US healthcare system

[Ali_R]

Re: US healthcare system

^ i live in a country with "free healthcare" and have lived in USA. I found the care I recieved in the US orders of magnitude better.

Can you elaborate on that "magnitude better" treatment you got?
Do you believe that USA is on the same level regarding healthcare treatment as compared to mid-Europe or UK?
Please do differ here. Some service is provided for "free", without spending another extra 10s of dollars i.e on a flue, allergy, dental treatment. Isn't that something worth? It is made to relieve the low middle and middle class financially. A person from upper middle class and hi-fi society will not feel the difference at all.

[ravage]

Re: US healthcare system

Can you elaborate on that "magnitude better" treatment you got?

One example: For a particular type of blood test, I got the results in an hour in the US, and in two-three weeks in UK. So if getting timely results is a measure (a necessary step in timely care) then the US provided care was two orders of magnitutde (100 times) better than the care in UK. I already talked about my mother's case that was hopelessly screwed by the carers here, constrained by the system they work in (which is constrained by the stress placed on it)

[quote]

Do you believe that USA is on the same level regarding healthcare treatment as compared to mid-Europe or UK?

[/quote]

Depends on how you define "level" doesnt it? Efficiency, competance, timeliness, quality? Definitely much better than the UK. Universality, no not as good.

[quote]

Please do differ here. Some service is provided for "free", without spending another extra 10s of dollars i.e on a flue, allergy, dental treatment. Isn't that something worth? It is made to relieve the low middle and middle class financially. A person from upper middle class and hi-fi society will not feel the difference at all.
[/QUOTE]

As you say, nothing is free. Unless the care providers are themselves government run, you will have money making endeavours inside the system. Inevitably everyone is paying for his own care, and the care of someone other than him, otherwise those endeavours wouldnt survive. So its safe to say that you end up paying more to the money making institutions than you otherwise would.

[Ali_R]

Re: US healthcare system

One example: For a particular type of blood test, I got the results in an hour in the US, and in two-three weeks in UK. So if getting timely results is a measure (a necessary step in timely care) then the US provided care was two orders of magnitutde (100 times) better than the care in UK. I already talked about my mother's case that was hopelessly screwed by the carers here, constrained by the system they work in (which is constrained by the stress placed on it)

May I ask what you paid for the blood test in US?
Well If UK has such delays then there is something wrong with their healthcare system. We in mid-Europe get the result on the same day (in some hours) (and yet I had to pay nothing). And even in Pak you get the result on the same day!
Well such incidents like that with your mom happen (unfortunately), but such cases do happen in the States as well. I have had people complaining about docs and their under-qualification and yet they paid lots of money to get one or two operations done properly.

[quote]
Depends on how you define "level" doesnt it? Efficiency, competance, timeliness, quality? Definitely much better than the UK. Universality, no not as good.
[/quote]

I'm talking about the treatment level, which includes efficiency, competance, quality and qualification of a doc. As I said above I had heard complains about US docs too. The more money you spend the better result you get....is actually not always true nor right. My father is best example and finally he had his health problem solved by a Pak military doc, with half as good equipment and with a doc's degree from a less respected UNIVERSITY.
And It worked.

But I still believe healthcare systems like in mid-Europe do benefit you financially a lot. You wont hesitate going to a doc at any time, since you will not feel that the docs are looting you. WHereas with private insurances docs tend to make more money, thus invite the patient every second day to their clinic although 1 check-up a month would be more than satisfying.

[ashtray]

Re: US healthcare system

^ i live in a country with "free healthcare" and have lived in USA. I found the care I recieved in the US orders of magnitude better.

says a 2 pasli ki jaan :p

[ravage]

Re: US healthcare system

May I ask what you paid for the blood test in US? Well If UK has such delays then there is something wrong with their healthcare system. We in mid-Europe get the result on the same day (in some hours) (and yet I had to pay nothing). And even in Pak you get the result on the same day!

I paid whatever my co-pay was.. I think 10 dollars for the doctor + two lab tests, one of which is very expensive.

And yes 2 weeks is normal turnover time here, for even simple X-rays.

