News The US has the best health care in the world?

[mheslep]

...Incidentally, these are the people that a health care system should be supporting: those who cannot afford to support themselves. However, it appears to me, that in the US these are the people that are forgotten about...

Yes, you've so stated a few times. A reminder: US state and federal government Medicaid (single payer health care for the poor) spending was some http://www.hhs.gov/news/press/2008pres/10/20081017a.html" .

Edit: and the U.S. EMPTALA law that mandates nobody can be turned away from an emergency room.
BTW, I don't really think any of the programs are a good idea, as they are.

 

[drankin]

Fine, but then to go around and say your health care system is the best in the world (which is what people who are opposed to nationalised health care systems do) is incorrect. The metric to judge whether a health care system is the best in the world is a combination of the health care available and the ability for every resident of that country to access it. It's all well and good having fantastic health care, but when the use of that health care is restricted to the wealthy, you've got to be asking questions about the system.

It's not restricted to the wealthy. I'm not wealthy. I have "fantastic" health care, that I pay for.

 

[mheslep]

Fine, but then to go around and say your health care system is the best in the world (which is what people who are opposed to nationalised health care systems do) is incorrect.

A reasonable take on what people say is that which I quoted from the opposition leader - a statement addressing the strengths and weaknesses.

The metric to judge whether a health care system is the best in the world is a combination of the health care available and the ability for every resident of that country to access it.

Interesting that you left out quality. My metric is quality, affordability, availability - all three.

It's all well and good having fantastic health care, but when the use of that health care is restricted to the wealthy,

'Restricted' is not an apt description of the gaps in the system.

you've got to be asking questions about the system.

Obviously we are.

 

[mheslep]

Speaking of the 'forgotten', I'm reminded of the splendid essay by Prof WG Sumner, The Forgotten Man, written in (I think) 1896. It's historically relevant because Franklin Roosevelt alluded to it and the "Forgotten Man" in his inaugural speech, though FDR changed the meaning a bit in his version. As I hope you'll agree, I think it worthy of insertion in this thread.

Briefly: Sumner broke down the construct of government based social programs algebraically: 'A' wants to help 'X'. 'B' wants to help 'X'. Then comes the problem when 'A' and 'B' conjure some legislation to force 'C' to help 'X'. 'C' then, per Sumner, is the man who pays, the man who prays, the man who is not thought of.

http://www.blupete.com/Literature/Essays/Best/SumnerForgotten.htm

"The Forgotten Man"
By William Graham Sumner.

The type and formula of most schemes of philanthropy or humanitarianism is this: A and B put their heads together to decide what C shall be made to do for D. The radical vice of all these schemes, from a sociological point of view, is that C is not allowed a voice in the matter, and his position, character, and interests, as well as the ultimate effects on society through C's interests, are entirely overlooked. I call C the Forgotten Man.
...
the characteristic of all social doctors is, that they fix their minds on some man or group of men whose case appeals to the sympathies and the imagination, and they plan remedies addressed to the particular trouble; ... They are always under the dominion of the superstition of government, and, forgetting that a government produces nothing at all, they leave out of sight the first fact to be remembered in all social discussion - that the State cannot get a cent for any man without taking it from some other man, and this latter must be a man who has produced and saved it. This latter is the Forgotten Man
...
go and search for the Forgotten Man. He will be found to be worthy, industrious, independent, and self-supporting. He is not, technically, "poor" or "weak"; he minds his own business, and makes no complaint. Consequently the philanthropists never think of him, and trample on him...
...
The fallacy of all prohibitory, sumptuary, and moral legislation is the same. A and B determine to be teetotalers, which is often a wise determination, and sometimes a necessary one. If A and B are moved by considerations which seem to them good, that is enough. But A and B put their heads together to get a law passed which shall force C to be a teetotaler for the sake of D, who is in danger of drinking too much. There is no pressure on A and B. They are having their own way, and they like it. There is rarely any pressure on D. He does not like it, and evades it. The pressure all comes on C. The question then arises, Who is C? He is the man who wants alcoholic liquors for any honest purpose whatsoever, who would use his liberty without abusing it, who would occasion no public question, and trouble nobody at all. He is the Forgotten Man again, and as soon as he is drawn from his obscurity we see that he is just what each one of us ought to be.

 

[cristo]

Speaking of the 'forgotten'

It's not a matter of people being 'forgotten'. Americans know that these people exist, but choose to ignore them. The two notions are entirely different.

