National education & health care

[member 5645]

Originally posted by Zero
This sort of thing happens in the US too, you know. It depends on where you live, and how busy the doctor is.

6 weeks for an MRI? My ass! Maybe somewhere in the middle of montana.
The fact is that we have more MRI's per capita than Italy.
We also treat out healthcare more efficiently.
I'm not sure what the rest of the country is doing, but I have viewed a growing trend throughout Texas (Houston, Austin, Dallas, Brownsville, and El Paso) of a hierarchial setup that allows a single doctor to handle 15 patient rooms. This is done through a 'stacking' of roles with a large number of nurses, a slightly smaller number of PA's, a nurse practitioner or two, and at the very top, a single doctor.
TO the patient, it looks like this:
Nurse runs you through triage and brings you into the exam room.
The PA comes in and does the diagnoses.
The Doctor comes in and makes sure that he concurs with the PA's findings, rights prescriptions, makes referal to another doctor, etc.

This setup is insanely efficient in moving patients through the process quickly. The down side, is as has been stated, it cost more for all that man power. However, it results in a much quicker program than the old process of nurse directly to doctor, in which a doctor would often only see 5-6 exam rooms at a time.

 

[member 5645]

Originally posted by ShawnD
I live in Canada so I can speak from experience here.

1. Canada does not have queues to see the doctor. When something is sort of wrong and I have to see the doctor, I go to the private clinic where I have to wait maybe 30 minutes. If it's sort of an emergency (like I'm bleeding really bad), they'll treat me immediately.

2. Waiting line for surgery also depends on urgency. My friend shattered his arm once and he was under the knife within 50 minutes of arriving at the hospital (that's including time it took for them to determine that his arm was shattered and needed surgery). If you need surgery that is not too important, such as fixing carpel tunnel syndrome, you can expect to wait about 3 weeks or so.

The research says different.
My girlfriend was misdiagnosed at Toronto General for having acute angular glaucoma. They couldn't get her in for 5 days. If they had diagnosed her properly, she would be blind right now.
Or when she had to have a splenectomy, she was given the option of almost 2 months later. Luckily, her doctor was able to find a doctor who had a patient cancel and she got in a week later, since her spleen was so far inflamed that docs told her to stay in bed for fear of rupture. The fact is, counting on someone cancelling should never be the only option to getting a surgery that your doctor deems vitally important.

 

[Zero]

Are we going to pretend that American medicine is magical, and everyone else's healthcare system is horrible?

 

[member 5645]

Originally posted by Zero
Are we going to pretend that American medicine is magical, and everyone else's healthcare system is horrible?

Nope, but when it comes so efficiency and expiediancy we take the prize.
I've already outlined my wants in a healthcare system, and it doesn't match the US's system or a fully socialized one :)

 

[Monique]

Originally posted by Evo
Where I live, if I need to see the doctor, I can usually get an appointment within a couple of hours. When I get there, I am seen exactly at my appointment time, no waiting. It costs me $10. If I need medicine, generic prescriptions cost me $5. There is no waiting if I need a procedure like an MRI, it is done immediately.

lol, are you serious? I required antibiotics for a gum infection in the US and I had to wait for TWO MONTHS! To see a $^#^&* doctor. I protested, they didn't care. If I required immediate attention, I should go to the emergency room in a hospital, they said!

That is not an isolated case, every single doctor visit was a disaster. Having to wait for three hours past my actual appointment time. Not getting to see anyone. Having to wait for TWO MONTHS to get the result from a simple blood test which I needed for work! Again I protested: get me a nurse to give me the results I said. No, you have to wait and make an appointment, which won't be until two months from now. Get me another doctor I said, no can't do. I stood there and argued for 30 minutes, until they finally gave up.

I could go on, but I won't :P

 

[Zero]

Originally posted by phatmonky
Nope, but when it comes so efficiency and expiediancy we take the prize.
I've already outlined my wants in a healthcare system, and it doesn't match the US's system or a fully socialized one :)

uh huh... so, do you want poor children to get no health care?

