Fri Feb 29, 2008 9:42 pm

spc wrote:
stockingfull wrote:So we're 45th in life expectancy by CIA data, behind Japan, France, Canada and the UK.
All the overweight dems are dragging us down.


I thought the "Fat Cats" were Republicans. :lol:
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Re: U.S. Healthcare

PostBy: spc On: Fri Feb 29, 2008 9:44 pm

stockingfull wrote:
No, YOU'RE missing the point. I'm as much of a citizen of this country as you are and, if I want to promote serious change to address serious problems, you can't force your "love it or leave it" BS on me. It's old, tired and lame.

Sorry.
You need a good Doctor, I'll set you up?
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Re: U.S. Healthcare

PostBy: spc On: Fri Feb 29, 2008 9:45 pm

stockingfull wrote:
I thought the "Fat Cats" were Republicans. :lol:
In the pocket :)
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Re: U.S. Healthcare

PostBy: stockingfull On: Fri Feb 29, 2008 9:46 pm

spc wrote:
stockingfull wrote:
No, YOU'RE missing the point. I'm as much of a citizen of this country as you are and, if I want to promote serious change to address serious problems, you can't force your "love it or leave it" BS on me. It's old, tired and lame.

Sorry.
You need a good Doctor, I'll set you up?


If I agree with you, I've got a serious decision to make -- whether to leave the country.

But not to worry, I don't. :P
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Re: U.S. Healthcare

PostBy: stockingfull On: Fri Feb 29, 2008 9:57 pm

Dallas wrote:
Wood'nCoal wrote:You're missing the point. There's lots of options for one who isn't happy with things in the US


For the money spent on healthcare in the US, much more per capita than anyone else, the heathcare is sub standard. That's not right, is it?


Of course it's not right. But it's sure evidence of the greed in the pharmaceutical and healthcare insurance industries here.

And that's the biggest reason we have to get it fixed.
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Re: U.S. Healthcare

PostBy: Wood'nCoal On: Fri Feb 29, 2008 10:05 pm

stockingfull wrote:
Dallas wrote:
Wood'nCoal wrote:You're missing the point. There's lots of options for one who isn't happy with things in the US


For the money spent on healthcare in the US, much more per capita than anyone else, the heathcare is sub standard. That's not right, is it?


Of course it's not right. But it's sure evidence of the greed in the pharmaceutical and healthcare insurance industries here.

And that's the biggest reason we have to get it fixed.


Agreed, costs are out of control. But pointing out facts about other countries and their health care doesn't address the problems.
I may disagree with some of the things that you say but that doesn't mean I dislike you (even if you are wrong... :devil:).
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Re: U.S. Healthcare

PostBy: spc On: Fri Feb 29, 2008 10:09 pm

For the money spent on public education in the US, it's sub standard. That's not right. Privatize it.
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Re: U.S. Healthcare

PostBy: Richard S. On: Fri Feb 29, 2008 10:13 pm

Attached is an image compiled from screenshots I took of the statistics appendix used to generate the 2000 WHO report.

Full report can be found here: http://www.who.int/whr/2000/en/

The appendix with just the tables that this imagfe was created from can be found here: http://www.who.int/whr/2000/en/whr00_annex_en.pdf

I listed just three countries, France listed number 1, Columbia ranked number 22 and The US ranked 37.

The only... and I'll repeat that... the only .... indicator where Columbia beats the U.S. is for "Fairness in distribution" .

You will note that that the last 2 categories listed where Columbia beat the U.S. are compiled from the other statistics. Obviously "the Fairness in distribution" put them over the top however overall the US simply has better health care with most of the statistics much closer to France than Columbia does...

Although there is explanations as to what is used to gauge many of the statistics whether they are compilations or single stats there is no explanation how the overall performance was calculated that I can find or I'd rip into it .

Obviously listing Columbia above the the U.S. simply because everyone is paying the same is flawed.
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Re: U.S. Healthcare

PostBy: Dallas On: Fri Feb 29, 2008 10:29 pm

This is from the link I posted earlier. https://opencrs.com/rpts/RL34175_20070917.pdf