[quote]

Well such incidents like that with your mom happen (unfortunately), but such cases do happen in the States as well. I have had people complaining about docs and their under-qualification and yet they paid lots of money to get one or two operations done properly.

[/quote]

I guess thats anecdotal. My experience with US docs is great, Im sure theres some bad stuff too. But waiting times are never as bad in US as they routinely are in UK and Canada.

[quote]

I'm talking about the treatment level, which includes efficiency, competance, quality and qualification of a doc. As I said above I had heard complains about US docs too. The more money you spend the better result you get....is actually not always true nor right. My father is best example and finally he had his health problem solved by a Pak military doc, with half as good equipment and with a doc's degree from a less respected UNIVERSITY.
And It worked.

[/quote]

Earlier in the thread I cited Pakistan as a case where the healthcare is much much better than is supposed. Its affordable and competant.

My mother eventually got her care from a surgeon in Karachi, who coincidentally had trained and practiced in UK too. Same level of competance, same equipment, different country. For a comparatively piddling amount (in pounds).

[quote]

But I still believe healthcare systems like in mid-Europe do benefit you financially a lot. You wont hesitate going to a doc at any time, since you will not feel that the docs are looting you. WHereas with private insurances docs tend to make more money, thus invite the patient every second day to their clinic although 1 check-up a month would be more than satisfying.
[/QUOTE]

Dunno. I've never lived in mid-europe (Im not even sure what mid-europe is!) so I cant say. It possibly has to do with the strain on the system, how many people are using it vs how many people are paying for it. NHS here is not in great shape, which I guess accounts for the bad services.

[ravage]

Re: US healthcare system

says a 2 pasli ki jaan :p

ab 4 pasli ka ho chuka houn

[X2]

Re: US healthcare system

In any case, why should physician wages be lower in the US? After at least 12 years of post-secondary training, plus approximately 300,000-500,000 dollars of educational debt, its absolutely absurd to expect physicians to work 60 hrs/week for 60K/year. They have every right to protect their profession from being flooded with poorly trained FMGs just to drop their wages...not to mention the fact that dropping physician wages wouldnt even have a dramatic effect on total healthcare expenditures.

decrease educational expenses then.

dropping physician wages will have a drmatic effect, there are case studies out there on costs.

but US doctors can either get with the program or start facing competition from nurse practitioners as is being piloted in partnerships with phramacies right now.

additionally, with areas like radiology being outsourced now in some areas, thats yet another challenge.

and lastly the increase in medical tourism indicates other issues.

the unholy greed between the medical establishment- lawsuit happy lawyers- and insurance comanies is screwing over people...and each other really.

[X2]

Re: US healthcare system

in US those who are covered and have insurance get better care than pretty much any other nation.

now lets look at the flip side..47 million people dont have ANY coverage. basically meaning they do not have access to the best care.

and the results..shameful..

http://www.msnbc.msn.com/id/22554235/

France best, U.S. worst in preventable deaths
British study’s rankings based on access to timely and effective health care
Reuters
updated 8:44 a.m. CT, Tues., Jan. 8, 2008
WASHINGTON - France, Japan and Australia rated best and the United States worst in new rankings focusing on preventable deaths due to treatable conditions in 19 leading industrialized nations, researchers said on Tuesday.

If the U.S. health care system performed as well as those of those top three countries, there would be 101,000 fewer deaths in the United States per year, according to researchers writing in the journal Health Affairs.

Researchers Ellen Nolte and Martin McKee of the London School of Hygiene and Tropical Medicine tracked deaths that they deemed could have been prevented by access to timely and effective health care, and ranked nations on how they did.

They called such deaths an important way to gauge the performance of a country’s health care system.

Nolte said the large number of Americans who lack any type of health insurance — about 47 million people in a country of about 300 million, according to U.S. government estimates — probably was a key factor in the poor showing of the United States compared to other industrialized nations in the study.

“I wouldn’t say it (the last-place ranking) is a condemnation, because I think health care in the U.S. is pretty good if you have access. But if you don’t, I think that’s the main problem, isn’t it?” Nolte said in a telephone interview.