 

[Zero]

I don't think isolated cases are worth mentioning, on either side.

I also think that insurance companies are in the business of lowballing hospital care. Competition doesn't improve health care, it makes it worse, because the insurance companies real customers are, frankly, stockholders, not patients.

 

[Njorl]

Originally posted by phatmonky
I'll humour (;) ) you.

First answer this:
Does the Netherlands' have the queues that Canada, Australia, and England have for doctors visits and surgeries?

I'm trusting an honest answer here.

I live in the US with our marvelously quick health care system. It often takes over 3 months wait to see a specialist. We are not paying more to have better health care, we are paying more so that we can have lots of fraud.

Individual patients defraud insurance companies.
Medical providers defraud insurance companies, patients and the government.
Insurance companies defraud their customer base.
Pharmaceutical companies defraud everyone by manipulation of patent laws.

The theory in health care is that insurance companies will act to counter the health care providers to keep prices low. The truth is that they merely fight over who gets how much. Because we feed two pigs instead of one, the cost is actually higher, not lower.

When the Clinton administration took office, health care costs were 20% of GNP and had an annual inflation rate of 19%. After the Clinton health care initiative was proposed, the associated inflation rate dropped to 1%. This clearly indicated that competition was not working to keep costs down. The only thing capable of affecting costs was the fear that health care would be nationalized. Threats work for only so long. Eventually, you have to follow through with action.


Njorl

 

[Nereid]

Originally posted by Zero
I don't think isolated cases are worth mentioning, on either side.

*SNIP

Aw come on Zero, isolated cases are what gets our blood racing!

Originally posted by Evo
Where I live, if I need to see the doctor, I can usually get an appointment within a couple of hours. When I get there, I am seen exactly at my appointment time, no waiting. It costs me $10. If I need medicine, generic prescriptions cost me $5. There is no waiting if I need a procedure like an MRI, it is done immediately.

I have a friend, who's over 50, who was recently laid off ("force adjusted" in PC-speak), and has joined the 'transition' group in the language of the link which kat posted earlier (previous income >300% FCL (whatever), present income <200% poverty level). He has coverage, paid from his own savings (>$7,000 pa, annualised), provided by his previous employer, under something called COBRA (no, it's not snake oil). He pays $25 "copay" just to see the doctor, and recently paid $75 for a generic medicine (£6.80 in the UK), and *might* get a rebate of ~$40 when the health plan gets around to sorting out its records (by then his coverage will have ended, no doubt, and he'll get nothing). I suggested that he go work in China (his kids are grown) - plenty of jobs teaching English - but he says he can't speak Mandarin.

Maybe he should move to near where you live Evo.

Originally posted by Njorl *SNIP
health care costs were 20% of GNP

... even higher than what I recalled! (~14% of GDP)

 

[Evo]

Originally posted by Monique
lol, are you serious? I required antibiotics for a gum infection in the US and I had to wait for TWO MONTHS! To see a $^#^&* doctor. I protested, they didn't care. If I required immediate attention, I should go to the emergency room in a hospital, they said!

That is not an isolated case, every single doctor visit was a disaster. Having to wait for three hours past my actual appointment time. Not getting to see anyone. Having to wait for TWO MONTHS to get the result from a simple blood test which I needed for work! Again I protested: get me a nurse to give me the results I said. No, you have to wait and make an appointment, which won't be until two months from now. Get me another doctor I said, no can't do. I stood there and argued for 30 minutes, until they finally gave up.

I could go on, but I won't :P

I would have gone ballistic if I had to deal with that. Health care in the US will vary greatly depending on where you are and who you see and what kind of insurance coverage you have. I know for you it was even worse being a foreign national.

I am a dual national, I have both US & French citizenship. My uncle and cousin are both doctors in Paris and they have to deal with the socialized medicine there. I have lived in Europe, and may live there again, but my personal experience with medical care has been much better here in the US. I'm not saying that there isn't superb medical care in Europe, it's just that it is not always easy to obtain. But that can be true in the US if you do not have adequate insurance.