 

[cristo]

Interesting that you left out quality.

I meant to say

a combination of the [quality of the] health care available and the ability for every resident of that country to access it.

 

[mheslep]

I meant to say

a combination of the [quality of the] health care available and the ability for every resident of that country to access it.

Well then there we generally have common ground on the goals.

 

[mheslep]

Americans know that these people exist, but choose to ignore them.

And here we don't. As per the Sumner essay above, I don't agree that enacting an anonymous social program, funded by forced taxation, is particularly paying attention to my fellow man.

 

[drankin]

And here we don't. As per the Sumner essay above, I don't agree that enacting an anonymous social program, funded by forced taxation, is particularly paying attention to my fellow man.

Agreed (following your response to cristo), and the assumption that fellow men are "forgotten" is bologne. In this country, you have the right to become "forgotten" if you so chose (to an extent, of course). It's not that they are ignored but we respect their desire to be ignored.

cristo, please point out these folks that are intentionally ignored. Provide some references.

 

[cristo]

cristo, please point out these folks that are intentionally ignored. Provide some references.

For example...

 

[Count Iblis]

That's completely false. Prostrate is slow moving, but it will inevitably kill you without treatment and is the second leading cause of cancer death in the US.
http://www.cancer.org/docroot/CRI/c...atistics_for_prostate_cancer_36.asp?rnav=cri"
5 year 100%
10 year 91%
15 year 76%

http://info.cancerresearchuk.org/cancerstats/types/prostate/survival/"
5 year 90%
10 year 70%
15 year 55%
Also, from the same UK source:



If that's true in general for Europe then it is at the cost a greater death rate for prostrate cancer.

Utter nonsense. It is well known that a large fraction of men have prostate cancer at the time of their death without it being a factor in their death. The reason why we don't screen in Europe is because of false positives in intial test, the cumbersome follow up tests and then, even if you detect prostate cancer, it is very unlikely to kill you.

Then, The major reason why prostate cancer survival rates appear to be much better in the US, is not because the early detection makes treatment better. It is simply the trivial statistical effect caused by the undetected prostate cancer survivors in Europe.

 

[Ivan Seeking]

I just wanted to post and say how thrilling it is to see the town hall meetings in the last couple of days. The crowds are still emotional, but things have calmed down a bit and we are now seeing some of the most engaged public discussion of a serious issue that I have ever seen in this country. Some of the critics are saying that the issue is spiralling out of control, but my view is the opposite. I think we are seeing the best of democracy in action. This is wonderful!

I for one want to see a bipartisan solution. I don't want the Dems to ram this through as long as the Republicans are being reasonable. However, if the Reps show that they only want to "hand Obama his Waterloo", not to arrive at an equitable solution in the best interest of the people, then the Dems will have no choice.

 

[turbo]

I for one want to see a bipartisan solution. I don't want the Dems to ram this through as long as the Republicans are being reasonable. However, if the Reps show that they only want to "hand Obama his Waterloo", not to arrive at an equitable solution in the best interest of the people, then the Dems will have no choice.

Unfortunately, one of the biggest GOP players on the bi-partisan effort (Grassly) is ramping up the fear factor, saying that people should fear that the government would "pull the plug on Granny". That is just vile.

 

[Ivan Seeking]

Unfortunately, one of the biggest GOP players on the bi-partisan effort (Grassly) is ramping up the fear factor, saying that people should fear that the government would "pull the plug on Granny". That is just vile.

Hopefully that boils down to nothing more than the following question: Should a government plan include payment for assisted suicide where it is legal? I would have to say no. While the States have the right to allow assisted suicide, there should be no impetus on the taxpayers who object to assisted suicide, to pay for it; unless the SC rules that assisted suicide is a right protected by the Constitution, and not a matter for the States.

The nutty side of this is the claim that payment for "end of life counselling" is somehow related to euthanasia. The provision related to counselling describes coverage already provided by many private insurers. The true intent of providing terminal patients with options and information has been palinized to mean something completely different than it does.

 

[Ivan Seeking]

I also think there is legitimate concern [in principle] wrt language in the plan that would open the door to problems later. That is to say that while I don't think there are any dark motives, unintended consequences are always a potential problem. There will always be people who try to abuse the system for their own selfish purposes - up to and including pulling the plug on grandma.

