US healthcare system

[X2]

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)  

of people who get surgery..

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) 

that does not explain the high levels of preventable deaths in US. they may be spending marginally more out of pocket but they are not getting the level of care they need otherwise we would not be rock bottom on that list.

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

No one is denying that US level of care is great for ppl who have access to it. but many dont.
as far as coronary bypass and angiplasty, lets also normalize that data with the prevelance of obesity and heart diease in US vis a vis other nations.

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) 

I know drug companies better than most here. But the prices of prescription drugs are higher in US. the expense on R&D and all needs to be spread equally internationally.

           - 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) 

wow, very recent research, and did they factor in that most insured ppl are limited by the PBM policies and even the formulary that the PBM decides. Shop around? sorry but in our system if u want to shop for pharma out of PBM u get screwed royally.

           - 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') 

shopping around sounds good in theory but in reality it is next to impossible.

so in essence all is hunky dory when it comes to healthcare in US. is that what you are trying to establish? :)

[janab-e-ali]

Re: US healthcare system

so in essence all is hunky dory when it comes to healthcare in US. is that what you are trying to establish? :)

No...I think the government needs to come up with a way to make health insurance more affordable for the middle/lower middle classes. Preferably through a market based system, with tax breaks to help cover the cost.

But it sounds like you're definitely trying to argue that things are all hunky dory abroad...all I'm doing is pointing out that European-style socialized healthcare isn't the utopian system you're making it out to be, and that socializing the healthcare system in isolation, without a major overhaul of everything else, simply isnt feasible.

[janab-e-ali]

Re: US healthcare system

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.

Oh please. People eat themselves into their coffins and it's the doctors fault. How many of those preventable deaths were sequelae of obesity, hypertension, type 2 diabetes, and all sorts of other illnesses that Americans eat themselves into? It's no secret that Americans are among some of the unhealthiest people in the world...you don't think our lousy diets and sedentary lifestyles have anything to do with that?

I also think we have a tendency to over-medicate here...deathly-ill patients will be put through operations and then put on life support in the ICU...only to die of something 'preventable' like sepsis a few days later, instead of just being allowed to die 'naturally' like they would in other countries. But what are you going to do in a country where everyone feels entitled to sue the pants off their physicians for just about anything?

[X2]

Re: US healthcare system

No...I think the government needs to come up with a way to make health insurance more affordable for the middle/lower middle classes. Preferably through a market based system, with tax breaks to help cover the cost.

and the way to make insurance affordable is to take out teh fat in the system, which there is a lot. salaries, overhead, all costs are high

But it sounds like you're definitely trying to argue that things are all hunky dory abroad...all I'm doing is pointing out that European-style socialized healthcare isn't the utopian system you're making it out to be, and that socializing the healthcare system in isolation, without a major overhaul of everything else, simply isnt feasible.

if it sounds liek that to you, then you are reading me wrong. and I am not making the european system to be a utopian system.

we dont have to take everythig from it, but what works, lets take that, what does not work as well as it should lets take that and make it work. if nothign applies then dont use anything.

I am arguing that our system is broken, and when you say that european system is broken itself, and then we see us score lower then them in prevtable deaths, then we know we have a real issue at hand.

I have not noted socialzing the system, read my previous posts, I have clearly noted that a secondary safety net system needs to be in place. how its done I dont really care, whether it is thru affordable insurance or through govt programs.

[janab-e-ali]

Re: US healthcare system

and the way to make insurance affordable is to take out teh fat in the system, which there is a lot. salaries, overhead, all costs are high

Good luck filling all those extra med schools you plan on building. It's not going to be easy convincing people to spend a good 400K and 12 years on school to enter a field that isnt all that lucrative.

[X2]

Re: US healthcare system

u missed the part where i said that the cost of education needs to be reduced as well. :halo:

[Dushwari]

Re: US healthcare system

i learnt in my health care econ class that the HMO and HHCs have a quality assurance task while for profit hosp and pharmacies have an other agenda.
so, the common lot i.e., the patients at any age and particularly with less expensive insurances and no insurances have a lot to cope with, in terms of not only access to health care, but also how they are dealt out by the health system in America.
what can we do about this, at individual and sociatal level, is what we should focus on, especially as immigrants.
it includes any thing from being into preventative care for decreasing the need for medical care and hospitalization. and then, if need be, to become aware of one's rights as a patient.
any other thoughts, please share?

best,
Dushwari

[janab-e-ali]

Re: US healthcare system

@X2

u missed the part where i said that the cost of education needs to be reduced as well. :halo:

I see…and how do you propose even funding all the seats we currently have, let alone new medical schools? Just funding 17,000 current seats will cost around 700 million dollars.

[ravage]

Re: US healthcare system

interesting alternative views janab-e-ali :k:. Like you I’d prefer a market based scheme that doesnt reduce the quality of US care to UK/Canada levels, who provide universal, but sub third-world care to most of their population. Part of that has to be working on the supply side of the market, and not just attempting to increase purchasing power. Thats the only way forward for those whom tax breaks wouldnt be much help, and there is a sizable number of such people.

if you think not enough people would be willing to put themselves through med school if the payoff isnt as high as before, just try it. Every second guy in the hospitals would be an Indian, but hey atleast hed be a doctor. and to lots of people money isnt the main incentive in studying medicine. The pay of doctors isnt that high in Pakistan, and there are now many careers more lucrative than medicine there. no seat ever goes unfilled, not in govt schools, not in the most third class private schools either. infact in private schools people pay in more money than they are likely to earn in 5 10 years after they graduate… heck half of those graduates dont even practice usually (the women)

finally there does need to be the government provided safety net for those who still cant afford market prices. in a way that is manifestly the refuge of those who dont have anything else, possibly through a reduction in quality, increased waiting times, more foreign looking doctors who blankly stare at the wall while talking to you etc.

[X2]

Re: US healthcare system

I see...and how do you propose even funding all the seats we currently have, let alone new medical schools? Just funding 17,000 current seats will cost around 700 million dollars.

lets first agree whether the concept is right or not.

lets first talk about what are the right components of a solution and then once we have agree din principle then start looking at feasibility, either you find funds then, or you find partial funds and go halfway or you try to do something which solves the issue.

but fundamentally at first the issues or issues have to be agreed upon, possible solutions have to be agreed upon and then ways and means have to be evaluated.