US dead last in health care

[Accountability Now]

So you give a summary of the report. Way to go! Where in your condescending yammering do you actual offer an idea of your own? Read your post again and tell me what you brought to the argument besides repeating what the study was about?

My specific argument was that I didn't agree with a couple categories. How do you compare road deaths with Japan when they widely use public transit compared to the US? I was not out to discredit the whole study...just pointing out the obvious. I'm sorry that closed minded people like you can't even have the conversation without getting your panties in a bunch.

[waldo]

Again. The researchers include "accidents" and "violence" in their life expectancy figures - and accidents and violence are not indicators of "health." In other words, the the research does not "indicate that the US health system is not performing well, even for those who have access to it," as you claim.

again, you don't know what constitutes a comprehensive accounting of overall health. You continue to deflect by doubling down on mortality rates/life expectancy as the, as your, dominant and prevailing metric within the study... with you most particularly zeroing in on injuries (unintentional and/or intentional).

now... if you really want to just, in isolation, concentrate solely on life-expectancy as a determiner of "health", perhaps you should chew on this study graphic that showcases just where the U.S. compares overall in breakout mortality ratings (above and below/at the other 16 peer country mortality rates):

alternatively, for a most enlightening perspective, you could examine this related interactive tool that will allow you to separate (across and within) the overall categorized mortality groupings of, 'Deaths from Non-Communicable Diseases', versus, ' Deaths from Communicable, Maternal, Perinatal and Nutritional Conditions', versus, 'Deaths from Injuries':

[waldo]

So you give a summary of the report. Way to go! Where in your condescending yammering do you actual offer an idea of your own? Read your post again and tell me what you brought to the argument besides repeating what the study was about?

yes, yes I did give a summary of the report... the report I actually found and read (overview, full summary and particular sections relative to the discussion at hand and those I found most interesting). The report that few around here, most pointedly you, actually went to. It is most reflecting on your own, as you say, "yammering", that you interpret challenge/criticism as condescension... perhaps you don't get out much!

I'm sorry that closed minded people like you can't even have the conversation without getting your panties in a bunch.

no bunched panties here. Do you always categorize those that challenge your simplistic, self-serving and unfounded positions/verbiage as being, as you say, "closed minded"?

[Pliny]

Pliny is why I don't want to open the healthcare debate to changing our system. I would have no problem learning from Europe, but there's too many Plinys that would be pushing for us to adopt that crap US system. I've lived and worked there. The system is crap. Even HMO coverage costs both the employer and the employee more than we pay here in premiums, and you can't choose any doctor you want, go to any hospital as needed, and there's some highschool grad deciding whether your condition is covered. Then there's the co-pays and pre-existing conditions exemptions.

Most Canadians think as you do and that is the reason our system never will change. I am well aware there are problems with the American medical system but they still have a chance to get it right, at least they did until Obamacare. Hopefully, they can scrap that and try again. Meanwhile, we'll settle for mediocrity and long wait times until we can no longer economically sustain the system.

[Accountability Now]

You have yet to address any of my specific arguement. How can you compare road deaths in Japan versus other countries? I have no other problems with this article other than that. I'll wait for your answer but it better not be a summary of a previous study.

BTW...I have been to most of the countries on that list. So yes...I get out much!

[bush_cheney2004]

Most Canadians think as you do and that is the reason our system never will change..... Meanwhile, we'll settle for mediocrity and long wait times until we can no longer economically sustain the system.

Hence the reason for the false association with "healthcare". There is a consistent crop of forum posts that strive to defend Canada's less than average performing healthcare "system" by pointing to the U.S. and creeping "American-style" solutions that would undermine the collectivist status quo, even as many Canadians already take advantage of a "n-tier" healthcare system.

Canadians are expected to patriotically suffer in wait time queues just to present a unified political front to any changes in funding or delivery competition.

[waldo]

You have yet to address any of my specific arguement. How can you compare road deaths in Japan versus other countries? I have no other problems with this article other than that. I'll wait for your answer but it better not be a summary of a previous study.

you've made a personal statement of disagreement with one particular facet of one particular metric within the overall study... you've certainly not made any, as you say, "specific argument", one you backed up with anything to support your personal statement of disagreement. Yes, the study does a peer-country comparison of the, 'road traffic accidents' subset of the, 'Unintentional injuries' subset of the, 'Deaths from Injuries' subset of the overall mortality groupings. If you bother to actually check the interactive link I supplied, you can see your exact, 'Japan-to-other-countries' comparison. Perhaps you have a concern over how this subset of a subset of a subset is weighted within the overall mortality assessment, within the overall study findings on the comparison of U.S. health relative to the other 16 peer countries reviewed. It's not clear... since, as I said, you've offered no specific argument.

