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Old March 15th, 2010, 10:09 AM   #1
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The reality about healthcare

We're arguing about whether UHC in the UK or Canada or other countries similar to ours in size is better than our system. The reality is that increasing medical costs and an aging population have caused major problems that no system addresses well.



One stat: Fact No. 7: People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand and British adults say their health system needs either "fundamental change" or "complete rebuilding."[9]



This isn't to say we're happy with ours. We're not.



I believe that Americans are as innovative as anyone. So, why can't someone come up with a better solution - better than what we have now and what the Euros/Canada have in UHC?



Costs and the uninsured are our problem. Someone can innovate a good way to solve this.



No system will work until people address the issue of whether we can afford all the new high-dollar treatments, especially since our population will be aging.



Here is an interesting tidbit:



Fact No. 1: Americans have better survival rates than Europeans for common cancers.[1] Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.



Fact No. 2: Americans have lower cancer mortality rates than Canadians.[2] Breast cancer mortality is 9 percent higher, prostate cancer is 184 percent higher and colon cancer mortality among men is about 10 percent higher than in the United States.



Fact No. 3: Americans have better access to treatment for chronic diseases than patients in other developed countries.[3] Some 56 percent of Americans who could benefit are taking statins, which reduce cholesterol and protect against heart disease. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons and 17 percent of Italians receive them.



Fact No. 4: Americans have better access to preventive cancer screening than Canadians.[4] Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate and colon cancer:
  • Nine of 10 middle-aged American women (89 percent) have had a mammogram, compared to less than three-fourths of Canadians (72 percent).
  • Nearly all American women (96 percent) have had a pap smear, compared to less than 90 percent of Canadians.
  • More than half of American men (54 percent) have had a PSA test, compared to less than 1 in 6 Canadians (16 percent).
  • Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with less than 1 in 20 Canadians (5 percent).
Fact No. 5: Lower income Americans are in better health than comparable Canadians. Twice as many American seniors with below-median incomes self-report "excellent" health compared to Canadian seniors (11.7 percent versus 5.8 percent). Conversely, white Canadian young adults with below-median incomes are 20 percent more likely than lower income Americans to describe their health as "fair or poor."[5]



Fact No. 6: Americans spend less time waiting for care than patients in Canada and the U.K. Canadian and British patients wait about twice as long - sometimes more than a year - to see a specialist, to have elective surgery like hip replacements or to get radiation treatment for cancer.[6] All told, 827,429 people are waiting for some type of procedure in Canada.[7] In England, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.[8]



Fact No. 7: People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand and British adults say their health system needs either "fundamental change" or "complete rebuilding."[9]



Fact No. 8: Americans are more satisfied with the care they receive than Canadians. When asked about their own health care instead of the "health care system," more than half of Americans (51.3 percent) are very satisfied with their health care services, compared to only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).[10]



Fact No. 9: Americans have much better access to important new technologies like medical imaging than patients in Canada or the U.K. Maligned as a waste by economists and policymakers naïve to actual medical practice, an overwhelming majority of leading American physicians identified computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade.[11] [See the table.] The United States has 34 CT scanners per million Americans, compared to 12 in Canada and eight in Britain. The United States has nearly 27 MRI machines per million compared to about 6 per million in Canada and Britain.[12]



Fact No. 10: Americans are responsible for the vast majority of all health care innovations.[13] The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other single developed country.[14] Since the mid-1970s, the Nobel Prize in medicine or physiology has gone to American residents more often than recipients from all other countries combined.[15] In only five of the past 34 years did a scientist living in America not win or share in the prize. Most important recent medical innovations were developed in the United States.[16] [See the table.]



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Old March 15th, 2010, 11:05 AM   #2
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I'm not sure where you got your information from, but I can correct it for you with a bona fide study.