In establishing their rankings, the researchers considered deaths before age 75 from numerous causes, including heart disease, stroke, certain cancers, diabetes, certain bacterial infections and complications of common surgical procedures.

Such deaths accounted for 23 percent of overall deaths in men and 32 percent of deaths in women, the researchers said.

France did best — with 64.8 deaths deemed preventable by timely and effective health care per 100,000 people, in the study period of 2002 and 2003. Japan had 71.2 and Australia had 71.3 such deaths per 100,000 people. The United States had 109.7 such deaths per 100,000 people, the researchers said.

After the top three, Spain was fourth best, followed in order by Italy, Canada, Norway, the Netherlands, Sweden, Greece, Austria, Germany, Finland, New Zealand, Denmark, Britain, Ireland and Portugal, with the United States last.

Previous rankings
The researchers compared these rankings with rankings for the same 19 countries covering the period of 1997 and 1998. France and Japan also were first and second in those rankings, while the United States was 15th, meaning it fell four places in the latest rankings.

All the countries made progress in reducing preventable deaths from these earlier rankings, the researchers said. These types of deaths dropped by an average of 16 percent for the nations in the study, but the U.S. decline was only 4 percent.

The research was backed by the Commonwealth Fund, a private New York-based health policy foundation.

“It is startling to see the U.S. falling even farther behind on this crucial indicator of health system performance,” Commonwealth Fund Senior Vice President Cathy Schoen said.

“The fact that other countries are reducing these preventable deaths more rapidly, yet spending far less, indicates that policy, goals and efforts to improve health systems make a difference,” Schoen added in a statement.

[ravage]

Re: US healthcare system

47 million.. wow. Thats basically 1 in every 6 americans, correct?

Still, I say dont mess with a system that according to X2 provides the best care in the world to 5 in 6 americans.

instead, maybe create a parallel system to cater for those left out. and reduce the financial burden (insurance costs) on the 5 out of 6 by the deregulation/lawyer busting etc.

[Ali_R]

Re: US healthcare system

I paid whatever my co-pay was.. I think 10 dollars for the doctor + two lab tests, one of which is very expensive.

And yes 2 weeks is normal turnover time here, for even simple X-rays.

I guess thats anecdotal. My experience with US docs is great, Im sure theres some bad stuff too. But waiting times are never as bad in US as they routinely are in UK and Canada.

Earlier in the thread I cited Pakistan as a case where the healthcare is much much better than is supposed. Its affordable and competant.

My mother eventually got her care from a surgeon in Karachi, who coincidentally had trained and practiced in UK too. Same level of competance, same equipment, different country. For a comparatively piddling amount (in pounds).

Dunno. I've never lived in mid-europe (Im not even sure what mid-europe is!) so I cant say. It possibly has to do with the strain on the system, how many people are using it vs how many people are paying for it. NHS here is not in great shape, which I guess accounts for the bad services.

mid-Europe = Central Europe :p

Well you should live in Central Europe to make proper judgement on healthcare systems for free or private based healthcare.
I wouldnt go judging by the UK system. What of I have heard by you It seems pretty awefull to what we have at "mid-Europe".

[X2]

Re: US healthcare system

47 million.. wow. Thats basically 1 in every 6 americans, correct?

Still, I say dont mess with a system that according to X2 provides the best care in the world to 5 in 6 americans.

instead, maybe create a parallel system to cater for those left out. and reduce the financial burden (insurance costs) on the 5 out of 6 by the deregulation/lawyer busting etc.

thats what I meant, a safety net system for those who fall through the cracks.
deregulation, lawsuit limitations, malpractice insurance limitations, health insurance company limitations on coverage, increase number of doctors and reduce doctor pay to bring it in line with the rest of the industrialized world.

[janab-e-ali]

Re: US healthcare system

decrease educational expenses then.

Easier said than done.

What are you going to do...nationalize all of the private medical schools in the US? Even public medical schools in the US charge 20-30,000/year in tuition.

dropping physician wages will have a drmatic effect, there are case studies out there on costs.

That's absurd.

