The US has the best health care in the world?

Ivan Seeking

This claim is often made by those who oppose Obama's efforts to reform the medical system.

I worked in health care [tech support and services] for seven years, and my wife has been an X-Ray and CT tech for over thirty years. She has worked everywhere from world-class hospitals, to one-horse hospitals in a town with two street lights. While I don't know what health care is like in other countries, to those who think the system here cannot be signifantly [dramatically] improved, I say you are seriously misguided. From my point of view, the claim is ludicrous! I cannot even begin to tell you how many times my wife [Tsu] has come home either steaming from the ears, or nearly in tears. One example that comes to mind was the time a major hospital at which she worked didn't even have the proper respirators for babies, but they did buy a grand piano and hire a pianist to play in the lobby. What has happened over the last two+ decades is that health care has become more about business than health.

Probably one of the most ridiculous experiences was when my mother was in the hosptial. After a botched surgery that left her crippled, I went down to help out. I then posted this rant in the mentors forum.

Boy, this just keeps getting better.

Mom had the implant done thursday morning, so I drove down last night anticipating that I could be some help when she gets home [again]. Yesterday she was doing absolutely great and declared the spinal nerve stimulator a raging success. So I expected that today we would pick her up around noon, and I could spend the weekend making food for the week and so forth. Having arrived at 4AM, I was awoke by my dad who was nearly in a state of panic at 8AM. Mom called at 7, and during the night the battery in the power pack for the stimulator went dead! They installed a ten thousand dollar device and put in a dead battery. So she called the nurse who got another battery and put it in, but then the thing wouldn't work. So what I wake up to is this: The stimulator isn't working and we need to go fix it!!!

So I'm laying there trying to make sense of this: Okay, the implant was done yesterday, she's still in the hospital, and I have to fix it???? WTF!!! He explained that the phone number for the technical support was sitting on her bedstand, and housekeeping threw it away so nobody knows who to call. As I'm still shaking my head in disbelief, I asked if we can't call the main number for the company, but of course, all that is heard is a message that they're closed for the weekend, and please enter the desired mailbox number to leave a message. Of course we have no idea who we even need.

We called the pain specialist's answering service, but the primary was off and the secondary gave explicit instruction that he was only to be contacted in the case of an emergency. But this is an emergency, she's in extreme pain we insisted. "I'm sorry, that's not an emergency", she replied. Okay so what is an emergency for a pain specialists? "I'm sorry, I have explicit instructions". So I made sure that we understood: You [a near min wage worker Iamb thinking] are refusing to contact the doctor. Yes she replied. "Well, I could if the nurse called me". So even though the pain specialists is on call mainly for when mom is home, we conceded to call the head nurse. The nurse thinks that she may know who to call by looking up the names in the registry for the day of the implant, since the technical specialist had to sign in. Meanwhile, I managed to fake my way into the mail system at the main number and started scrolling through what turned out to be at least a hundred different names; none of which began with what we knew was the first name of the support specialists - Don.

At about 11AM, while my dad and I are still scrambling for some way to resolve this situation, we get a call from mom saying that the surgeon who did the implant showed up with the support guy, the thing is now working, and "get me the hell out of here".

While at the hospital, the nurse gave mom some paperwork with emergency number needed for the tech support person. I then asked the nurse to write it down on one of my business cards and joked that when they lose the number again they can call me. Well, later and back at home, mom wasn't doing so well, so we wanted to talk with tech support to see if an adjustment can be made. We then discover that we had been given the same phone number that we had at 7AM. We never got the emergency number. By the time we discovered this, the nurse of interest was off duty and had left.

The pain specialist was scheduled to call and check in this evening so we figured that he could help, or at least have the information needed. He never called.

That was only one week. It went on for years and was a freaking nightmare. IIRC, she was taking something like 80mg of morphine a day for about two years!