The World Health Organization's ranking of the world's health systems



Quote:
Rank Country



1 France

2 Italy

3 San Marino

4 Andorra

5 Malta

6 Singapore

7 Spain

8 Oman

9 Austria

10 Japan

11 Norway

12 Portugal

13 Monaco

14 Greece

15 Iceland

16 Luxembourg

17 Netherlands

18 United Kingdom

19 Ireland

20 Switzerland

21 Belgium

22 Colombia

23 Sweden

24 Cyprus

25 Germany

26 Saudi Arabia

27 United Arab Emirates

28 Israel

29 Morocco

30 Canada

31 Finland

32 Australia

33 Chile

34 Denmark

35 Dominica

36 Costa Rica

37 United States of America


Health, Life Expectancy



World Health Organization Disability Adjusted Healthy Life Expectancy Table (HALE)



Quote:
1 Japan 74.5 71.9 77.2

2 Australia 73.2 70.8 75.5

3 France 73.1 69.3 76.9

4 Sweden 73.0 71.2 74.9

5 Spain 72.8 69.8 75.7

6 Italy 72.7 70.0 75.4

7 Greece 72.5 70.5 74.6

8 Switzerland 72.5 69.5 75.5

9 Monaco 72.4 68.5 76.3

10 Andorra 72.3 69.3 75.2

11 San Marino 72.3 69.5 75.0

12 Canada 72.0 70.0 74.0

13 Netherlands 72.0 69.6 74.4

14 United Kingdom 71.7 69.7 73.7

15 Norway 71.7 68.8 74.6

16 Belgium 71.6 68.7 74.6

17 Austria 71.6 68.8 74.4

18 Luxembourg 71.1 68.0 74.2

19 Iceland 70.8 69.2 72.3

20 Finland 70.5 67.2 73.7

21 Malta 70.5 68.4 72.5

22 Germany 70.4 67.4 73.5

23 Israel 70.4 69.2 71.6





24 United States 70.0 67.5 72.6



Health Total Expenditures as % of GDP



Quote:
Rank Location 2000 2001 2002 2003 2004 2005

------- --------------------------------------------- ------- ------- ------- ------- ------- -------

1 Marshall Islands 22 19.1 18.4 16.3 13.2 15.4

2 United States of America 13.2 13.9 14.7 15.1 15.2 15.2

3 Niue 8 38.1 11.1 12.5 15.5 14.5

4 Timor-Leste 8.8 8.6 8.5 9.2 10.3 13.7

5 Micronesia (Fed. States of) 9 9.8 9.1 10.7 11.7 13.5

6 Kiribati 11.6 12.3 12.6 13.7 13.7 12.7

7 Maldives 6.8 6.8 6.6 7.2 7.8 12.4

8 Malawi 6.1 7.8 10 12.8 12.8 12.2

9 Switzerland 10.3 10.7 11 11.4 11.4 11.4

10 France 9.6 9.7 10 10.9 11 11.2

11 Germany 10.3 10.4 10.6 10.8 10.6 10.7

12 Jordan 9.4 9.6 9.3 9.3 10.1 10.5

13 Nauru 11 10.8 10.6 10.3 10.4 10.3

14 Argentina 8.9 9.5 8.9 8.3 9.6 10.2

15 Austria 10 10 10.1 10.2 10.3 10.2

16 Portugal 8.8 8.8 9 9.7 10 10.2

17 Greece 9.3 9.8 9.7 10 9.6 10.1

18 Canada 8.8 9.3 9.6 9.8 9.8 9.8

19 Sao Tome and Principe 6.3 9.1 8.6 11.9 12.1 9.8

20 Belgium 9.1 9.3 9.5 9.5 9.7 9.6

21 Palau 9.7 9.1 10.1 11.5 9.7 9.6

22 Denmark 8.3 8.6 8.8 9.3 9.4 9.4

23 Iceland 9.3 9.2 9.9 10.2 9.9 9.4

24 Netherlands 8 8.3 8.9 8.9 9 9.2

25 Sweden 8.2 8.6 9 9.1 9.2 9.2

26 Norway 8.4 8.8 9.8 10 9.7 9.1

27 Italy 8.1 8.2 8.3 8.3 8.7 8.9

28 New Zealand 8.1 8.3 8.5 8.4 8.5 8.9

29 Australia 8.3 8.4 8.6 8.6 8.8 8.8

30 Bosnia and Herzegovina 7 6.9 7.7 8.1 8.6 8.8

31 Tuvalu 13.4 10.5 9.4 11.1 9.2 8.8

32 Lebanon 11 10.7 9.4 8.9 8.8 8.7

33 South Africa 8.1 8.4 8.3 8.4 8.5 8.7

34 Georgia 7.4 7.8 8.7 8.5 8.5 8.6

35 Slovenia 8.4 8.7 8.8 8.8 8.5 8.5

36 Malta 6.8 7.2 7.8 8.1 8.2 8.4


We pay more for less.
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Old March 15th, 2010, 11:07 AM   #3
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Our system is great only for those who can afford it. How can a nation make its health care system "for profit" and not be seen as a joke?
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Old March 15th, 2010, 11:18 AM   #4
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Quote:
Originally Posted by leighredf
We're arguing about whether UHC in the UK or Canada or other countries similar to ours in size is better than our system. The reality is that increasing medical costs and an aging population have caused major problems that no system addresses well.



