The timing of the health care law

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jbuck919
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Re: The timing of the health care law

Post by jbuck919 » Mon Apr 09, 2012 2:06 pm

living_stradivarius wrote:
Teresa B wrote: There are no better "medical advancements" in the ER to evaluate and treat somebody's sore throat or bladder infection. These things would be ever so much more logically treated in a non-emergency facility at way less cost.
Which is why I mentioned that we need to create a secondary and cheap insurance market using less advanced technology and treatments without grouping expensive technologies into premium levels to cover sore throats and bladder infections when they arise. One of the problems with health insurance today is that there is a tendency to group many different levels of care into one or two policies, which results in lower premiums for super expensive treatments but higher premiums for simple problems. De-couple those treatments in a market specific for those who fall between the Medicaid and insurance gap, and you solve that problem. It can be solved by the private market if someone takes the initiative to do it.
The thing about a huge private market is that it self-organizes into profitable models, and if there were one that incentivized the kind of alternative you are talking about, it would long ago have become a reality. Unless you can actually come up with a viable plan yourself, stop browbeating us with your assumption that there must be an unrealized entrepreneurial approach which would cut through what you see as a limitation in the current market. As a heuristic approach that with respect to the context you have cut from the whole cloth, this flight of fancy of yours has no more value than (as I said before) assuming that we are on the verge of an unspecified scientific breakthrough, or even, for that matter, reassuring us that God will provide.
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Teresa B
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Re: The timing of the health care law

Post by Teresa B » Mon Apr 09, 2012 2:13 pm

living_stradivarius wrote:
Teresa B wrote: There are no better "medical advancements" in the ER to evaluate and treat somebody's sore throat or bladder infection. These things would be ever so much more logically treated in a non-emergency facility at way less cost.
Which is why I mentioned that we need to create a secondary and cheap insurance market using less advanced technology and treatments without grouping expensive technologies into premium levels to cover sore throats and bladder infections when they arise. One of the problems with health insurance today is that there is a tendency to group many different levels of care into one or two policies, which results in lower premiums for super expensive treatments but higher premiums for simple problems. De-couple those treatments in a market specific for those who fall in the gap between Medicaid and being insured, and you solve that problem. It can be solved by the private market if someone takes the initiative to do it.
So you're saying, have two tiers of insurance coverage? I'm not sure what you mean by lower premiums for expensive treatments and higher premiums for simple problems. Premiums are a lump amount per month (or whatever) for the overall policy. If you buy a policy that is cheap because it will cover only things like sore throats, what do you do if you get seriously ill or suffer an accident that results in your needing the expensive technologies? I mean, maybe you wouldn't use the ER for your throat then, but if you have a life-threatening illness requiring a $500,000 hospitalization who pays?

Teresa
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Re: The timing of the health care law

Post by living_stradivarius » Mon Apr 09, 2012 2:43 pm

Teresa B wrote: So you're saying, have two tiers of insurance coverage?
Yes, but only specific to those who are between the Medicaid and insurance gaps, not anyone else.
If you buy a policy that is cheap because it will cover only things like sore throats, what do you do if you get seriously ill or suffer an accident that results in your needing the expensive technologies? I mean, maybe you wouldn't use the ER for your throat then, but if you have a life-threatening illness requiring a $500,000 hospitalization who pays?
If you have a life-threatening illness requiring $500k hospitalization then you spend down until you qualify for Medicaid to cover it.
jbuck wrote:The thing about a huge private market is that it self-organizes into profitable models, and if there were one that incentivized the kind of alternative you are talking about, it would long ago have become a reality.
It is profitable, but hasn't been considered as profitable as operating a health insurance company that partners with expensive technology providers. However, as the volume of users declines for mainstream health insurance companies precisely because of the "cost" of these advanced technologies, the market for second tier insurance becomes comparatively more viable and profitable based on user volume instead of unit cost.
jbuck wrote:Unless you can actually come up with a viable plan yourself, stop browbeating us with your assumption that there must be an unrealized entrepreneurial approach which would cut through what you see as a limitation in the current market.
I'm actually working on one. Every new market takes time to realize, and we're currently in the awkward transition phase.
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Re: The timing of the health care law

Post by jbuck919 » Mon Apr 09, 2012 3:06 pm

living_stradivarius wrote:we're currently in the awkward transition phase.
Well one of you seems to be. :P :lol: :wink:

(You walked right into that one.)