 

[mheslep]

... It is well known that a large fraction of men have prostate cancer at the time of their death without it being a factor in their death.

Yes, it is said that if a man lives long enough it is certain that eventually he will contract prostate cancer. People no doubt carry many fatal ailments to the grave that because because some ailments are slower than others to act. So what?

... even if you detect prostate cancer, it is very unlikely to kill you.

http://www.cancer.org/docroot/CRI/c...atistics_for_prostate_cancer_36.asp?rnav=cri"

Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. About 1 man in 35 will die of prostate cancer. Prostate cancer accounts for about 10% of cancer-related deaths in men.

It appears you are mistaking the fact that prostate cancer is often very slow growing with the equally true facts that a) even when slow growing it eventually can and will kill, and b) prostate cancer can also spread quickly though not commonly.

Then, The major reason why prostate cancer survival rates appear to be much better in the US, is not because the early detection makes treatment better. It is simply the trivial statistical effect caused by the undetected prostate cancer survivors in Europe.

I think you are referring to survivor time bias here, that is, the survivor statistics should be differentiated by the cancer stage at diagnosis as was discussed above in https://www.physicsforums.com/showpost.php?p=2304039&postcount=295". I agree that for especially for slow cancers like prostate time bias will skew the stats. I'll come back here w/ something by stage.

 

[Al68]

The metric to judge whether a health care system is the best in the world is a combination of the health care available and the ability for every resident of that country to access it.

Based on such a definition, the U.S. does not have a good or a bad system. There simply is no such system. And there never has been.

Historically, in the U.S., most health care has been private, not part of a system.

It's just faulty logic to refer to a bunch of individual private voluntary agreements as a "system", when they're not in fact part of any real system, then blame them for shortcomings in a "system" that they were never intended to have anything to do with.

 

[Al68]

While the States have the right to allow assisted suicide, there should be no impetus on the taxpayers who object to assisted suicide, to pay for it...

What about all the other things that a plan must cover to be a "qualifying" plan, that many Americans object to paying for, and will have to pay an income tax penalty if they don't participate?

I know the details aren't finalized, but some examples might be: abortion, sterilization, Ritalin, etc.

There is an exception for members of recognized religious "sects" (Amish?), but many non-sect belonging people would object to participating as well.

 

[mheslep]

For example...
...

Amusing advertisement from Gordon Brown state TV.

BTW, Brock, the orgnizer of that clinic also comments:

He is also seriously thinking of returning to Britain - with a team of RAM volunteers.

He has heard his old country has a shortage of NHS dentists.

"I am sure we'll get just as large a crowd as we're getting here in the US," he says.

http://news.bbc.co.uk/2/hi/americas/7420744.stm

 

[mheslep]

...Then, The major reason why prostate cancer survival rates appear to be much better in the US, is not because the early detection makes treatment better. It is simply the trivial statistical effect caused by the undetected prostate cancer survivors in Europe.

...I think you are referring to survivor time bias here, that is, the survivor statistics should be differentiated by the cancer stage at diagnosis as was discussed above in https://www.physicsforums.com/showpost.php?p=2304039&postcount=295". I agree that for especially for slow cancers like prostate time bias will skew the stats. I'll come back here w/ something by stage.

I can't quickly locate by stage stats on prostate, so here are the five year survival rates by stage for breast cancer, which is also faster acting than prostate:
http://www.imaginis.com/breasthealth/statistics2.asp#5"
0 100%
I 100% (in situ)
IIA 92%, IIB 81%,
IIIA 67%, IIIB 54%
IV 20%

http://www.guardian.co.uk/lifeandstyle/besttreatments/breast-cancer-survival-rates-for-breast-cancer"
I 88%
II 69%
III 43%
IV 12%

Overall 5 year survival rate is http://repository.upenn.edu/cgi/viewcontent.cgi?article=1012&context=psc_working_papers" (the overall figure is as of 2001-2003 for the UK)

 

[cristo]

Amusing advertisement from Gordon Brown state TV.

I'm sorry, but are you claiming that was a staged scene, and that the people interviewed were actors? If so, I'd like to see your evidence. What I see is a documentary from one of the best documentary makers in the world. If you've actually ever watched anything from the BBC, you'll know that it is not a puppet channel.