Here is one study that ranks the US as 37th in the world, in health care.
http://dll.umaine.edu/ble/U.S.%20HCweb.pdf

From my point of view, waving the flag at the expense of people who are suffering terribly, is right up there with 911 and moon hoax conspiracy theories. Honestly, when I hear someone talking about how wonderful our health care system is, I want to hurt someone!

turbo

It's even worse than you think, Ivan. Medical practices have to hire tons of coding specialists to work through the maze of hoops that the insurance companies set up, and even then, claims are denied over and over again so that the insurance companies can make money off interest on the "float". I would like my wife to retire a bit early, but I have pre-existing medical conditions and could never be insured on my own without disastrous premiums.

Don't get sick and don't get old unless you have a LOT of money.

maverick_starstrider

You have to pay for health care in the states. How could it possibly be "the best in the world". Best by what possible criteria? That if you're employed and insured and you walk into a clinic you're going to get better treatment then any other country?

seycyrus

There is a logical fallacy here.

The assumption that since mistakes and abuses occur in the present system, they will not occur in the proposed system.

This is a ludicrous claim.

In fact, from my experience with govt. I envision the number of mistakes getting greater, and the abuses getting far worse.

seycyrus

And evidently, Barack Obama's Health care system will cure stupidity, and remove beauracracy.

seycyrus

Quote by maverick_starstrider

You have to pay for health care in the states. How could it possibly be "the best in the world". Best by what possible criteria? That if you're employed and insured and you walk into a clinic you're going to get better treatment then any other country?

You have to pay for food at a fine restaurant ... Does the place with free food for everyone generally have the best food in the world?

turbo

Quote by seycyrus

There is a logical fallacy here.

The assumption that since mistakes and abuses occur in the present system, they will not occur in the proposed system.

This is a ludicrous claim.

In fact, from my experience with govt. I envision the number of mistakes getting greater, and the abuses getting far worse.

The insurance companies do not engage in "mistakes and abuses". They intentionally deny and delay payment as long as possible to make money off the interest on their holdings, and the magnitude of the fraud is incredible. A couple of decades ago, banks were required to clear checks on a timely basis to stop them from capitalizing on the "float" - insurance companies are presently exempt and are raking in the dough.

If you think that a government-based program will perpetuate this kind of crap, please link to some legitimate sources to support your claim.

D H

Quote by maverick_starstrider

You have to pay for health care in the states. How could it possibly be "the best in the world". Best by what possible criteria? That if you're employed and insured and you walk into a clinic you're going to get better treatment then any other country?

Health care isn't free anywhere. Somebody pays for it. You just want that somebody to be someone else. While doctors in other countries might not be as well off as doctors are in the US, they are still receive above-average compensation. Hospitals do not pop out of the ground for free in other countries and they do not have fancy equipment and pharmaceuticals trees from which medical devices and drugs can be plucked au gratis.

Quote by turbo-1

If you think that a government-based program will perpetuate this kind of crap, please link to some legitimate sources to support your claim.

I suspect that what the government will do is to deny the request up-front rather than after the fact. In other words, you won't be allowed to receive the medical treatment you (and your doctor) think you need. HMO⁺. If they do allow the treatment, they won't quibble over the claim as insurance companies do. They'll accept it forthwith -- and then take six months to make good on it.

Have you ever contracted with the government? If you want to do contract work for the government you better have a healthy cash reserve to pay your bills, pay your employees, and pay yourself. The government takes their sweet time to make good on obligations. Those laws that require banks to clear checks on a timely basis -- Who do you think wrote them? Do you really think they would have subjected themselves to those same laws?

russ_watters

Quote by Ivan Seeking

[title statement] The US has the best health care in the world?

This claim is often made by those who oppose Obama's efforts to reform the medical system.

.....to those who think the system here cannot be signifantly [dramatically] improved, I say you are seriously misguided.

Your counterargument does not address your title statement! Saying something is the best does not imply that it cannot be improved. Heck, it doesn't even imply that it is good, much less perfect!

russ_watters

Quote by turbo-1

If you think that a government-based program will perpetuate this kind of crap, please link to some legitimate sources to support your claim.

You cannot provide direct evidence of a prediction, since it hasn't happened yet, so that is an unreasonable request.