I have never had difficulty in getting immediate medical attention for anything, but I also choose not to live in a crowded metropolitan area. I live 8 minutes from 2 of the finest hospitals in the region. I have had to go to the emergency room twice (once to each) and both times there were no other patients and I was seen immediately. If I lived in downtown Chicago or Detroit, etc...it would have been a much differnt scenario.

Nereid, yes, your friend should live here, I selected this area for these specific reasons.

COBRA was enacted to guarantee employees that lose employment the possibility to extend their previous employer's health insurance plan temporarily so that they are not suddenly left without insurance. He might be better off trying to buy health insurance himself.

Zero, you're absolutely right about insurance being the driving force behind many of the problems within the health care industry.

Let's not forget the costs and issues created by out of control medical malpractice lawsuits in the US that have driven malpractice insurance through the roof. Now there are added costs from HIPPA.

 

[Zero]

Now, let's not place the blame for malpractice on anyone but the doctors who are screwing people up. Plus, of course insurance companies blow the problem all out of proportion in order to justify rate increases above and beyond covering malpractice costs.

 

[member 5645]

Originally posted by Zero
uh huh... so, do you want poor children to get no health care?

Why don't you take the time to go read my posts instread of putting words in my mouth?[zz)]

 

[member 5645]

Originally posted by Zero
I don't think isolated cases are worth mentioning, on either side.

I also think that insurance companies are in the business of lowballing hospital care. Competition doesn't improve health care, it makes it worse, because the insurance companies real customers are, frankly, stockholders, not patients.

Hence the reason I spent all the time posting link after link from sources like the OECD showing average wait time for various countries and procedures.

 

[member 5645]

Originally posted by Zero
Now, let's not place the blame for malpractice on anyone but the doctors who are screwing people up. Plus, of course insurance companies blow the problem all out of proportion in order to justify rate increases above and beyond covering malpractice costs.

Just 5 percent of U.S. doctors are responsible for 54 percent of all malpractice. ( National Practitioner Data Bank)
The problem isn't with doctors in general. It is a very select few. I read somewhere (wish I could find the link) that the averag doctor in that 5% has settle 4 malpractice cases. Now the question is, when will their be a doctorial review board setup to remove these licenses?
Medicine is as much an art, as it is a science, and thus things can not always be predicted. There are legitiamte malpractice cases, but there are plenty that aren't.

Then you have people like john edwards who goes through 41 expert witnesses until he can find one that will say what is needed to win billions in law suits ...but that just pisses me off. I don't want to even get into it.

 

[Zero]

Originally posted by phatmonky
Hence the reason I spent all the time posting link after link from sources like the OECD showing average wait time for various countries and procedures.

Average wait time isn't the only measure, though...wasn't it you who claimed that American doctors also call for unneeded procedures on a regular basis?(if it wasn't, just ignore that part)

Other measures would have to include infant mortality, missed work days, etc.

 

[Zero]

Originally posted by phatmonky
Just 5 percent of U.S. doctors are responsible for 54 percent of all malpractice. ( National Practitioner Data Bank)
The problem isn't with doctors in general. It is a very select few. I read somewhere (wish I could find the link) that the averag doctor in that 5% has settle 4 malpractice cases. Now the question is, when will their be a doctorial review board setup to remove these licenses?
Medicine is as much an art, as it is a science, and thus things can not always be predicted. There are legitiamte malpractice cases, but there are plenty that aren't.

Then blame the AMA, not the victims.

Then you have people like john edwards who goes through 41 expert witnesses until he can find one that will say what is needed to win billions in law suits ...but that just pisses me off. I don't want to even get into it.

Good, don't bother getting into it, because if you think that the insurance companies don't have doctors on the payroll to say whatever will get them off the hook, you are fooling yourself.

But, it does bring up a good issue...blame the victim, blame the lawyers, even blame the doctors...can we not blame the insurance companies for dragging out the lawsuits to the point that no one can afford to sue for reasonable damages, they are forced to sue for millions upon millions in order to recoup any of their expenses? That's why the insurance companies want a $250,000 cap on lawsuits...because they can drag out a lawsuit until you run out of money and are frced to drop the case.