Summary of Findings
Total Spending. In 2004, the United States spent more than twice as much
on health care as the average OECD country, at $6,102 per person (compared with
the OECD average of $2,560). Health care spending comprised 15.3% of the U.S.
GDP in 2004, compared with an average of 8.9% for the average OECD country
(Figure 1). Although a country’s health expenditures are highly correlated with GDP
(Figure 2), U.S. health spending is nevertheless 60% greater than its GDP alone
would predict.
Health Care Resources. The United States has fewer hospital admissions
(Figure 3) and doctor visits (Figure 4) than the average OECD country. The United
States has a below-average number of hospital beds (Figure 22) and practicing
physicians per population (Figure 15), but its number of nurses per population is
roughly the same as the OECD average. The United States has a higher than average
number of staff per hospital bed (Figure 10) and nurses per bed (Figure 11). The
length of hospital stays in the United States are the same as the OECD average
(Figure 5).
The United States spent a per capita average of $2,668 on outpatient care in
2004 — three-and-a-half times the OECD average. In most OECD countries, visits
to general practitioners outnumber visits to specialists — but not in the United States.
The United States has a greater supply of advanced technological equipment than
other OECD countries, with nearly twice as many CT scanners per capita as the
OECD average (Figure 12) and three times as many MRI machines (Figure 13).
The United States also performs far more heart procedures per population than the
average OECD country (Figure 9), and an above-average amount of organ
transplants per capita, but does not perform more of all types of surgical procedures.
Pharmaceuticals. The United States spends more on prescription drugs per
capita than any other OECD country (Figure 18). The United States also consumes
more prescription drugs than most OECD countries, according to a nine-country
study (Figure 17). That study found that the United States paid more for brand name
drugs but less for generic drugs than other OECD countries (Figure 16).
CRS-59
102 Association of American Medical Colleges, “2006 Medical School Graduation
Questionnaire: All Schools Report, FINAL,” p. 49, available at [http://www.aamc.org/
data/gq/allschoolsreports/2006.pdf].
Health Administration and Insurance. Spending on health administration
and insurance cost $465 per person in the United States in 2004, which was seven
times that of the OECD median (Figure 20). Americans pay less out-of-pocket for
health care (as a percentage of total health care spending) than residents of most
OECD countries (Figure 21).
Prices. Although OECD data does not compare prices of medical care, other
studies have found that the United States pays higher prices for medical care than
countries such as Canada and Germany. Part of the reason for this may be that U.S.
general practitioners and nurses are the highest paid in the OECD, and U.S.
specialists are the third-highest paid in the OECD (Table 2). Health professionals
in wealthier countries earn higher salaries than those in poorer countries (Figure 14),
but even accounting for this, U.S. health professionals are paid significantly more
than the U.S. GDP would predict (for example, specialists are paid approximately
$50,000 more than would be expected). However, U.S. health care professionals also
enter the careers with substantially more educational debt than in other OECD
countries. For example, in 2006, 62% of new U.S. medical school graduates had
educational debt exceeding $100,000.102
Population Risk Factors. The United States had a lower than average
proportion of the population that is elderly in 2004, and lower than average rates of
smoking and drinking. The United States consumes more calories and sugar per
capita than any other OECD country: the United States consumes 156 pounds of
sugar per person per year, compared with 99 pounds in the average OECD country.
In 2004, 34% of Americans were overweight and an additional 32% were obese.
Obesity is associated with a 77% increase in consumption of medications and a 36%
increase in inpatient and outpatient spending, according to one study.
Quality. In terms of quality of health care, a five-country study found that each
of the five countries studied (the United States, Canada, the United Kingdom,
Australia, and New Zealand) had the best and worst health outcomes on at least one
measure, but no country emerged as a clear quality leader. For example, the United
States had the highest breast cancer survival rate but the lowest kidney transplant
survival rate. A six-country study (the United States, Canada, the United Kingdom,
Australia, New Zealand, and Germany) found that Americans were most likely to
report receiving specific recommended preventive services for diabetic and
hypertensive patients, but were most likely to complain that their doctor did not
spend enough time with them and did not have a chance to answer all of their
questions.
Wait Times. The United States is one of eight countries in which wait times
for elective surgery are reported to be low. In a recent survey, a quarter to a third of
respondents in Canada, the United Kingdom, and Australia reported waiting more
than four months for a non-emergency procedure, compared with only 5% of
Americans. In terms of doctor visits to primary care physicians, a five-country
CRS-60
survey found that Americans had the greatest difficulty getting care on nights and
weekends and were the most likely to forgo care because of cost.
Health Outcomes. The United States has the third-highest percentage of the
population that reports their health status as being “good,” “very good,” or
“excellent” (Figure 23). However, the United States has below-average life
expectancy (Figure 24) and mortality rates (Table 5). The United States has the
third-highest rate of deaths from medical errors (Figure 25) and the highest infant
mortality rate among the eight countries that report this metric similarly (Figure 26).
However, such measures are often subjective or limited by differing measurement
methodologies. They may also reflect fundamental population differences (in
underlying health, for example) rather than differences in countries’ health care
systems. These are just some of the difficult research issues facing international
comparisons like those used in this report.
Dallas
 
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Re: U.S. Healthcare

PostBy: pvolcko On: Sat Mar 01, 2008 2:27 am

1) Many (perhaps most or even all) of these national ranking type lists are based on data that is self reported by the nations in question. Many industrialized nations suffer for being truthful in their reporting and having strong overall auditing of their national data. This makes finding a reliable list very difficult.