BTW...I have been to most of the countries on that list. So yes...I get out much!

then rise above your defensive (and unwarranted) claims of condescension... rise above your labeling others 'close minded'. If you can't accept challenge/critical assessment, perhaps a discussion board isn't the best avenue for your minimalist expression.

Edited January 20, 2013 by waldo

[Pliny]

[/size]again, you don't know what constitutes a comprehensive accounting of overall health. You continue to deflect by doubling down on mortality rates/life expectancy as the, as your, dominant and prevailing metric within the study... with you most particularly zeroing in on injuries (unintentional and/or intentional).

now... if you really want to just, in isolation, concentrate solely on life-expectancy as a determiner of "health", perhaps you should chew on this study graphic that showcases just where the U.S. compares overall in breakout mortality ratings (above and below/at the other 16 peer country mortality rates):

alternatively, for a most enlightening perspective, you could examine this related interactive tool that will allow you to separate (across and within) the overall categorized mortality groupings of, 'Deaths from Non-Communicable Diseases', versus, ' Deaths from Communicable, Maternal, Perinatal and Nutritional Conditions', versus, 'Deaths from Injuries':

Couldn't it possibly be that for some of those statistics the US has better diagnostics than other countries? In Canada you might die waiting in line before you get a proper diagnosis from a specialist.

The hackneyed quote from Twain contains much truth. There are statistics, then there are damned statistics and then there are lies.

I'm certain the US NRC, US NIH, the US Institute of medicine, the Department of HHS all see the need for improvement in the American medical system to make it more accessible for the economically disadvantaged but of course the answers they seek must be provided by government. There is no non-government solution to healthcare problems, it seems.

This is one of the areas where we need to collectively act but why does it have to be a system forced upon everyone by government. Society can do some great things collectively and co-operatively without government. As far as I can see medical insurance companies have done nothing to improve healthcare in the US they simply keep the apparency of competition there and some concept of a private market. But really they are just a cartel and as rigid a systemic establishment as any government run healthcare system.

[Pliny]

Hence the reason for the false association with "healthcare". There is a consistent crop of forum posts that strive to defend Canada's less than average performing healthcare "system" by pointing to the U.S. and creeping "American-style" solutions that would undermine the collectivist status quo, even as many Canadians already take advantage of a "n-tier" healthcare system.

Canadians are expected to patriotically suffer in wait time queues just to present a unified political front to any changes in funding or delivery competition.

The strongest resistance to change comes form within the system itself. Any apparent threat to the status quo starts a mobilization of ultra-conservative forces of the fascist bully variety.

[Pliny]

Do you have some non-flawed statistics to back that up?

Do you have some non-flawed statistics to back that up?

He wants deeper thought not more statistics.

[bush_cheney2004]

....As far as I can see medical insurance companies have done nothing to improve healthcare in the US they simply keep the apparency of competition there and some concept of a private market. But really they are just a cartel and as rigid a systemic establishment as any government run healthcare system.

In the U.S., medical insurance companies are an outgrowth of market based cost mitigation by employers who wanted to offer employment related incentives during a workforce shortage (i.e. Kaiser, WW2, etc.). Government got into the game as a Great Society social program much later, followed by so called non-profit HMOs. Health care costs rose dramatically compared to normal inflation because billions in new spending was now available from taxpayers.

Most doctors and other health care professionals bemoan the amount of influence and resources that have to be dedicated to the insurance and claims adjudication systems. Years ago, and like many others, my family never had health insurance nor was it necessary. The sign on the wall said that "Payment is due upon delivery of services.". It was a simple cash transaction. I have a receipt for a sibling's birth in a NJ hospital from 1962 for the amazing total of $35.17.

[Argus]

Most doctors and other health care professionals bemoan the amount of influence and resources that have to be dedicated to the insurance and claims adjudication systems. Years ago, and like many others, my family never had health insurance nor was it necessary. The sign on the wall said that "Payment is due upon delivery of services.". It was a simple cash transaction. I have a receipt for a sibling's birth in a NJ hospital from 1962 for the amazing total of $35.17.

There is certainly some truth to the fact that the more money available, the more people will charge. You can't get an aspirin from a doctor for that now. But then again, I can't get a plumber to come and look at my toilet for less than $50. That's just to show up. Anything else is extra. So even without insurance I think the price of health care would have risen dramatically by now.