One stat: Fact No. 7: People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand and British adults say their health system needs either "fundamental change" or "complete rebuilding."[9]



This isn't to say we're happy with ours. We're not.



I believe that Americans are as innovative as anyone. So, why can't someone come up with a better solution - better than what we have now and what the Euros/Canada have in UHC?



Costs and the uninsured are our problem. Someone can innovate a good way to solve this.



No system will work until people address the issue of whether we can afford all the new high-dollar treatments, especially since our population will be aging.



Here is an interesting tidbit:



Fact No. 1: Americans have better survival rates than Europeans for common cancers.[1] Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.



Fact No. 2: Americans have lower cancer mortality rates than Canadians.[2] Breast cancer mortality is 9 percent higher, prostate cancer is 184 percent higher and colon cancer mortality among men is about 10 percent higher than in the United States.



Fact No. 3: Americans have better access to treatment for chronic diseases than patients in other developed countries.[3] Some 56 percent of Americans who could benefit are taking statins, which reduce cholesterol and protect against heart disease. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons and 17 percent of Italians receive them.



Fact No. 4: Americans have better access to preventive cancer screening than Canadians.[4] Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate and colon cancer:
  • Nine of 10 middle-aged American women (89 percent) have had a mammogram, compared to less than three-fourths of Canadians (72 percent).
  • Nearly all American women (96 percent) have had a pap smear, compared to less than 90 percent of Canadians.
  • More than half of American men (54 percent) have had a PSA test, compared to less than 1 in 6 Canadians (16 percent).
  • Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with less than 1 in 20 Canadians (5 percent).

Fact No. 5: Lower income Americans are in better health than comparable Canadians. Twice as many American seniors with below-median incomes self-report "excellent" health compared to Canadian seniors (11.7 percent versus 5.8 percent). Conversely, white Canadian young adults with below-median incomes are 20 percent more likely than lower income Americans to describe their health as "fair or poor."[5]



Fact No. 6: Americans spend less time waiting for care than patients in Canada and the U.K. Canadian and British patients wait about twice as long - sometimes more than a year - to see a specialist, to have elective surgery like hip replacements or to get radiation treatment for cancer.[6] All told, 827,429 people are waiting for some type of procedure in Canada.[7] In England, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.[8]



Fact No. 7: People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand and British adults say their health system needs either "fundamental change" or "complete rebuilding."[9]



Fact No. 8: Americans are more satisfied with the care they receive than Canadians. When asked about their own health care instead of the "health care system," more than half of Americans (51.3 percent) are very satisfied with their health care services, compared to only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).[10]



Fact No. 9: Americans have much better access to important new technologies like medical imaging than patients in Canada or the U.K. Maligned as a waste by economists and policymakers naïve to actual medical practice, an overwhelming majority of leading American physicians identified computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade.[11] [See the table.] The United States has 34 CT scanners per million Americans, compared to 12 in Canada and eight in Britain. The United States has nearly 27 MRI machines per million compared to about 6 per million in Canada and Britain.[12]



Fact No. 10: Americans are responsible for the vast majority of all health care innovations.[13] The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other single developed country.[14] Since the mid-1970s, the Nobel Prize in medicine or physiology has gone to American residents more often than recipients from all other countries combined.[15] In only five of the past 34 years did a scientist living in America not win or share in the prize. Most important recent medical innovations were developed in the United States.[16] [See the table.]






Did any of these opinion polls include samples from the 47m uninsured Americans?



How many of them have access to MRI's for examples (a technology developed jointly in the US and UK).



How many of them are satisfied with the care they receive?



How many of them don't appear on waiting lists even though they need treatment?



Good to know Medicare is working so well
.



That table of the 10 Most Important Recent Medical Innovations includes contributions from UK, Sweden. Japan and Switzerland, all of which have some form of UHC.
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Old March 15th, 2010, 11:26 AM   #5
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I'd like to see a comparison of other factors that whether the country has UHC. Like gun laws, dietary culture, type of economy, environmental conditions, crime statistics, etc. Looking at "who lives longer" doesn't necessarily have a direct correlation to health insurance. You can live a long time and hardly ever see a doctor. An example...