 

[Zero]

Originally posted by phatmonky
Why don't you take the time to go read my posts instread of putting words in my mouth?[zz)]

Why don't you answer the question?

 

[member 5645]

Originally posted by Zero
Average wait time isn't the only measure, though...wasn't it you who claimed that American doctors also call for unneeded procedures on a regular basis?(if it wasn't, just ignore that part)

Other measures would have to include infant mortality, missed work days, etc.

No, it was me who said that overly beauracratic hospitals tie the hands of the doctor by telling them they are ordering too many tests (for the budget). My point is that I want more doctor autonomy, and I don't see that happening with a fully socialized system in this very political country.


The reason I mentioned the wait times agian, was that your post came in response to mine(mentioning specific incendents). In that post, I first mentioned the research I had posted earlier concerning the topic.

 

[member 5645]

Originally posted by Zero
Why don't you answer the question?

Because, as USUAL, you are unable to read the thread you wish to participate in. I'm tried of having to hold your hand, like a child, through all the big bad discussions...


FROM THIS VERY SAME THREAD:

Originally posted by phatmonky
I prefer a privatized healthcare system no matter what. When I say that, that doesn't mean I woudl be against looking at alternatives to the insurance setup. It means I am against having doctors and hospitals all put under government control,pay, etc.

I believe that doctors need to be given the autonomy to do what is best for the patient. Ask a doc who has worked in a heavily beaurocratic hospital, and you will know that they are told to stop ordering so many CTscans and other tests.

I also would like to see a revamp of our medicare/medicaid system. I believe that all children should have healthcare access,and I believe that for extremely high cost/income ratios there needs to be some sort of aide given.

With that all said, I don't support any system that will limit the patients ability to pay for the most superior service available, if they are so inclined. I also don't like the idea of a socialized healtcare because of the lack of incentives to NOT go to the doctor. I have spoken with Canadian doctors who tell me about abuse of the 'free' system. The nurses would chew people out because they come up there with mosquito bites wanting a benadryl shot to stop the itching. How can such a system work, when people are so obese and unhealthy here already? The answer is, that it can't. Not without raising costs evenmore.

Cover children and extreme cases. Give selection, incentives to stay healthy, and doctor autonomy. Then you have the perfect system.

EDIT- HOw funny, it's even the thread you referenced concerning doctors ordering tests.

 

[Zero]

Originally posted by phatmonky
No, it was me who said that overly beauracratic hospitals tie the hands of the doctor by telling them they are ordering too many tests (for the budget). My point is that I want more doctor autonomy, and I don't see that happening with a fully socialized system in this very political country.


The reason I mentioned the wait times agian, was that your post came in response to mine(mentioning specific incendents). In that post, I first mentioned the research I had posted earlier concerning the topic.

Ok, cool...carry on. Of course, I don't see the difference between insurance companies screwing us over and teh government screwing us over...with the possible exception that there should be more money for health care compared to private insurance, since a government program would be not-for-profit, and no CEO would be skimming off our premiums to but a home in Aspen.

(can anyone spell bureaucratic?!?)

 

[Zero]

Originally posted by phatmonky
Because, as USUAL, you are unable to read the thread you wish to participate in. I'm tried of having to hold your hand, like a child, through all the big bad discussions...


FROM THIS VERY SAME THREAD:




EDIT- HOw funny, it's even the thread you referenced concerning doctors ordering tests.

Thanks for answering the question... You didn't have to be rude about it, though. You can stop being a poopyhead anytime you like.

 

[member 5645]

Originally posted by Zero


(can anyone spell bureaucratic?!?)

I can now.

 

[Zero]

Originally posted by phatmonky
I can now.

So can I, now, thanks to dictionary.com...let's see how long it lasts, though.

 

[Monique]

Originally posted by Evo
I would have gone ballistic if I had to deal with that.

I know, they run those places like it's a business and they don't need the customers.

Nereid, yes, your friend should live here, I selected this area for these specific reasons.