In the US, though, one of the primary drivers of health care are the huge sums charged by big pharma (mostly for drugs developed with government money). Big pharma has dramatically increased its promotion, and the number of prescriptions written in the US has gone up by 1/3 in the last decade.

Another is simply demand for more services brought about by a growing and aging population. Not much you can do about that one. New technology is another big one, and that is greatly influenced by the fact every hospital has to have the newest gizmo. There is no collective sharing in the sense we see among hospitals in Canada.

[bush_cheney2004]

.... So even without insurance I think the price of health care would have risen dramatically by now.

If by dramatically you mean cost increases because of inflation, that is a given. But that has not been the case, in the U.S. or Canada.

....New technology is another big one, and that is greatly influenced by the fact every hospital has to have the newest gizmo. There is no collective sharing in the sense we see among hospitals in Canada.

Americans see that as systemic rationing, and a market based delivery system will always resist that. If I have the means to pay, I expect services to be available in short order, as there is no compensation for waiting. Government (federal, state, and county) hospitals do share such resources in the U.S., but there is a larger private delivery system competing with excess capacity by design.

[Accountability Now]

Look back at the conversation and see who started the attacks first. Nice try backing out now.

I did state my specific arguement with canuckistani and he got it. You were so riled up that I questioned your study that you didn't see it.

Simple comment on not liking the categories. And no I don't care if it was a subset of a subset...because I agreed with everything else. Did you hear that....I agreed with everything else so don't cut and paste someone else's work for me to look at.

I would say you are the one that needs to consider leaving the forums but I'm sure it's the only thing you have in your life so that's not really an option.

I'm done arguing on this as I do have other things to do.

[Canuckistani]

There is certainly some truth to the fact that the more money available, the more people will charge. You can't get an aspirin from a doctor for that now. But then again, I can't get a plumber to come and look at my toilet for less than $50. That's just to show up. Anything else is extra. So even without insurance I think the price of health care would have risen dramatically by now.

In the US, though, one of the primary drivers of health care are the huge sums charged by big pharma (mostly for drugs developed with government money). Big pharma has dramatically increased its promotion, and the number of prescriptions written in the US has gone up by 1/3 in the last decade.

Another is simply demand for more services brought about by a growing and aging population. Not much you can do about that one. New technology is another big one, and that is greatly influenced by the fact every hospital has to have the newest gizmo. There is no collective sharing in the sense we see among hospitals in Canada.

As well as the inefficiencies of the multiple payer system. Also just read a piece that said the super rich are sucking up healthcare resources because they can afford to pay for them, which in turn of course raises costs for everybody else.

[waldo]

Hence the reason for the false association with "healthcare". There is a consistent crop of forum posts that strive to defend Canada's less than average performing healthcare "system" by pointing to the U.S. and creeping "American-style" solutions that would undermine the collectivist status quo, even as many Canadians already take advantage of a "n-tier" healthcare system.

no - the false association within this thread comes from you and your cohort deflectors attempting to shift... and limit... the thread's referenced study on comparative health to a singular focus on healthcare "systems". You certainly have no credibility in your continued false posturing over the failed results of your own country's health care "system". You continue to bleat on about 'rich' Canadians traveling to the U.S. for private healthcare (to avoid line-ups). I don't recall you ever providing a definitive account/number of just how many Canadians do so, whether at the behest of provincial healthcare decisions or through independent choice. Somehow, the subject of thousands upon thousands of Americans traveling abroad under the guise of 'medical tourism' is conveniently ignored... somehow that described independent choice carries a different value!

Canadians are expected to patriotically suffer in wait time queues just to present a unified political front to any changes in funding or delivery competition.

nonsense - wait time queues are a topical point of concern continually being raised... there is no, as you say, 'presented unified political front' objecting to funding/delivery revision - other than adhering to the Canada Health Act that presumes to set guidelines for charges to Canadians.

[waldo]

Look back at the conversation and see who started the attacks first. Nice try backing out now.

what "attacks"? I didn't attack you - I certainly don't consider anything you said an attack. Is this your first experience with a discussion board?

I did state my specific arguement with canuckistani and he got it. You were so riled up that I questioned your study that you didn't see it.

no - again, you offered no argument... you simply declared your disagreement with, again, one particular facet of one particular metric, within one particular category, within the overall study.