Total annual healthcare expenditures in the US amount to over $2 trillion.

There are approximately 800,000 physicians in the US...earning an average of approximately $180,000/year. Lets just round that up to 200K...which means that the annual income for all American physicians adds up to $160 billion...or 8% of total healthcare expenditures. Clearly, the problem lies elsewhere.

but US doctors can either get with the program or start facing competition from nurse practitioners as is being piloted in partnerships with phramacies right now.

additionally, with areas like radiology being outsourced now in some areas, thats yet another challenge.

So you're saying that the solution to these 'turf wars' is to just open the floodgates to FMGs, and not even expect them to pass the same exams as American doctors. Brilliant.

the unholy greed between the medical establishment- lawsuit happy lawyers- and insurance comanies is screwing over people...and each other really.

Since when are malpractice attorneys part of the "medical establishment?"

They take the same exams (you meant USMLE right?) as their american counterparts. As I understand it the process is two exams, spaced out over a few months, then wait for a residency, then in-house training over there? Just takes way too long, even if its the same time as american doctors take.

That's about right. The USMLEs are in 2 parts...American medical students take the first part after completing the first two years of medical school, then take the second part before graduating. There's also a clinical skills exam that they have to take before they graduate as well.

FMGs have to take all 3 exams, then compete for a residency training position through the same system as American med students. As it stands, the American system is probably more egalitarian than the vast majority of European healthcare systems...many of which don't even allow foreign trained doctors to practice, period.

Other countries have healthcare too. How about having equivalency at the level of medical associations with trustworthy countries, and then having a much less rigorous process?

The vast majority of doctors who will want to immigrate to the US will be from places like India, Pakistan, the Philippines, etc...developing nations with unreliable medical training. Moreover, the training they receive is going to be more geared towards medical problems that they see there...different subjects are emphasized, etc.

As it stands people are losing their lives and health at a very large scale anyway. The only thing you're saying is that we wont provide them potentially inferior (but much needed) care at the risk that they will file a lawsuit. The only thing standards are doing is depriving the lower classes of healthcare.. the insured will always be able to afford quality care.

The solution is to make insurance cheaper with tax breaks and whatnot, not bringing in foreign quacks and reducing the average quality of healthcare in the US. And what about lawsuits...considering how litigious American society is, its a serious concern? Why would hospitals even want to incur the liability of having poorly trained physicians on staff?

Again, lower standards are not the solution.

Hospitals can enforce stringent standards at the level of their institutions. If you can afford it, go to one of those hospitals that only hires Amreeki thoroughbred doctors. If you're living in an urban ghetto, Im sure you'd appreciate being able to see ANYONE, even if they didnt jump through the USMLE hoops.

So you think we should follow the Saudi model...2 parallel healthcare systems.

One with the fancy, American trained physicians...the other with the foreign, non-board-certified, doctors who couldnt even pass their exams? And you don't think people would have issues with that?

[ravage]

Re: US healthcare system

@janab-e-ali

So you think we should follow the Saudi model...2 parallel healthcare systems.

One with the fancy, American trained physicians...the other with the foreign, non-board-certified, doctors who couldnt even pass their exams? And you don't think people would have issues with that?

I think they need the tax breaks, the reduction in lawsuits, more doctors, AND something like the parallel healthcare/safety net (that doesnt end up lowering quality of the existing system)/whatever you want to call it for those who still cant afford insurance.

no matter how many tax breaks you give thats still not gonna help those not paying tax.

having levels of healthcare depending on ability to pay may not be palatable, but until everyone is able to pay, something needs to be done for them beyond tax breaks.

[X2]

Re: US healthcare system

@janab-e-ali

Easier said than done.

just because something is hard to do does not mean its nto worth doing. do u know the change in number of docs graduated from US unis in 1970s, and 1980s and now? clearly there is an issue

@janab-e-ali

What are you going to do…nationalize all of the private medical schools in the US? Even public medical schools in the US charge 20-30,000/year in tuition.

nope, just have more med schools

@janab-e-ali

That’s absurd.

Total annual healthcare expenditures in the US amount to over $2 trillion.