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Teresa B
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Re: The timing of the health care law

Post by Teresa B » Mon Apr 09, 2012 5:43 pm

living_stradivarius wrote:
If you buy a policy that is cheap because it will cover only things like sore throats, what do you do if you get seriously ill or suffer an accident that results in your needing the expensive technologies? I mean, maybe you wouldn't use the ER for your throat then, but if you have a life-threatening illness requiring a $500,000 hospitalization who pays?
If you have a life-threatening illness requiring $500k hospitalization then you spend down until you qualify for Medicaid to cover it.
Sorry, but Medicaid will only pay pennies on the dollar. And how does a poor person manage to survive while "spending down" until they qualify for Medicaid?
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Re: The timing of the health care law

Post by living_stradivarius » Mon Apr 09, 2012 5:57 pm

Teresa B wrote:Sorry, but Medicaid will only pay pennies on the dollar.
Then no health care system would solve the problem for everyone who "needs" $500k worth of hospital care. We would even exceed our currently exorbitant military budget if we did attempt to provide the latest and greatest in care and technology for everyone who "needed" it. There are people with terminal illnesses today who have a need for infinitely expensive forms of care - perhaps if we put several trillion tax dollars into it we would come across a treatment, but by then we'd have no economy left.

If someone is in that kind of a dire position, they'd never receive adequate treatment in any existing single payer country because they don't have the technology to treat it.

But if you mean $500k in the sense that US medical technologies have driven up the price tag, then a second-tier provider network using older technologies and standards would be able to offer treatment at a lower price. If the price tag is the difference between whether a treatment exists or not, then tough luck. The only way to solve this kind of 'problem' in a sustainable fashion is to push forward with medical innovation so that the treatment they need today is cheaper in the future.
And how does a poor person manage to survive while "spending down" until they qualify for Medicaid?
Welfare. $4k in assets is plenty to live on.
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Re: The timing of the health care law

Post by Teresa B » Mon Apr 09, 2012 7:14 pm

living_stradivarius wrote:
Teresa B wrote:Sorry, but Medicaid will only pay pennies on the dollar.
Then no health care system would solve the problem for everyone who "needs" $500k worth of hospital care. We would even exceed our currently exorbitant military budget if we did attempt to provide the latest and greatest in care and technology for everyone who "needed" it. There are people with terminal illnesses today who have a need for infinitely expensive forms of care - perhaps if we put several trillion tax dollars into it we would come across a treatment, but by then we'd have no economy left.
Clearly there is no system that will be perfect. Medicare pays far more than Medicaid. If we had a single payer equivalent to Medicare for all, there could be a solution. All the money going into insurance premiums would better be channeled into the single payer system. Yes, there is a need to limit excessively costly treatments--the key is to discern which patients are likely to benefit, and for the Medicare system to deny coverage for those who will not. Terminal illness is the huge bugaboo that Republicans have taken advantage of in dissing the Affordable Health Care Act for having "death panels" (no such thing, of course). While we all know that it makes no sense to be spending the most health care dollars on the last two weeks of people's lives, that's what we do anyway, because god forbid we let some death panel decide!
If someone is in that kind of a dire position, they'd never receive adequate treatment in any existing single payer country because they don't have the technology to treat it.
Well, better tell that to Agnes and our other Australian friends. And are you telling me they don't have the technology in countries like France?
living_stradivarius wrote:
And how does a poor person manage to survive while "spending down" until they qualify for Medicaid?
Welfare. $4k in assets is plenty to live on.
Oh come on.

Teresa
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Re: The timing of the health care law

Post by living_stradivarius » Mon Apr 09, 2012 9:11 pm

Teresa B wrote: Well, better tell that to Agnes and our other Australian friends. And are you telling me they don't have the technology in countries like France?
Because they are copying and piggybacking off of US technology. Kill US tech, and healthcare around the world will remain stagnant. Had we given out $500k treatments for free 40 years ago, no country today would be able to treat a number of diseases we can treat today.
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nut-job
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Re: The timing of the health care law

Post by nut-job » Mon Apr 09, 2012 10:10 pm

living_stradivarius wrote: Then no health care system would solve the problem for everyone who "needs" $500k worth of hospital care. We would even exceed our currently exorbitant military budget if we did attempt to provide the latest and greatest in care and technology for everyone who "needed" it. There are people with terminal illnesses today who have a need for infinitely expensive forms of care - perhaps if we put several trillion tax dollars into it we would come across a treatment, but by then we'd have no economy left.
If we need any evidence that you are arguing from a position of utter ignorance, or simple need to be the center of attention (I suspect the latter) it is here. Any sensible definition of "need" for medical care takes into account whether the care is likely to be effective and/or will have a major effect on their length or quality of life. To deploy such care based on anything other than a fair assessment of need is a waste of resources.