Simple comment on not liking the categories. And no I don't care if it was a subset of a subset...because I agreed with everything else. Did you hear that....I agreed with everything else so don't cut and paste someone else's work for me to look at.

no - you most certainly did not. Among your assorted transgressions, you discounted the overall study by throwing out unfounded agenda labeling. The 'cut & paste' you seem to object to, the "someone else's work' you describe, is simply direct extract from the study/authors. It's quite puzzling that you would raise objection to having detailed study references made.

I would say you are the one that needs to consider leaving the forums but I'm sure it's the only thing you have in your life so that's not really an option.

??? there's certainly no need for you to personalize these exchanges.

[waldo]

Couldn't it possibly be that for some of those statistics the US has better diagnostics than other countries?

the study authors are quite forthcoming in their decisions made as to which countries were compared... the so-called 'peer countries'. In this particular mortality section breakout that you're posing your question to, the study authors relied upon OECD data - which aligns, quite naturally, with the designation of peer.... yes, all countries in the comparison are OECD member countries. If your raised possibility has any bearing, any significance, I've personally not read it mentioned within the study itself, nor within any review articles/critical commentary.

[Pliny]

the study authors are quite forthcoming in their decisions made as to which countries were compared... the so-called 'peer countries'. In this particular mortality section breakout that you're posing your question to, the study authors relied upon OECD data - which aligns, quite naturally, with the designation of peer.... yes, all countries in the comparison are OECD member countries. If your raised possibility has any bearing, any significance, I've personally not read it mentioned within the study itself, nor within any review articles/critical commentary.

The US health care system has no "peer". It is unique in first world countries. If you want to compare health care systems we can compare ours to France or Switzerland or Sweden, all socialized medical healthcare systems. I think we are dead last in comparison to them.

And I am not saying the US health care system is the best thing in the world, either. We can start comparing the US in a few years after Obamacare has settled in. Poor guys.

OECD data does not put the US last in service. hey have the most MIRs, the most CT scanners well check out this study based on OECD data.

The United States ranks number one in terms of spending among the 28 OECD countries studied. Yet at the same time, the United States ranks higher than Canada in 16 out of 19 (84%) medical resources and output indicators where data are avail able (table 3). Over all, the United States ranks among the top three countries in 11 of the 19 medical resource and output indicators where data are available for comparison

From http://www.fraserins...ystems-2012.pdf

If you don't like the fact it is from the Fraser Institute just analyze the OECD data it contains for yourself.

I think this refutes the claim that the US is dead last in healthcare as the thread title states but the OP is not about.

Edited January 21, 2013 by Pliny

[waldo]

The US health care system has no "peer". It is unique in first world countries. If you want to compare health care systems we can compare ours to France or Switzerland or Sweden, all socialized medical healthcare systems. I think we are dead last in comparison to them.

And I am not saying the US health care system is the best thing in the world, either. We can start comparing the US in a few years after Obamacare has settled in. Poor guys.

the OP linked study did not evaluate and assign countries 'peer' designation based upon respective health care systems. As an aside, I note your own "system" designation appears to delineate to the exclusion of public health while focusing entirely on health care. In any case, the study itself speaks to the difficulty in making absolute health care system comparisons between peer countries and that in particular areas, data is lacking. The study also speaks to separate active research that continues to work towards improving and strengthening health care comparisons between countries... that complete data is still evolving. That being said, where sufficient data exists the study does draw comparisons.

OECD data does not put the US last in service. hey have the most MIRs, the most CT scanners well check out this study based on OECD data.

The United States ranks number one in terms of spending among the 28 OECD countries studied. Yet at the same time, the United States ranks higher than Canada in 16 out of 19 (84%) medical resources and output indicators where data are avail able (table 3). Over all, the United States ranks among the top three countries in 11 of the 19 medical resource and output indicators where data are available for comparison

From http://www.fraserins...ystems-2012.pdf

If you don't like the fact it is from the Fraser Institute just analyze the OECD data it contains for yourself.

you're taking the Fraser Institute (FI) study descriptors for select 'medical resources' and 'output indicators' and giving them your summary designation of "service". You then proceed to close with your statement below extending your self-designation of "service" to encompass healthcare in whole/totality. The Fraser Institute certainly isn't taking the same liberties you are! More pointedly, within those FI select study resources/indicators, the examples of having the most number of CT, MRI & PET scanners does not speak directly to a quality measurement of health care, particularly when access to the scanners and related care, follow-up care and ongoing care are considered. Most pointedly, several of the FI select indicators are a direct reflection upon the related ill-health or disease of respective patients undergoing procedures; (i.e., poor/reduced health).