BTW, Brock, the orgnizer of that clinic also comments:

I'm not going to argue that there aren't problems with the dental system, but then, what are the odds of dying of toothache against dying of cancer? The fact is that every single citizen of the UK can see a doctor at any time by walking into a clinic, or making an appointment with their GP, for no charge. The same thing cannot be said for the US, hence why people are fighting their way into a sports hall at 4am to be seen by a third world charity (as per the above film).

 

[Al68]

After rereading the bill, it's clear that it's a complete government takeover of health insurance in the U.S. Although there is a 5 year grace period for some employer based plans, and a grandfather clause for some policies, they are only relevant in the short term. After that all health insurance in the U.S. that are not part of the government "system" will be outlawed. Source: Section 102(c)(1) of http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200:

Although private companies may offer insurance as part of the system, they cannot offer private insurance plans "outside" the new system.

Anyone who chooses not to subsidize the things they find objectionable, or simply have no interest in being in the new system, not only will have to pay an income tax penalty, but will not be able to obtain other health insurance at all in the long term.

Apparently, Democrats are just counting on the fact that most people won't read the bill, and the media won't report the facts, to get away with not telling the truth, and demonizing anyone who does.

The tree of liberty in the U.S. is getting thinner and thinner.

 

[WhoWee]

Full disclosure, I'm a licensed insurance broker. I operate a self quote website with multiple carriers. I am very unhappy with the current discussion in Congress. Health insurance underwriting is down by as much as 80%, as are renewals. People who have lost their jobs are opting for the COBRA extension are facing the reality of future disqualification (pre-existing conditions) due to a new event happening while between policies. I know of cases where people have actually dropped their coverage to (save money now) because "free" health care is on the way. Agents have told me the people opting out of coverage aren't worried about getting sick because the government will take care of them. This is very risky behavior.

As the President mused recently about UPS and FedEx getting it right and the Post Office always being in trouble, the same is true with private insurance companies and Medicare/Medicaid/Social Security.

The biggest challenges to profitability the private companies have are in dealing with government regulation and lawsuits. Otherwise, the insurance companies already have the very best IT in place. The insurance companies are efficient. Insurance companies are rated by how fast they can pay a claim. This information is public and must be disclosed to all applicants.

If you want to address health care reform, start with Tort reform. Then, clean up the fraud and waste in the government run programs.

One aspect of private insurance that works is high deductible catastrophic coverage ($10,000 to $25,000 deductibles) coupled with Health Savings Accounts. Under these plans, patients pay all of the doctor visits and routine tests out of pocket and can write off roughly $5,000 per year. They only use their insurance for large claims such as surgery or cancer treatments. The Health Reform Bills under consideration will outlaw this type of plans.

The next issue is eligibility. Why should US taxpayers pay for the health care of illegal immigrants? If you want to break the law and sneak into this country to work, then pay for your own health insurance - just saying.

Last, modern medicine has extended life-spans. The longer we live, the more medical care will cost. We can debate quality of life (well, until we die) but the prospect/fear of someone making that decision for us is terrifying to most people.

 

[mheslep]

I'm sorry, but are you claiming that was a staged scene, and that the people interviewed were actors?

No I'm not claiming any staging. I claim a great deal of the commentary was bogus, and I suspect the scenes were cherry picked.

If so, I'd like to see your evidence. What I see is a documentary from one of the best documentary makers in the world. If you've actually ever watched anything from the BBC, you'll know that it is not a puppet channel.

And I see a state run broadcasting station, with some good quality programming, but to my mind still biased out over the horizon.

...I'm not going to argue that there aren't problems with the dental system, but then, what are the odds of dying of toothache against dying of cancer?

The cancer treatment is better in the US, better odds of survival.

...The fact is that every single citizen of the UK can see a doctor at any time by walking into a clinic, or making an appointment with their GP, for no charge.

Even if that's true, to what end? Seeing a free GP does not necessarily equal good medical care, as the survival statistics and the waiting lists show. And every single US citizen can walk into an emergency room in the US, and not be turned away based on ability to pay (though I'd change this).

The same thing cannot be said for the US, hence why people are fighting their way into a sports hall at 4am to be seen by a third world charity (as per the above film).

I'd like to know how many of those folks qualified for US Medicaid (single payer for the poor), and avoided that government run system to attend the hall, perhaps because they thought so little of it.

 

[mheslep]

...