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Re: The timing of the health care law

Post by living_stradivarius » Mon Apr 09, 2012 11:25 pm

nut-job wrote:Any sensible definition of "need" for medical care takes into account whether the care is likely to be effective and/or will have a major effect on their length or quality of life. To deploy such care based on anything other than a fair assessment of need is a waste of resources.
Your analysis is completely ignorant of medicine as a dynamic, changing phenomenon over time. Beyond basic, readily available forms of treatment that have stabilized in cost over time, medical need is quite subjective because of the constant evolution of medical technology and treatment. Half a century ago, people died from diseases that were nearly impossible to treat at the time until someone came along and took the risk of investing heavily in a developing a treatment. Was that treatment given away freely even though people "needed" it? No, and if it were that risk-taker would have never ventured to research and develop the treatment so that millions of people who need it today can actually have it.

Assuming we keep the incentive cycle alive, in a couple of decades we'll have discovered several cures for diseases that are prominent killers today and improvements to treatments we have today. The new treatments will be expensive at first, but at the same time, the treatments that are rightfully expensive and inaccessible today will be cheaper and more accessible by that time.
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Re: The timing of the health care law

Post by nut-job » Mon Apr 09, 2012 11:32 pm

living_stradivarius wrote:
nut-job wrote:Any sensible definition of "need" for medical care takes into account whether the care is likely to be effective and/or will have a major effect on their length or quality of life. To deploy such care based on anything other than a fair assessment of need is a waste of resources.
Your analysis is completely ignorant of medicine as a dynamic, changing phenomenon over time. Beyond basic, readily available forms of treatment that have stabilized in cost over time, medical need is quite subjective because of the constant evolution of medical technology and treatment. Half a century ago, people died from diseases that were nearly impossible to treat at the time until someone came along and took the risk of investing heavily in a developing a treatment. Was that treatment given away freely even though people "needed" it? No, and if it were that risk-taker would have never ventured to research and develop the treatment so that millions of people who need it today can actually have it.

Assuming we keep the incentive cycle alive, in a couple of decades we'll have discovered several cures for diseases that are prominent killers today and improvements to treatments we have today. The new treatments will be expensive at first, but at the same time, the treatments that are rightfully expensive and inaccessible today will be cheaper and more accessible by that time.
I have no clue what you are talking about, it seems to me that you are string buzzwords together with no rhyme or reason. No one is proposing that expensive treatment would not be paid for, they are proposing that the payment be organized differently to maximize the effectiveness of treatment. Despite all of your florid words, you have given no cogent explanation why the extremely inefficient system of managing health care is better at fostering innovation than any of the various alternatives.

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Re: The timing of the health care law

Post by living_stradivarius » Mon Apr 09, 2012 11:43 pm

nut-job wrote:I have no clue what you are talking about, it seems to me that you are string buzzwords together with no rhyme or reason.
You might want to read The Patient Protection and Affordable Care Act.
nut-job wrote:No one is proposing that expensive treatment would not be paid for
Yes they are, if they are supporting the PPACA. It's not simple "re-organization". There are a multitude of taxes, regulations, and price controls layered on top of each other in the legislation that stymie medical innovation and artificially drive the price of expensive medical technologies down to cover more people. Insurers are required to "justify" premium increases of 10% or greater, which often happens when some new medical technology is added to any coverage plan. The end result of this, and several other parts of the legislation, is that expensive treatments would not actually be paid for, adversely affecting the incentives driving medical innovation in the US.