One can only say that since government is extremely inefficient with everything it does, it stands to reason that it would be extremely inefficient managing healthcare.

russ_watters

Quote by seycyrus

You have to pay for food at a fine restaurant ... Does the place with free food for everyone generally have the best food in the world?

And, of course, (duh), free isn't free! Someone has to pay for it. In the case of a food bank, the free food is paid for by someone else, but in the case of healthcare, you pay for your free healthcare!

So the question really is, does the cost vs quality of Canada's "free" healthcare exceed the cost vs quality of the US's. And that is not a straightforward question, since the quality of the actual care for Canadians is roughly uniformly mediocre (it doesn't vary depending how much you pay for it) whereas the quality for Americans is highly variable, depending on how much you pay for it. At the same time, the cost for "free" healthcare for Canadians varies widely by income, as does the cost for healthcare for Americans - though the cost for Americans is generally higher.

So the answer, in terms of bang for the buck, is probably that if you are poor, the mediocre free (it really is free if you are poor) coverage of Canada is probably better than the bad free coverage for poor Americans. But if you are much above the poverty line, it is probably better in the US.

And since people like anecdotes so much, I have a good example from my own life of a minor surgery I had that went extremely smoothly: Last year, I found what I realized was a growing hernia in my abdomen. I saw my doctor (took a week to get the appointment) and he referred me to a specialist (another week's wait for an appointment). He scheduled surgery for two weeks later because he happened to be moving in the intervening week. The surgery was outpatient and went perfectly. Altogether, I had to live with the hernia for about a month from the time I realized what it was to when I got the surgery. I shudder to think about how long I would have had to wait if I was Canadian. At the same time, the cost out of pocket was about $4,000. I had personal health insurance with a high deductable and moderate coverage, a calculated risk on my part due to my age (33) and general health (excellent). Overall, I'm very happy with how it all went and the level and cost of care I got were highly accessible to a very large fraction of the US population (I was paying $120 a month for my insurance).

The biggest problem I see with health care in the US is that I think the business model of the insurance providers has been allowed by lax legislation to get a little out of hand (turbo-1's point about attempting to deny as much coverage as possible). So legislation and oversight of that needs to be tightened-up. Prescription drug overcharges too (such as the government not being allowed to negotiate drug prices in their own plans). But beyond that, I don't see much wrong with our system. Possibly too much malpractice (too many lawyers), but I've seen conflicting reports on the reality of that issue.

JaredJames

I'll be honest, I don't like the idea of requiring medical insurance. I much prefer the British way of the NHS. But it ISN'T free, not by a long shot. You pay it directly out of your wages (not sure what percentage it is, but it's there).
The big difference is, no matter who you are in Britain you are entitled to the same health care (unless you go private of course). Whereas I believe in America it's a case of "patch 'em up and throw em out", or to get it correct, get the patient stable and then they no longer are required to do anything else.
The downside of the NHS is that the people who work end up paying for everyone, the bums who refuse to work, which is wrong. If you can't work for a reason then yes, you should be entitled to it (and income support off the government) but those who refuse to work should get nothing.
Right, rant over.
I wouldn't say America has the best health care in the world, I would like to think it is fairly level over most 'rich' countries, but I suppose like everything, different countries will have their strong aspects in the health system and their weak aspects.

The NHS in Britain currently has exceptionally long waiting lists for seeing doctors and operations. However, in other European countries they are far shorter (I believe 18 weeks). So it depends what you rate it one.

mgb_phys

Quote by russ_watters

So the question really is, does the cost vs quality of Canada's "free" healthcare exceed the cost vs quality of the US's. And that is not a straightforward question,

The admin costs of US healthcare are roughly twice those in Canada, mainly due to the layers of billing. There are also other hidden costs like unnecessary scans and procedures performed in the US largely to cover hospitals/doctors from liability.
Admin costs in the NHS (uk) are supposedly only 6% - half of Canada's, but real comparisons are always tricky.

since the quality of the actual care for Canadians is roughly uniformly mediocre (it doesn't vary depending how much you pay for it) whereas the quality for Americans is highly variable, depending on how much you pay for it.

