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

[mheslep]

The US ranks very low in the life expectancy ranking. It is at 50th place ranking below all the Western countries that have government funded "socialist" health care systems.

Consider that life expectancy is also dependent on many factors unrelated to health care or medicine. http://www.aei.org/docLib/20061017_OhsfeldtSchneiderPresentation.pdf Table 5-1

 

[Al68]

The cancer survival rates of cancer patients, however, is indicative of the quality of care.

Cancer survival rates are indicative of how early you detect the cancer.

You're right, and early detection is directly related to quality of care.

 

[Al68]

After a talk with a very conservative friend of mine, one thing that seems worth mentioning is this: This is a difficult issue. In the grand tradition of democracy, it [health care reform] should be a down-and-dirty dog fight. That is how democracy works; esp when it comes to issues as weighty as this one. So while I do object to people disrupting town halls and the like, I think a big nasty fight in the form of legitimate discourse is exactly what we NEED to see.

That is, provided that we actually do see change. We cannot afford to bury this one again.

I agree with all of this, but I don't know anyone that is generally opposed to change. Of course the change I want is in the opposite direction of the change you want. The current proposal (abomination) in congress desperately needs burying.

 

[Al68]

The US ranks very low in the life expectancy ranking. It is at 50th place ranking below all the Western countries that have government funded "socialist" health care systems.

Yeah, and France has more topless beaches, too. Must be related.

 

[Jimmy Snyder]

Free National Health Care =
Joe, Sarah, Bob, Emily, and Frank are sitting in the waiting room of the local NHS office as they do every day, discussing their grandchildren, their ailments, the long wait to see a doctor, and Amy who couldn't come today because she wasn't feeling well.

 

[Count Iblis]

Yeah, and France has more topless beaches, too. Must be related.

First, I think it is a prori reasonable to assume that there is a link between the health care system and life expectancy (although there are other factors that influence life expectancy as wel).

Second, I'm not sure that the 49 countries that have a higher life expectancy than the US, all have more topless beaches than the US.

 

[Count Iblis]

Free National Health Care =
Joe, Sarah, Bob, Emily, and Frank are sitting in the waiting room of the local NHS office as they do every day, discussing their grandchildren, their ailments, the long wait to see a doctor, and Amy who couldn't come today because she wasn't feeling well.

More precisely, this belongs to the subset: "mismanaged free health care systems".

 

[mheslep]

First, I think it is a prori reasonable to assume that there is a link between the health care system and life expectancy (although there are other factors that influence life expectancy as wel)...

Then why waste your time (and ours) with those conflicted measurements when instead one can go directly to purely health system related outcomes such as cancer survivor rates, transplant survivor rates and so on?

 

[Count Iblis]

Then why waste your time (and ours) with those conflicted measurements when instead one can go directly to purely health system related outcomes such as cancer survivor rates, transplant survivor rates and so on?

The performance of the health care system should be judged by the net result. If in the US a lot of older man are diagnosed with prostate cancer which typically doesn't kill if left untreated, while in other countries less of these cancers are detected in the first place (becuase they don't do screening for these cancers), then obviously the US is going to have a seemingly higher "cancer survival rate".

Also, in the US many more people get skin cancer than in Europe. This is usually detected in early stages and usually doesn't lead to death.

 

[sylas]

This is sort of relevant to the thread, though a bit of a laugh on the side. It is too good to pass up, and it is relevant both to physics and to health care systems...

From the "Investors Business Daily", http://www.ibdeditorials.com/IBDArticles.aspx?id=333933006516877 :

People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.​

 

[mgb_phys]

People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.​

You have to wonder if any US university could hire him with an existing medical condition.

 

[Jimmy Snyder]

More precisely, this belongs to the subset: "mismanaged free health care systems".

No, I think it would apply to anything that was free, whether health care system, or candy.

 

[avec_holl]

Free National Health Care =
Joe, Sarah, Bob, Emily, and Frank are sitting in the waiting room of the local NHS office as they do every day, discussing their grandchildren, their ailments, the long wait to see a doctor, and Amy who couldn't come today because she wasn't feeling well.

How does this pertain to the current health care reform bill? The current bill would allow Joe, Sarah, Bob, Emily, Frank and Amy to keep private health care if they desired and does not cut funding from medicaid or medicare.

 

[mgb_phys]

This is sort of relevant to the thread, though a bit of a laugh on the side. It is too good to pass up, and it is relevant both to physics and to health care systems...