Why are these price controls in the legislation then? Why not actually just pass on the cost to everyone else? Because the cost that would be passed on to everyone else would be exorbitant enough to screw over our economy, that's why.
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Re: The timing of the health care law

Post by Teresa B » Tue Apr 10, 2012 10:13 am

Here's an interesting article that is critical of both sides and supports a single payer system:

America's Superficial Health Care Debate Silences Single-Payer Supporters
Monday, 09 April 2012 10:06
By Chris Hedges, Truthdig | News Analysis


The debate surrounding the Patient Protection and Affordable Care Act illustrates the impoverishment of our political life. Here is a law that had its origin in the right-wing Heritage Foundation, was first put into practice in 2006 in Massachusetts by then-Gov. Mitt Romney and was solidified into federal law after corporate lobbyists wrote legislation with more than 2,000 pages. It is a law that forces American citizens to buy a deeply defective product from private insurance companies. It is a law that is the equivalent of the bank bailout bill—some $447 billion in subsidies for insurance interests alone—for the pharmaceutical and insurance industries. It is a law that is unconstitutional. And it is a law by which President Barack Obama, and his corporate backers, extinguished the possibilities of both the public option and Medicare for all Americans. There is no substantial difference between Obamacare and Romneycare. There is no substantial difference between Obama and Romney. They are abject servants of the corporate state. And if you vote for one you vote for the other.

But you would never know this by listening to the Democratic Party and the advocacy groups that purport to support universal health care but seem more intent on re-electing Obama. It is the very sad legacy of the liberal class that it proves in election cycle after election cycle that it espouses moral and political positions it will not pay a price to defend. And since we have no fight in us, since we will not punish politicians like Obama who betray our core beliefs, the corporate juggernaut rolls forward with its inexorable pace to cement into place our global neofeudalism.

Protesting outside the Supreme Court recently as it heard arguments on the constitutionality of the Affordable Care Act were both conservatives from Americans for Prosperity who denounced the president as a socialist and demonstrators from Democratic front groups such as the SEIU and the Families USA health care consumer group who chanted "Protect the law!" Lost between these two factions were a few stalwarts who hold quite different views, including public health care advocates Dr. Margaret Flowers, Dr. Carol Paris and attorneys Oliver Hall, Kevin Zeese and Russell Mokhiber. They displayed a banner that read: "Single Payer Now! Strike Down the Obama Mandate!" They, at least, have not relinquished the demand for single payer health care for all Americans. And I throw my lot in with these renegades, dismissed, no doubt, as cranks or dreamers or impractical by those who flee into the embrace of empty political theater and junk politics. These single payer advocates, joined by 50 doctors, filed a brief to the court that challenges, in the name of universal health care, the individual mandate.

"We have the solution, we have the resources and we have the money to provide lifelong, comprehensive, high-quality health care to every person," Dr. Flowers said when we spoke a few days ago in Washington, D.C. Many Americans have not accepted the single payer approach "because people get confused by the politics," she said. "People accept the Democratic argument that this [Obamacare] is all we can have or this is something we can build on."

"If you are trying to meet the goal of universal health coverage and the only way to meet that goal is to force people to purchase private insurance, then you might consider that it is constitutional," Flowers said. "Our argument is that the individual mandate does not meet the goal of universality. When you attempt to use the individual mandate and expansion of Medicaid for coverage, only about half of the uninsured gain coverage. This is what we have seen in Massachusetts. We do, however, have systems in the United States that could meet the goal of universality. That would be either a Veterans Administration type system, which is a socialized system run by the government, or a Medicare type system, a single payer, publicly financed health care system. If the U.S. Congress had considered an evidence-based approach to health reform instead of writing a bill that funnels more wealth to insurance companies that deny and restrict care, it would have been a no-brainer to adopt a single payer health system much like our own Medicare. We are already spending enough on health care in this country to provide high-quality, universal, comprehensive, lifelong health care. All the data point to a single payer system as the only way to accomplish this and control health care costs."

Obamacare will, according to figures compiled by Physicians for a National Health Plan (PNHP), leave at least 23 million people without insurance, a figure that translates into an estimated 23,000 unnecessary deaths a year among people who cannot afford care. Costs will continue to climb. There are no caps on premiums, including for people with "pre-existing conditions." The elderly can be charged three times the rates provided to the young. Companies with predominantly female workforces can be charged higher gender-based rates. Most of us will soon be paying about 10 percent of our annual incomes to buy commercial health insurance, although this coverage will pay for only about 70 percent of our medical expenses. And those of us who become seriously ill, lose our incomes and cannot pay the skyrocketing premiums are likely to be denied coverage. The dizzying array of loopholes in the law—written in by insurance and pharmaceutical lobbyists—means, in essence, that the healthy will receive insurance while the sick and chronically ill will be priced out of the market.