Another advantage of 'free' health care is that there is much more incentive for preventative care than in a system where insurance only pays for a hospital visit.
It's like having the insurance cover free breakdown repairs on your car, but having to pay $10,000 for an oil change.

mgb_phys

Quote by jarednjames

The downside of the NHS is that the people who work end up paying for everyone,

That's not a new problem. One of the grievances in the Magna Carta was inland towns having to pay for the navy. Since they didn't have any boats that needed protecting why should they pay for the navy?

the bums who refuse to work, which is wrong. If you can't work for a reason then yes, you should be entitled to it (and income support off the government) but those who refuse to work should get nothing.

That is one of the problem of the US system. 'Bums' are (in theory) covered by free health care Medicaid, but because it is means tested and tied to a whole range of other benefits it is a hugely complex and expensive nightmare. It also leaves the vast majority of people too rich for free care and too poor to pay - the Daily Mail would be proud!

JaredJames

Quote by mgb_phys

That's not a new problem. One of the grievances in the Magna Carta was inland towns having to pay for the navy. Since they didn't have any boats that needed protecting why should they pay for the navy?

I think that's a slightly different concept. The navy is there to protect the boats AND country (offcoast obviously), the whole country. If there was an attack on the coast, its effect isn't likely to stop there. Hence, everyone should pay. The people who refuse to work, expect to get free health care. They don't want to work, they don't want to pay and yet they expect to get free health care. It would be like you living mid country, refusing to pay for the navy and then expecting them to protect you during an attack.

Evo

Quote by mgb_phys

That is one of the problem of the US system. 'Bums' are (in theory) covered by free health care Medicaid, but because it is means tested and tied to a whole range of other benefits it is a hugely complex and expensive nightmare. It also leaves the vast majority of people too rich for free care and too poor to pay - the Daily Mail would be proud!

That's where a misunderstanding of the excellence and availabilty of US healthcare comes in. Just because it takes a bit more time to get to see a specialist through medicaid, it's nowhere near as long as in socialized or government run healthcare.

I had a condition recently (I am recovering from surgery right now). I was referred to a specialist, got in in 3 days. I had a cat scan prior to seeing the specialist and I only waited 2 days for that. When I saw the specialist, he said I should have surgery (elective) and could have surgery the following Tuesday, that wasn't convenient for me, so I scheduled it a few weeks out.

Now tell me that I could have a non-emergency problem in the UK and from the first day I went to the doctor (called that morning and got in within a few hours), was diagnosed, had a cat scan and a biopsy and had surgery all within a week and a half? And it cost me $40 for the specialist, $20 for the regular MD and the cat scan and other dianostic tests were free. For the surgery/hospital, I had a deductible of $150. And I don't pay through the nose in taxes to pay for any of that. My employer pays for it, private medical insurance is a perk.

On one hand, I would be willing to pay some to extend a bit more universal health benefits to the unemployed, but I do not want to give up the excellent health care I have right now. I am not in favor of an all or nothing solution.

Topher925

You only need one visit to the hospital to realize that the US health system is FUBAR. It seems to me that its the lower middle class sort of folks who get screwed the worst. If your to poor to afford decent or no health insurance and to wealthy to qualify for medicare/medicaid, your basically screwed. Same goes if your employer doesn't offer medical insurance.

I'm all for trying to fix the problem, but I don't understand how a NHS is going to solve it. The two biggest problems are access and cost. NHS may fix the access problem, but I don't see how it will affect the cost. Lawyers will still make billions off of frivolous law suits and stupid people will continue to smoke and be obese. I don't understand how standardizing everything and taxing the rich is going to be an incentive for people to take care of themselves and create less lawsuits.

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maverick_starstrider	You have to pay for health care in the states. How could it possibly be "the best in the world". Best by what possible criteria? That if you're employed and insured and you walk into a clinic you're going to get better treatment then any other country?

seycyrus	The US has the best health care in the world? There is a logical fallacy here. The assumption that since mistakes and abuses occur in the present system, they will not occur in the proposed system. This is a ludicrous claim. In fact, from my experience with govt. I envision the number of mistakes getting greater, and the abuses getting far worse.