I think this refutes the claim that the US is dead last in healthcare as the thread title states but the OP is not about.

the thread author has qualified, several times, the intended OP focus on health, not specifically health care. Many thread posts have been made by certain MLW members attempting to deflect away from health comparisons; equally, many posts have been made by certain MLW members calling out these blatant attempts to deflect. To your self-satisfying refute claims (and deflection away from the threads intended health comparison focus)... yes, I guess the thread title could be changed (presuming upon the OP).

[cybercoma]

Most Canadians think as you do and that is the reason our system never will change.

No. The reason our system won't change the way you want it to is that you don't completely overhaul something that works. Your idea of change would be like buying an entirely new car because the tires on the old one are bald. Edited January 21, 2013 by cybercoma

[Canuckistani]

No. The reason our system won't change the way you want it to is that you don't completely overhaul something that works. Your idea of change would be like buying an entirely new car lemon because the tires on the old one are bald.

[Pliny]

No. The reason our system won't change the way you want it to is that you don't completely overhaul something that works. Your idea of change would be like buying an entirely new car because the tires on the old one are bald.

Being last in comparison to similar nationalized health care systems is not something that works.

If you want a reasoned debate about health care you should stop assuming what I want. I would like to have accessibility to the widest number of people at the most reasonable cost which I assume would be something you would agree with.

We can start asking questions by wondering why the national government has to collect money from the provinces to distribute it back to the provinces? Is the answer that some provinces need the support of other provinces and equalization payments are necessary? What if per capita every provincial government could raise the same money or enough to meet the needs of their governance and equalization could be achieved that way instead of being run through a costly national bureaucratic redistributive process?

I, nor you, will resolve our health care problems but first you have to admit you have a lemon before you will even consider meaningful, efficient, change. You are hiding your head in the sand if you think you are any better off than Americans. At least if I had a lemon I would recognize the need to change the car before the tires had a chance to even get bald.

[Pliny]

the OP linked study did not evaluate and assign countries 'peer' designation based upon respective health care systems. As an aside, I note your own "system" designation appears to delineate to the exclusion of public health while focusing entirely on health care. In any case, the study itself speaks to the difficulty in making absolute health care system comparisons between peer countries and that in particular areas, data is lacking. The study also speaks to separate active research that continues to work towards improving and strengthening health care comparisons between countries... that complete data is still evolving. That being said, where sufficient data exists the study does draw comparisons.

you're taking the Fraser Institute (FI) study descriptors for select 'medical resources' and 'output indicators' and giving them your summary designation of "service". You then proceed to close with your statement below extending your self-designation of "service" to encompass healthcare in whole/totality. The Fraser Institute certainly isn't taking the same liberties you are! More pointedly, within those FI select study resources/indicators, the examples of having the most number of CT, MRI & PET scanners does not speak directly to a quality measurement of health care, particularly when access to the scanners and related care, follow-up care and ongoing care are considered. Most pointedly, several of the FI select indicators are a direct reflection upon the related ill-health or disease of respective patients undergoing procedures; (i.e., poor/reduced health).

the thread author has qualified, several times, the intended OP focus on health, not specifically health care. Many thread posts have been made by certain MLW members attempting to deflect away from health comparisons; equally, many posts have been made by certain MLW members calling out these blatant attempts to deflect. To your self-satisfying refute claims (and deflection away from the threads intended health comparison focus)... yes, I guess the thread title could be changed (presuming upon the OP).

In any event, the OP cited study is an interpretation of data by third parties, while some of it might be interesting it is far from conclusive, which you have succinctly pointed out. And is its purpose to bring reflection upon and change in comparative systems, such as may be deemed necessary in Canada, or is it for Canadians to gloat about their obvious superiority over one other nation that perhaps shouldn't even be included in such a comparison, if only for the reason that Americans have in the past had a choice to make their own personal risk assessments regarding their expenditures in health care.

[Guest American Woman]

No. The reason our system won't change the way you want it to is that you don't completely overhaul something that works. Your idea of change would be like buying an entirely new car because the tires on the old one are bald.

Yet the idea of many here is to simply exchange one negative for another in the U.S., and call it better.

When dealing with your scenario, it would not make sense to replace a really good battery just because the tires are bald - especially if they then would have to rely on their neighbor for a jump start at times because their replacement battery wasn't as good. New tires don't help if the car won't start, so it would be foolish to mess with a battery that works in the process.

Edited January 22, 2013 by American Woman