See, this is a major difference between the US and (western) Europe. In the US it is all privately owned and people flock to the areas that are most profitable and comfortable to live in. About a year ago I read about a research which showed that certain areas in the US have a grave shortage of doctors, while other areas are completely overcrowded by them. Ofcourse Europe consists of all small countries, so coverage is much more uniform.

Zero, you're absolutely right about insurance being the driving force behind many of the problems within the health care industry.

Oh, I agree here too, if doctors don't want to see you because the TYPE of insurance that you have, that is just rediculous and shouldn't even be on their mind.

 

[Zero]

Originally posted by Monique

Oh, I agree here too, if doctors don't want to see you because the TYPE of insurance that you have, that is just rediculous and shouldn't even be on their mind.

Unfortunately, the free market leads to consolidation, uniformity of service, and a health care field run by accountants.

 

[adrenaline]

Originally posted by Monique
I know, they run those places like it's a business and they don't need the customers.

See, this is a major difference between the US and (western) Europe. In the US it is all privately owned and people flock to the areas that are most profitable and comfortable to live in. About a year ago I read about a research which showed that certain areas in the US have a grave shortage of doctors, while other areas are completely overcrowded by them. Ofcourse Europe consists of all small countries, so coverage is much more uniform.

Oh, I agree here too, if doctors don't want to see you because the TYPE of insurance that you have, that is just rediculous and shouldn't even be on their mind. [/B]

Unfortunately, many times a doctor can't see a patient with a particular insurance because they are not on the "plan". Not out of choice...for instance, United for Seniors HMO dropped eastern Georgia because they were losing money in that region. Doctors did not drop it. If a United for Seniors wanted to see a doctor, they could, but would have to pay a office visit (say $75) and if any tests had to be ordered, the ordering doctor, who is not part of United for Seniors ,cannot get the referral and precertification so that the insurance can pay for it. This is becoming more and more common. Instead, these poor folks have to drive 45 miles into Atlanta to see a doctor or hospital on their plan.

As for medicine being a business, unfortunately, it has to be so... in part. With one doctor requiring ancillary staff of at least 2 phone people, 2 nurses (one to take care of patients and one to take care of referrals), an insurance specialist, a check in person to verify and ask permission from the insurance each time, a person to pull files, an office manager, a computer specialist etc. (our practice of three docs have over 20 ancilllary staff... they cannot be asked to work for free.)

They want their raises, 401K, dental and medical and disability insurance, workman's comp, disability insurance, three weeks of paid vacation and paid continuing medical ed ,uniform allowance and this is in addition to malpractice premiums more than half a doc's salary, a rent of $25,000 a month, 18 phone lines (always busy) costing over three thousand a month etc. Docs are taking it out of their paychecks (as I stated, Georgia docs average less than plumbers and chiropractors) but still the overhead grows. If we don't keep ourselves in business, there is no service to the patients if we go out of business and move to another state...as it is already happening.

I don't like our system as it is. It is broken. We need to salvage it. We have a lot to learn from socialized medicine...negatives and positives. The AMA, American Medical Association, favors a nationalised health insurance...just getting rid of the bureaucratic nonsense with all the different paperwork and rules will be more cost effective. Medicare is already a form of it, though wrought with bureaucracy, it is the same from patient to patient. The rules and regulations change from one private insurer to another.

Uninsured patients are bankrupting our local hospitals as insured patients don't necessarily pick up the difference anymore.

However, a socialized medical system won't work for the simple reason that americans will not give up the right to sue, so that's out. (Can't expect a doc to pay for huge malpractice premiums on a civil servant's salary. ) In addition, we are too big and inhomogenous.

The Canadian medical system is pretty good until you get very sick and the "limit" has been spent. They have a back door... us, which is why they work. (For instance, a 8 year old with a leukemia that is 80% curable could not be treated in Canada until the new year came around due to the budget deficit in her area hospital. She was in a blast crisis and waiting 3 months was sure death. Her mother took her 3 hours south to Dartmouth Hithcock medical center in New Hampshire, and had her treated successfully with induction therapy within 2 weeks.) That is just one small sample.