From the "Investors Business Daily", http://www.ibdeditorials.com/IBDArticles.aspx?id=333933006516877 :

The same article also suggests doctors must be opposed to a free health care system because:

...Hippocratic Oath doctors take to first do no harm, compelling them "as an imperative to do everything for the patient regardless of cost or effect on others," thereby avoiding the inevitable move toward "socially sustainable, cost-effective care."

So good news - under a commercial system no doctor at a hospital or a managed care provider would ever; refuse or delay regardless of cost or effect on others.

 

[CRGreathouse]

How does this pertain to the current health care reform bill? The current bill would allow Joe, Sarah, Bob, Emily, Frank and Amy to keep private health care if they desired and does not cut funding from medicaid or medicare.

Because Joe, Sarah, Bob, Emily, Frank and Amy will subsidize the system. Employer-funded healthcare (beyond a certain point) becomes taxable, unlike current law. And the smart money says money will come, directly or indirectly, from general funds as well.

The money doesn't come from nowhere.

 

[Jimmy Snyder]

My little story was not about health care. It was about the value that people place on things that are 'free'.

 

[mgb_phys]

My little story was not about health care. It was about the value that people place on things that are 'free'.

Funny but perhaps a little too subtle!

 

[Al68]

The performance of the health care system should be judged by the net result. If in the US a lot of older man are diagnosed with prostate cancer which typically doesn't kill if left untreated, while in other countries less of these cancers are detected in the first place (becuase they don't do screening for these cancers), then obviously the US is going to have a seemingly higher "cancer survival rate".

Also, in the US many more people get skin cancer than in Europe. This is usually detected in early stages and usually doesn't lead to death.

So the cancer survival rate isn't indicative of the quality of care, but the overall life expectancy is? Life expectancy isn't a "net result" of health care quality. Cancer survival rates are, even if not a perfect indicator.

 

[mgb_phys]

So the cancer survival rate isn't indicative of the quality of care, but the overall life expectancy is?

Cancer cure rates might be, cancer survival rates just mean you were alive 5years after they declared 'cancer'.

Life expectancy isn't a "net result" of health care quality. Cancer survival rates are, even if not a perfect indicator.

Life expectancy is heavily dependant on childhood and neonatal health so it is also sensitive to nutrition and housing.
Cancer rates only measure those people that get cancer !

 

[Al68]

The current bill would allow Joe, Sarah, Bob, Emily, Frank and Amy to keep private health care if they desired and does not cut funding from medicaid or medicare.

No, it won't, unless you call a private company participating in a government system "private health care". If someone gets a private insurance plan that does not qualify for the government system (because they are against subsidizing the types of things covered, or just because they only need insurance for the unexpected instead of a comprehensive health plan that covers everything under the sun), they will have to pay an income tax penalty (limited to the average cost of a qualifying plan, of course). Simply put, this bill assesses an income tax penalty against any American for failure to prove to government they have a "qualifying" plan. Whether or not the plan meets the standards of the person getting it is irrelevant. You call that "private health care"?

Allowed to keep their current plan, maybe. Allowed to ignore the new law and make their own choice without being penalized, no.

And being able to choose among the "government approved" choices doesn't count as freedom of choice despite the fraud and deception being perpetrated.

Of course the details aren't finalized, but I doubt if they will take out the part that says, "join this system or pay a stiff penalty".

 

[Al68]

Cancer cure rates might be, cancer survival rates just mean you were alive 5years after they declared 'cancer'. Life expectancy is heavily dependant on childhood and neonatal health so it is also sensitive to nutrition and housing.
Cancer rates only measure those people that get cancer !

You're right! Three times! (I assume you agree that 5 years after diagnosis, it's fairly important to the patient whether or not he/she's alive.)

 

[Al68]

First, I think it is a prori reasonable to assume that there is a link between the health care system and life expectancy (although there are other factors that influence life expectancy as wel).

Second, I'm not sure that the 49 countries that have a higher life expectancy than the US, all have more topless beaches than the US.

Maybe not, but they all have a larger percentage of their cancer patients dead after five years.

It's much more reasonable to consider cancer survival rates a much better indicator of health care quality than life expectancy, because life expectancy depends on so many more things completely unrelated to health care quality, such as genetics, lifestyle, eating habits, smoking, drinking, job/family stress, etc.

Cancer survival rates at least mostly can be expected to depend on the quality of medical care received. And the other factors are much less likely to depend on what country you're in, so would be much less relevant.

 

[Count Iblis]

Maybe not, but they all have a larger percentage of their cancer patients dead after five years.

It's much more reasonable to consider cancer survival rates a much better indicator of health care quality than life expectancy, because life expectancy depends on so many more things completely unrelated to health care quality, such as genetics, lifestyle, eating habits, smoking, drinking, job/family stress, etc.