10 fattest countries in the world: Obesity Statistics | Eat Smart Age Smart

3. U.S., 66.7 per cent

In the early 1960s, 24 per cent of Americans were overweight. Today, two-thirds of Americans are too fat, and the numbers on the scale keep going up. Health experts attribute the rise to an over-production of oil, fat and sugar — the result of government farm subsidies started in the 1970s that made it much cheaper to manufacture products like high fructose corn syrup, a common ingredient in processed foods.

Murders (per capita) statistics - countries compared - NationMaster

Notice where Japan is on the longest living vs. the crime statistics.





I'll say our system is doing fine. It's the people that are broken.

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Old March 15th, 2010, 11:51 AM   #6
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Quote:
Originally Posted by Mrs. CJ Parker
I'm not sure where you got your information from, but I can correct it for you with a bona fide study.



The World Health Organization's ranking of the world's health systems







Health, Life Expectancy



World Health Organization Disability Adjusted Healthy Life Expectancy Table (HALE)







Health Total Expenditures as % of GDP







We pay more for less.
The studies I cited were bona fide, and the WHO is hardly some neutral organization. You are citing a general study, I am citing specifics. But, what you cited is completely different information. I posted the text to show that there are facets of UHC that are not as good as what we have in our system, just like there are facets of our system that are likewise not as good.



It is always presented as UHC is great, and it's not.



Gary was right, because the 10 facts don't address the uninsured. That's a problem with our system.
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Old March 15th, 2010, 12:04 PM   #7
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Quote:
Originally Posted by leighredf
The studies I cited were bona fide, and the WHO is hardly some neutral organization. You are citing a general study, I am citing specifics. But, what you cited is completely different information. I posted the text to show that there are facets of UHC that are not as good as what we have in our system, just like there are facets of our system that are likewise not as good.



It is always presented as UHC is great, and it's not.



Gary was right, because the 10 facts don't address the uninsured. That's a problem with our system.




I don't hear that UHC is always presented as great. Just not as bad is the patchwork US system, and a lot less expensive.



Elective surgery will always take longer under a UHC, as it should.



Some of your stats are out of date and the links don't work. The UK has introduced new practices and benchmarks for cancer patients in the past few years which aren't shown in your stats.
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Old March 15th, 2010, 01:35 PM   #8
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Quote:
Originally Posted by garysher
I don't hear that UHC is always presented as great. Just not as bad is the patchwork US system, and a lot less expensive.



Elective surgery will always take longer under a UHC, as it should.



Some of your stats are out of date and the links don't work. The UK has introduced new practices and benchmarks for cancer patients in the past few years which aren't shown in your stats.


I was looking for a study that just came out that had similar stats re: the number of MRI machines, waiting periods, etc. I heard about it on the radio Saturday (no, it wasn't conservative talk radio). I can't remember the sponsor, unfortunately.
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Old March 15th, 2010, 01:45 PM   #9
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Quote:
Originally Posted by garysher
I don't hear that UHC is always presented as great. Just not as bad is the patchwork US system, and a lot less expensive.



Elective surgery will always take longer under a UHC, as it should.



Some of your stats are out of date and the links don't work. The UK has introduced new practices and benchmarks for cancer patients in the past few years which aren't shown in your stats.


Those weren't links. They were footnotes pasted in.



Interestingly, the stats were from a U.N. study.



Here's another article:



Study Of 31 Countries Finds Wide Variations In Cancer Survival Rates



There are a lot of good things about UHC in the UK. There are also problems. And, you are honest enough to admit that. There are good things and problems in our system too. The problem I was addressing was that the debate is never couched in those terms. It is always about how great the system you want is and how bad the other is.
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Old March 15th, 2010, 02:17 PM   #10
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Quote:
Originally Posted by leighredf
Those weren't links. They were footnotes pasted in.



Interestingly, the stats were from a U.N. study.



Here's another article:



Study Of 31 Countries Finds Wide Variations In Cancer Survival Rates



There are a lot of good things about UHC in the UK. There are also problems. And, you are honest enough to admit that. There are good things and problems in our system too. The problem I was addressing was that the debate is never couched in those terms. It is always about how great the system you want is and how bad the other is.


Some of the footnotes led to links.



I agree it all depends on how you choose to compare systems. For me the most important aspect is availability and affordability.



Having a Rolls Royce system that leaves out tens of millions is not good. Especially when it costs the country more than twice as much
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