However, socialized medicine has it right when it allocates care to children and infants, and denies protracted, futile care in those who are elderly. (50% of all medicare dollars are spent on the last year of a elderly person's life.) Right now, if you want your 99 year old mother to have full artificial resuscitation and life suuppport costing $10,000 a day in the ICU, you have every right to it...and trust me, this happens.

Don't know what the answer is but just the acknowledgment that we are not the best system in the world will be a first step...In short, Canada's health care system achieves more for less than the U.S. system. But to be perfectly honest, neither country is close to the top of the heap when you look around the globe. Back in 2000, if memory serves, the World Health Organization ranked countries' medical systems on the basis of how much bang they got for their buck. The world leaders were the French and Spanish. Canada ranked 30th; the U.S., 37th.

 

[Nereid]

I was wondering how long it would be for adrenaline to post to this thread. Great post, as always ... too few of us know what it's like from the POV of a dedicated doctor.

On another aspect, I realize (thanks to some PMs) that the gross economic inefficiency of the US health-care sector hasn't been well described.

I ask Njorl, SelfAdjoint and others who understand these concepts well to please jump in and amplify/clarify/correct.

In economics, the activity of an industry sector can be described in terms of the proportion of the national GDP which it accounts for. This activity encompasses all aspects of the sector, and all players. While there is always room for disagreement over definitions and accuracy of statistics, economists generally have a pretty good handle on both the data and concepts, at least in developed economies like the US, the countries of the EU, Japan, Australia, etc.

When you examine the level of economic activity by industry sector, you find a most extraordinary result - the US spends* approx twice as much as other developed economies on health care.

By itself this isn't particularly noteworthy; the theory of economic advantage says (for example, caveats apply) that global economic utility is maximised by each economy concentrating its economic activity in sectors where it has a comparative advantage (this does NOT mean where it is cheapest! note the word 'comparative').

However, when it comes to health-care, where almost all the economic activity is domestic (ie no significant imports or exports), the benefits are not purely economic - most of us don't seek good health in order to work harder! So, what are the (economic or other) returns on the disproportionately large 'investment' that the US economy (not people!) makes in health care?

That's the paradox; apparently none (of any significance):
- no increase in life expectancy
- no decrease in infant mortality
- no reduction in incidence of major cancers
- no increase in 5-year survival rates from major cancers
- no decrease in incidence of heart disease
- no increase in 'quality of life' for seniors
- etc, etc, etc.

Note that we're not talking about a few % at the margin; the contrast with ALL other advanced economies is stark.

Some links:
http://www.economist.co.uk/research/backgrounders/displaystory.cfm?story_id=80699
A major business opportunity

*this is measured as % of GDP (a measure of total economic activity) per capita (a.k.a. population), expressed in $PPP (purchasing power parity; basically this metric removes distortions due to differences in exchange rates and the fact that the same basket of goods and services cost very different amounts in each economy, even when measured in constant (inflation-adjusted) US$).

Oh, and just to forestall some likely questions, my sources are that well-known left-wing, all-but-communist publication, The Economist, among whose avid readers are most Economics Nobel Prize winners, Henry Kissenger, Pascal Lamy, Robert Zoellick, Tony Blair, Gordon Brown, ... (but not a certain Bush from Texas)

 

[Nereid]

Why a paradox?

The US health-care sector is quite mysterious because, AFAIK, there are no* other large sectors of the US economy that are so far out of whack (cf other advanced economies).

*well, there's one other - agriculture (US farmers are grossly inefficient - economically, on average - when compared to those in other countries). However, this sector is well understood, and the gross inefficiencies far from unique - e.g. French farmers are far worse - and the EU's CAP is even worse for *everyone* (except a few thousand rich farmers) than the US's agricultural subsidies.

 

[member 5645]

That's the paradox; apparently none (of any significance):
- no increase in life expectancy
- no decrease in infant mortality
- no reduction in incidence of major cancers
- no increase in 5-year survival rates from major cancers
- no decrease in incidence of heart disease
- no increase in 'quality of life' for seniors
- etc, etc, etc.