There are approximately 800,000 physicians in the US…earning an average of approximately $180,000/year. Lets just round that up to 200K…which means that the annual income for all American physicians adds up to $160 billion…or 8% of total healthcare expenditures. Clearly, the problem lies elsewhere.

its the entire medical establishment, which is overpriced, costs of tests, medicines, diocs, nurses, u name it.

@janab-e-ali

So you’re saying that the solution to these ‘turf wars’ is to just open the floodgates to FMGs, and not even expect them to pass the same exams as American doctors. Brilliant.

No, thats not what I am saying, thats what you are hearing. I simply said, allow more physicians to practice. The limitations on number of residencies is one issue, and if you go back to the whoel issue of more teaching hospitals and more med schoosl that is looking at the same point. There clearly is an issue witrh supply and demand, u can only decrease demand so much, so u have to increase the supply.

@janab-e-ali

Since when are malpractice attorneys part of the “medical establishment?”

well lets call it medical messup that we have right now, when their actions increase costs of medical industry then they are part and parcel of the issue, just like teh artificial measured to keep physician supplies low and thus wages high.

i know where u get your figures from, and teh same place had the strategies proposed by AMA.

clearly there is an issue with AMA stance. i would let others read it and decide what gaps they see here

http://www.ama-assn.org/ama1/pub/upload/mm/478/healthcarecosts.pdf

[X2]

Re: US healthcare system

a quarter of the docs in US already are foriegn educated and this the breakdown of where they are from’

American Medical Association | AMA

Top 20 countries where IMGs received medical training

The following list ranks the top 20 countries where the largest numbers of U.S. physicians trained. These data do not represent citizenship or ethnic origin; they only represent the location of the medical school where the U.S. practicing physician obtained their medical degree.

India - 19.9% (47,581)
Philippines - 8.7% (20,861)
Mexico - 5.8% (13,929)
Pakistan - 4.8% (11,330)
Dominican Republic - 3.3% (7,892)
U.S.S.R. - 2.5% (6,039)
Grenada - 2.4% (5,708)
Egypt - 2.2% (5,202)
Korea - 2.1% (4,982)
Italy - 2.1% (4,978)
China - 2.0% (4,834)
Iran - 2.0% (4,741)
Spain - 1.9% (4,570)
Dominica - 1.9% (4,501)
Germany - 1.9% (4,457)
Syria - 1.5% (3,676)
Columbia - 1.4% (3,335)
Israel 1.4% (3,260)
England- 1.4% (3,245)
Montserrat (3,111)

[janab-e-ali]

Re: US healthcare system

just because something is hard to do does not mean its nto worth doing. do u know the change in number of docs graduated from US unis in 1970s, and 1980s and now? clearly there is an issue

The number has gone up. A number of medical schools have opened since then, and none (as far as I know) have closed.

nope, just have more med schools

Really? And where will the funding for that come from? What about the funding for residency training for all those new graduates? And, if you do reduce wages by flooding the market, who's going to want to incur hundreds of thousands of dollars of debt and spend over a decade in training to become a doctor?

its the entire medical establishment, which is overpriced, costs of tests, medicines, diocs, nurses, u name it.

You were talking about physician wages specifically, and I was just pointing out how ridiculous that was.

And how, pray tell, will flooding the market with doctors reduce the cost of medications and tests?

No, thats not what I am saying, thats what you are hearing. I simply said, allow more physicians to practice. The limitations on number of residencies is one issue, and if you go back to the whoel issue of more teaching hospitals and more med schoosl that is looking at the same point. There clearly is an issue witrh supply and demand, u can only decrease demand so much, so u have to increase the supply.

The US already has a higher physician to population ratio than a number of countries with more "egalitarian" healthcare systems (the UK, Canada).

[X2]

Re: US healthcare system

The number has gone up. A number of medical schools have opened since then, and none (as far as I know) have closed.

you are missing the point. compare the number as a ratio to population growth rates as well as teh number of foriegn doctors. dont look at plain numbers look at ratios..