One aspect of private insurance that works is high deductible catastrophic coverage ($10,000 to $25,000 deductibles) coupled with Health Savings Accounts. Under these plans, patients pay all of the doctor visits and routine tests out of pocket and can write off roughly $5,000 per year. They only use their insurance for large claims such as surgery or cancer treatments. The Health Reform Bills under consideration will outlaw this type of plans...

What section of the House bill would outlaw HSAs?

 

[cristo]

No I'm not claiming any staging. I claim a great deal of the commentary was bogus, and I suspect the scenes were cherry picked.

Cherry picked or not, the fact of the matter is that such scenes exist.

And I see a state run broadcasting station, with some good quality programming, but to my mind still biased out over the horizon.

What would be the gain to the viewers to be biased about this? It is providing documentary coverage of the situation in a completely different part of the world to the UK. The NHS is not under debate in the UK-- both major parties support it-- so there really is no point to the alleged bias.

The cancer treatment is better in the US, better odds of survival.

Sorry, are you reading different things to those that I'm writing? I don't recall questioning that in the quote...

Even if that's true, to what end? Seeing a free GP does not necessarily equal good medical care, as the survival statistics and the waiting lists show. And every single US citizen can walk into an emergency room in the US, and not be turned away based on ability to pay (though I'd change this).

But a GP and an emergency room are two completely different things, aimed at solving completely different issues. Are you telling me that I can go into an emergency room in the US and say "I think I've got cancer, can you test me and find out?" and walk out, having been tested, and given treatment to help cure me without having to pay a penny?

I'd like to know how many of those folks qualified for US Medicaid (single payer for the poor), and avoided that government run system to attend the hall, perhaps because they thought so little of it.

So they'd rather die than use the aid they could be provided with? Not very likely to me!

 

[Al68]

...One aspect of private insurance that works is high deductible catastrophic coverage ($10,000 to $25,000 deductibles) coupled with Health Savings Accounts. Under these plans, patients pay all of the doctor visits and routine tests out of pocket and can write off roughly $5,000 per year. They only use their insurance for large claims such as surgery or cancer treatments. The Health Reform Bills under consideration will outlaw this type of plans...

What section of the House bill would outlaw HSAs?

I think WhoWee was referring to the insurance plans being outlawed, not HSA's. It's in section 102(c)(1).

Personally, I like the medium deductible ($1,000 to $5000) catastrophic coverage plans. They're a fraction of the cost of comprehensive health plans, and a bargain for people that just need insurance in case they are seriously injured or get sick, but don't need a comprehensive plan that covers everything under the sun.

Democrats apparently have no problem outlawing private agreements between private parties, violating the right of private individuals to contract.

 

[mheslep]

...But a GP and an emergency room are two completely different things, aimed at solving completely different issues. Are you telling me that I can go into an emergency room in the US and say "I think I've got cancer, can you test me and find out?" and walk out, having been tested, and given treatment to help cure me without having to pay a penny?

Yes the GP and emergency room serve different purposes. But then GP's also don't test for cancer, specialists do. Are you telling me you can walk into a specialist office? I just had a family member go to a specialist for a cancer test within two days of a GP visit. And I don't agree w/ the the not-paying-a-penny. You simply don't pay at the door. Also we've heard in this thread that if you ask for say, a PSA test for prostate, its sorry we don't do that, its unnecessary.

So they'd rather die than use the aid they could be provided with? Not very likely to me!

Again there the suggestion that all aid is the same. Visibly it is not. Maybe the government aid was known to be rude and indifferent, and this at the town hall was not.

 

[mheslep]

...What would be the gain to the viewers to be biased about this? It is providing documentary coverage of the situation in a completely different part of the world to the UK.

Why would a government run broadcasting network travel around making documentaries emphasizing how superior this of that government run program is to private alternatives? Not hard to imagine.

The NHS is not under debate in the UK-- both major parties support it-- so there really is no point to the alleged bias.

Perhaps that is a reflection of the BBC coverage. Perhaps the lack of debate reflects that the fact the NHS employs 1.2 million voters. I know of at least of one UK EMP (back bencher) that attacks it regularly.

 

[Hurkyl]

Cherry picked or not, the fact of the matter is that such scenes exist.

Is that relevant? Is mere existence the thing you (or the documentary) were trying to argue?

Or were you trying to argue something about the extent to which such scenes exist? In that case, cherry picking scenes and presenting them as if they are representative is a rather nasty bit of intellectual dishonesty.