I would like to see other country's statistics for cancer rates, murder rates, obesity rates, obesity related illnesses (all of which are typically assumed to be higher in the US than other industrialized nations).
I'm not arguing our system is perfect, I am trying to help you pin point the answers to your questions

 

[Nereid]

Originally posted by phatmonky
I would like to see other country's statistics for cancer rates, murder rates, obesity rates, obesity related illnesses(all of which are typically assumed to be higher in the US than other industrialized nations).
I'm not arguing our system is perfect, I am trying to help you pin point the answers to your questions

I'm sure someone can dig these up - a few hours with google (and a good nose for BS and agendas) should do it. From memory:
- cancer rates: no significant differences
- murder rates: US way higher (murders involving firearms), but when age adjusted (young men seem especially prone to murder), not that much different
- obesity rates: I don't know
- obesity related illnesses: ditto.

The comparisons that need to be made involve many other economies. For example, the murder rate in Japan is way lower than that in the US. However, does that difference contribute in any significant way to a 2x difference in the economic efficiency of the health-care sector? I rather doubt it. First, I'd guess that murder has next to no impact on either economy's health-care costs (it would've been far, far different in WWII). Second, if it were a significant contributor, the effect should show up in the health care spending in the UK (say), where the murder rate is significantly higher than in Japan.

In the same way, other demographic differences should (could?) matter too. For example, the Japanese population is significantly older than that of the US (look at the age demographics; look at the life expectancies), and older people are heavier consumers of health-care than the rest of the population. You would thus expect that health-care would be a greater proportion of per-capita GDP in Japan than the US (cet. par.). It isn't.

 

[GENIERE]

Monique seems oblivious to the imminent failure of Belgium’s health care system and her government’s serious investigation into “privatizing” healthcare.

The present system is described as free but in reality is costing Monique and others 3.5% or more of their income not including the insidious co-payments demanded of the poor. It is not mentioned that her government is seriously pursuing “privatizing” healthcare. Industry in her country will soon face severe competition from within the EU and will have to relocate to friendlier countries to remain competitive. Monique’s parents may enjoy the fruits of Monique’s labor but it is not likely that Monique will.

Adrenaline is fortunate to be attending med school in the US. If she were from Belgium, the government might have prevented her from attending a med school or even a pharmacy school.

From MarketResearch.com:

“This report covers detailed socio-demographic, market analysis, and business evaluation for private medical insurance coverage in Austria, Belgium, France, Germany, Italy, Ireland, Netherlands, Portugal, Spain, Switzerland, Czech Republic, Hungary and Poland.

The rising cost of medical treatment and aging populations are putting enormous strains on public funding for health. Governments are under increasing pressure to encourage people to subscribe to private cover and alleviate the burden on state facilities.”

The US is to a great extent subsidizing and improving healthcare the world over. American companies develop most technological advances via research paid for by the US worker.

 

[Nereid]

Er, I think that Monique lives in the Netherlands, not Belgium.

 

[Nereid]

GENIERE wrote: The US is to a great extent subsidizing and improving healthcare the world over. American companies develop most technological advances via research paid for by the US worker.

Evidence?

 

[Nereid]

Response to GENIERE:

{I don't want to copy the whole post again}

That some European governments are having difficulties funding the health-care of their aging populations isn't the point.

To repeat: why does the US spend - on average, per capita, PPP, inflation adjusted $$ - *twice* as much as the Netherlands, UK, Japan, Australia, Canada, Switzerland, Singapore, ... for essentially the same outcome (health-wise)? That's why it's called "gross economic inefficiency".

Especially as this same thing is not observed in any other significant economic sector (the US gets more bang for its $buck than most other economies), other than agriculture.

 

[GENIERE]

Er, I think that Monique lives in the Netherlands, not Belgium.

My apologies to Monique.

Evidence?

Good point, I’ll try to provide it although I’m tempted to utilize the liberal ploy of having someone prove the negative.