Really? And where will the funding for that come from? What about the funding for residency training for all those new graduates? And, if you do reduce wages by flooding the market, who's going to want to incur hundreds of thousands of dollars of debt and spend over a decade in training to become a doctor?

why is it that medical education is not that expensive in other countries?
other nations produce doctors, where med schools are cheaper and wages are low, and in terms of quality of care, they are not that bad are they.

You were talking about physician wages specifically, and I was just pointing out how ridiculous that was.

physician wages are ridiculous, and so are that of nursing staff. our entire medical system is overpriced. and sadly each group, doctors, nurses, pharma, point fingers at others.

And how, pray tell, will flooding the market with doctors reduce the cost of medications and tests?

i am talking about teh entire medical cost issue, our entire medical establishment and everything related to it is way overpriced.

The US already has a higher physician to population ratio than a number of countries with more "egalitarian" healthcare systems (the UK, Canada).

such a shame that US scores rock bottom in industrialized nations when it comes to preventable deaths then eh?

so more doctors, whi are more expensive, more expensive medical facilities, more expensive meds..all have basically screwed over the consumer

[janab-e-ali]

Re: US healthcare system

you are missing the point. compare the number as a ratio to population growth rates as well as teh number of foriegn doctors. dont look at plain numbers look at ratios..

Again, the doctor to population ratio has been going up.

why is it that medical education is not that expensive in other countries? other nations produce doctors, where med schools are cheaper and wages are low, and in terms of quality of care, they are not that bad are they.

Simple...the government basically pays for medical school (which might work when you have a smaller population, and aren't training that many doctors), and medical training is a lot shorter in those countries.

If you paid a few hundred Euros/year for school, and your medical training consists of a bachelors level degree, then it's not a big deal if you're earning 60-80K/year.

Unfortunately, here in the US, where many doctors make have to make loan payments of 20-25K/year, that's just not practical.

such a shame that US scores rock bottom in industrialized nations when it comes to preventable deaths then eh?

Yeah, its also such a shame that most cutting-edge medical discoveries happen here, most new drugs are discovered here...and just about everyone from those industrialized nations who can afford it comes here for treatment when they're really sick.

It's ridiculous to take 1 statistic in isolation and use it to condemn the entire American healthcare establishment.

[janab-e-ali]

Re: US healthcare system

**Some additional statistics on healthcare in the industrialized world:

***Waiting times *

          - Patients having to wait more than four months for surgery, by country - **US 5%**, Aus 23%, NZ 26%, Can 27%, Britain 36% (Schoen, Blendon, DesRoches, Osborn "Comparison and HEalth Care Systtem Views and Experiences in Five Nations, 2001" Commonwealth Fund, May 2002/ Harvard School of Public Health) Public Health) 

Equality

           - **Low income people in the US without job-related insurance spend only about $50 more out of pocket for health than those with**, 2.4 visits to doctor each year (3.4 without). When they are seriously ill, they receive same level of treatment (Johnson and Crystal, "Uninsured Status and Out of Pocket Costs at Midlife', Health Services Research 35, no 5, Dec 2000) 

Advanced technology

            - **In availability of advanced medical technology, Canada ranks last out of the 29 OECD countries** ('It's the Prices, Stupid: Why the United States is so Different from Other Countries' Anderson, Reinhardt, Hussey and Petrosyan, Health Affairs, vol 22, no 3, May 2003)

           - MRI units per capita: 2.5 canada, 3.9 UK, **8.1 US**; CT scanners, **13.6 US**, 8.2 Can, 6.5 UK, Lithotripsy units **1.5 US**, .4 Can, .2 UK (ibid)

           - Coronary bypass (per 100,000 people per yr), **203 US**, 65 Can, 41 UK, coronary angioplasty **388.1 US,** 80.8 Can, 51 UK, renal dialysis **US 86.5**, Can 45.7, UK 27

                          **Quality**

           - % of individuals 65+ reporting health as 'good', Aus 70.8, Can 70.2, Denmark 59.7, Ger 47.4, Neth 56.8, Nor 62.3, Swe 55.5, UK 56.5, **US 72.6** (OECD Health Data, 2002)