Cancer survival rates at least mostly can be expected to depend on the quality of medical care received. And the other factors are much less likely to depend on what country you're in, so would be much less relevant.

Cancer survival rates also depend on a number of factors that are not directly related to the medical treatment, genetic factors being an important factor.

Another factor is screening. In the US you e.g. screen for prostate cancer. But almost all men who have prostate cancer survive this without any form of treatment. In Europe we don't screen for it. The people who are detected to have it, have prostate cancer that is causing complaints and those cancers are a bit more likely to kill.

So, if you compare survival rates for prostate cancer in the US to survival rates for prostate cancer in Europe, you're not measuring a difference in the effectiveness of any treatment.

 

[Al68]

Cancer survival rates also depend on a number of factors that are not directly related to the medical treatment, genetic factors being an important factor.

I agree. But the number and extent of the other factors affecting life expectancy is much greater than for cancer survival rates. My point was that cancer survival rates were a much better indicator than life expectancy, not that it was a perfect indicator.

Another factor is screening. In the US you e.g. screen for prostate cancer. But almost all men who have prostate cancer survive this without any form of treatment. In Europe we don't screen for it. The people who are detected to have it, have prostate cancer that is causing complaints and those cancers are a bit more likely to kill.

So, if you compare survival rates for prostate cancer in the US to survival rates for prostate cancer in Europe, you're not measuring a difference in the effectiveness of any treatment.

I agree that prostate cancer survival rates aren't very indicative of anything. But based on your post, the lack of early detection seems to be a relevant factor in Europe, since prostate cancer rarely kills within 5 years if detected early, before it causes complaints.

 

[mheslep]

Cancer survival rates also depend on a number of factors that are not directly related to the medical treatment, genetic factors being an important factor.

You are likely confusing cancer incident or mortality rates (very dependent on non medical system factors) with outcomes (which are not). They are two very different things.

 

[mheslep]

Another factor is screening. In the US you e.g. screen for prostate cancer. But almost all men who have prostate cancer survive this without any form of treatment.

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:

The increase in prostate cancer survival rates is particularly pronounced in the 1990s when PSA testing became more prevalent.

but In Europe we don't screen for it.

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

 

[mheslep]

Cancer cure rates might be, cancer survival rates just mean you were alive 5years after they declared 'cancer'...

What are you talking about? Physicians don't use the word 'cure' in connection with cancer.
Look, a woman is diagnosed with breast cancer. In the US her chance of dying inside five years is essentially zero. In the UK, 1 chance in 5 she's dead in five years.

...Life expectancy is heavily dependant on childhood and neonatal health...

and also dependent on
-driving after 19 pints 'o Guiness,
-being capped in the head by a jealous husband,
-eating 14 donuts at every meal,
-whether or not a parent died of a heart attack at 39

... so it is also sensitive to nutrition and housing.
Cancer rates only measure those people that get cancer !

That may be true, but the thread is not about nutrition and housing in any major way. My Medicare taxes and your NHS taxes don't go to food and housing. The thread is about _health care_, as in that which is provided by doctors, nurses, and hospitals, in hopes of informing decisions about the make up the _heath care_ system.

 

[cristo]

In the US her chances of dying in five years is essentially zero.

Of those that are known about, yes. But what happens to the person who is uninsured and can't afford to pay the fees to go to hospital. The bean counters will never know that her illness existed, it will never have been diagnosed, since she can't afford to get it diagnosed. In the UK, such a person will be diagnosed, and thus will be counted in the statistics. Thus, as with all statistics, they must be taken with a pinch of salt.

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. It brings me back to the same point that I make whenever such a topic is discussed, namely, what is the metric you choose to measure the "best in the world"? Is the best system the one that offers assistance to everyone, or is the best system the one that has the most effective treatment in the world for those who can afford it?

 

[mheslep]

...It brings me back to the same point that I make whenever such a topic is discussed, namely, what is the metric you choose to measure the "best in the world"? Is the best system the one that offers assistance to everyone, or is the best system the one that has the most effective treatment in the world for those who can afford it?

All of the above, and answered I believe back in #55 (Sen. McConnell statement).
https://www.physicsforums.com/showpost.php?p=2280345&postcount=55
The US has lousy cost performance compared to other countries, insurance coverage problems, but the effectiveness of the medical practice itself can reasonably be called the 'best in the world.'

 

[cristo]

The US has lousy cost performance compared to other countries, insurance coverage problems, but the effectiveness of the medical practice itself can reasonably be called the 'best in the world.'

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.