2) Many of these efforts confuse good health of a nation with good health care. They are two different things. I have excellent health care available to me. I probably should avail myself of it more often, but I don't. Beyond that I make and have made choices in my life that would put me on the list of the unhealthy, despite having access to excellent health care my entire life. Is that the fault of the health care system? Only if you believe people should be mandated to make doctors visits and follow medical advice and be unable to refuse doctor/system recommended treatments. I'm not alone, a great many people in this country are unhealthy of their own accord or due to circumstance outside the control of any freedom embracing health care system. Furthermore a great many people chose not to carry insurance or avail themselves of the services available to them for any number of reasons (excluding for the moment those who are poor). A nation can have excellent health care available yet still have a disproportionately unhealthy populace due to this kind of cultural ethic and personal freedom.

2.1) Many of these reports, including the WHO 2000 report, place higher value on "pre payment" systems vs at the moment systems. Sometimes this refers to preventative care and sometimes it refers to simple insurance premiums vs. paying the whole shot at the time of treatment. In either case, it is again often a philosophical difference that should be immaterial to a ranking of quality of health care in a nation. If a nation or a person choses to pay only when services are needed instead of pre-paying for expected services or if a person favors lots of preventative care instead of waiting until the health crisis occurs, that says nothing about the quality of care available, only the cultural and philosophical (and perahaps cost basis) of that care.

3) Many such studies assume that people paying for health services out of pocket is a bad thing. This is a philosophical issue that should have no place in a reliable report, but it finds its way into a great many of them, including the WHO 2000 report. India and Brazil, for instance, get very low rankings due to their populations paying high out of pocket shares for their services. The US, similarly, gets docked for having a roughly 50-60% share of medical expenses paid either by individuals or private medical insurance. This report and many others start with the assumption that health care should be paid as much as possible by anyone but the patient.

4) Connected to #3, these reports also often find nations at fault for what they consider unfair or inequitable health care distribution based on economic need. These reports favor highly progressive out of pocket payment structures. Put simply, the poor should get all the health care available for nothing, the rich should have to pay for that same care. If the rich can afford out of system (or even out of country) care that isn't available to the poor who are covered by public funds, then it is counted as a ding against the nation. This is one of the reasons why nations like England and Canada don't do better on such rankings, due to the high cost of the excellent services available, they end up rationing availability of care to keep costs down. This rationing has secondary effects of reducing the attractiveness of practicing medical professions in those countries, which also hurts the nations in their rankings due to imbalances of doctors/nurses to patient ratios.

I don't know if there exists a report that concerns itself purely with the quality of care available in nation. I'm certainly not going to go looking for it. I don't have the time or inclination and I doubt that if I did manage to dig up such a gem that it would be accepted as an unbiased or reliable source. And even if it was accepted as such, it isn't at all clear it would make a difference to anyone's thinking. I've spent a good part of the last several years debating people on a politics oriented discussion list and the one thing I've learned is that it is a very rare thing for an "advocate" to change their mind, regardless of the time, effort, and quality of argument and/or research provided. Too rare for me to try any more.
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Re: U.S. Healthcare

PostBy: stockingfull On: Sat Mar 01, 2008 1:33 pm

Excellent analytical points.

But what I've been getting at here is that, if there are well over 40 million people without health insurance in this country, we've got a problem that has to be dealt with. And, for that reason alone, we can't possibly have the "best healthcare in the world."

So we need to have a fullsome discussion of how to make it better. Unburdened by the flag-waving, walk-away lines that we've got the "best healthcare in the world," implying that what ain't broke don't need fixin'. It's definitely in need of fixin'.

Besides, don't people realize that, once we get healthcare separated from the workplace, employers won't have to be the bad guys who have to raise employee contributions and co-pays all the time and people won't have to stay in jobs they don't want just because they need the health insurance for their families? It's really a liberty issue.

We need new group health coverage -- and the "group" is the population of the United States of America. If we can shoot down satellites, we're smart enough to study the other programs that have been tried and devise one that works best for everybody.
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