           - Ages 45-64: Aus 81.8, Can 84.9, Den 74.2, Ger 58.2, Neth 71.7, Nor 75.6, Swe 71.1, UK 71, **USA 85.4**

           - **In Britain, 20% of colon cancer considered curable at diagnosis are incurable by time of treatment **(The Observer, "Cash-strapped NHS Hospitals Chase Private Patient Bonanza" Anthony Browne Dec 2001)

                           - Breast cancer mortality ratio (% of those who have it that die from it) NZ 46 UK 46 Germ 31 Can 28 **US 25** France 35 Aus 28 (ibid) 

• Prostate cancer mortality ratio - NZ 30 UK 57 Ger 44 Can 25 US 19 France 49 Aus 35 (bid)

Prescription drugs

            - Only one in five drugs tested ever makes the market, averaging $900 million in costs for each new drug (Press release, "Total Cost to Develop a New Prescription Drug, Including Cost of Post-approval Research, is $897 Million" May 13, 2003, Tufts Center for the Study of Drug Development)

           - Economist Patricia Danzon discovered, excluding generic drugs (42% of US purchases), ignoring different consumption patterns, and ignoring rebates as a result of controlled study, comparing between 187 to 484 products, average prices in Canada, Germany, Sweden and Switzerland higher than in the US, but France, Italy, Japan, and the UK are lower. **But when variations of income are accounted for, prices in the US are lower than all except France **(Danzon, 'The Uses and Abuses of International Price Comparisons' in 'Competitive Strategies in the Pharmaceutical Industry, R. B. Hems (AEI press 1996), also 'Pharmaceutical Price Regulation: National Policies Versus Global Interests (AEI 1997)

           - By shopping around, best price shopping versus Canadian drugs,** for seven of ten drugs, US buyers can lower their costs an average of 38% below Canadian price**, and all **ten drugs produces average cost of 10% below buying in Canada **(Survey of pharmaceutical websites by 'Lives at Risk: Single Payer Health Insurance Around the World') 

• In Britain, the lack of access to the best cancer drugs costs lives of 25,000 Britons every year (Karol Sikora, 'Cancer Survival in Britain' British Medical Journal 319, no 7208 (Aug 1999) 461-62)

[X2]

Re: US healthcare system

Again, the doctor to population ratio has been going up.

US doctor to foriegn medical grad ratio is going down..

Simple...the government basically pays for medical school (which might work when you have a smaller population, and aren't training that many doctors), and medical training is a lot shorter in those countries.

the level of expertise of those docs is not inferior, as can be seen in hospitals in those countries and

If you paid a few hundred Euros/year for school, and your medical training consists of a bachelors level degree, then it's not a big deal if you're earning 60-80K/year.

sure, so lets have a bachelors level degree. seems to be working in other countries that are ahead of us in the preventable death stats. That alone shows there is an issue.

Unfortunately, here in the US, where many doctors make have to make loan payments of 20-25K/year, that's just not practical.

so the system needs changing, we can justify one ill with another ill. I am not suggesting that docs pay high fees and then are paid less, although it does seem to happen to teachers. have more schools, cheaper med education, and have docs comensated at similar levels as other palces, same goes for nurses, and then take a look at hospital admon costs, and pharma and tests costs and really decide whether an xray in US ought to be 3 times as much as in UK.

Yeah, its also such a shame that most cutting-edge medical discoveries happen here, most new drugs are discovered here...and just about everyone from those industrialized nations who can afford it comes here for treatment when they're really sick.

what good are cutting edghe medical discoveries when we have 47million ppl who cant get basic health care and when we have the highest level of preventable deaths. So as we focus on cutting edge treatments and fresearch that rich from those countries come and pay for, we are losing teh sight of the fact that basic healthcare is not accessible to millions of americans.

insurance premiums are high, because medical costs are high, and the costs need to be controlled. whether its salaries, mgmt costs, meds or tests.

that is a real shame.

It's ridiculous to take 1 statistic in isolation and use it to condemn the entire American healthcare establishment.

what is ridiculous, is to think that there is no problem with the entire american healthcare establishment. and pretend that there is nothing wrong. Its a mess.