Medical bills already lead to 62 percent of personal bankruptcies, and nearly 80 percent of those declaring personal bankruptcy because of medical costs had insurance. The U.S. spends twice as much per capita on health care as other industrialized nations, $8,160. Private insurance bureaucracy and paperwork consume 31 percent of every health care dollar. Streamlining payment through a single, nonprofit payer would save more than $400 billion per year, enough, the PNHP estimates, to provide comprehensive, high-quality coverage for all Americans.

But as long as corporations determine policy, as long as they can use their money to determine who gets elected and what legislation gets passed, we remain hostages. It matters little in our corporate state that nearly two-thirds of the public wants single payer and that it is backed by 59 percent of doctors. Public debates on the Obama health care reform, controlled by corporate dollars, ruthlessly silence those who support single payer. The Senate Finance Committee, chaired by Max Baucus, a politician who gets more than 80 percent of his campaign contributions from outside his home state of Montana, locked out of the Affordable Care Act hearing a number of public health care advocates including Dr. Flowers and Dr. Paris; the two physicians and six other activists were arrested and taken away. Baucus had invited 41 people to testify. None backed single payer. Those who testified included contributors who had given a total of more than $3 million to committee members for their political campaigns.

"It is not necessary to force Americans to buy private health insurance to achieve universal coverage," said Russell Mokhiber of Single Payer Action. "There is a proven alternative that Congress didn't seriously consider, and that alternative is a single payer national health insurance system. Congress could have taken seriously evidence presented by these single payer medical doctors that a single payer system is the only way to both control costs and cover everyone."

This piece was reprinted by Truthout with permission or license.

CHRIS HEDGES

Chris Hedges spent nearly two decades as a foreign correspondent in Central America, the Middle East, Africa and the Balkans. He has reported from more than 50 countries and has worked for The Christian Science Monitor, National Public Radio, The Dallas Morning News and The New York Times, for which he was a foreign correspondent for 15 years.
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Re: The timing of the health care law

Post by nut-job » Tue Apr 10, 2012 1:12 pm

Pretty depressing article. It seems we have a government where neither party can put the interests of the country ahead of their grasp on power, ideology, or the special-interest groups that bankroll them.

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Re: The timing of the health care law

Post by Teresa B » Tue Apr 10, 2012 3:00 pm

nut-job wrote:Pretty depressing article. It seems we have a government where neither party can put the interests of the country ahead of their grasp on power, ideology, or the special-interest groups that bankroll them.
Unfortunately it kinda rings true.
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Agnes Selby
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Re: The timing of the health care law

Post by Agnes Selby » Tue Apr 10, 2012 3:52 pm

Strad, you speak from ignorance about Australian Medicine.
Please look into the Medical achievements of our scientists
and medical doctors before you make your pronouncements.
At the same time, also see on Google our Health Care system which
has been working for us exceedingly well for almost 40 years.

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Re: The timing of the health care law

Post by living_stradivarius » Tue Apr 10, 2012 3:59 pm

Agnes Selby wrote:Strad, you speak from ignorance about Australian Medicine.
Please look into the Medical achievements of our scientists
and medical doctors before you make your pronouncements.
Like I said, OZ has piggybacked off of US medical technology. Had we never come up with what we did, OZ wouldn't be where it is today in medicine, as is the case for any country claiming to have "better" healthcare.
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Re: The timing of the health care law

Post by Agnes Selby » Tue Apr 10, 2012 4:49 pm

As we say in Oz: "Ignorance is bliss!" Before you display further
ignorance about the Australian Health System, please look it up!
It is a living thing, updated as required. No political party has
had a disagreement about what is necessary for the welfare
of Australian citizens.

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Re: The timing of the health care law

Post by living_stradivarius » Tue Apr 10, 2012 5:03 pm

Agnes Selby wrote:No political party has
had a disagreement about what is necessary for the welfare
of Australian citizens.
I don't see how this assertion does anything to negate the fact that the US is coming up with the most advanced treatments that other countries are piggybacking on. It is precisely because the US' maintenance of
market-based incentives towards innovation that even allow countries like Australia to provide the services it has. The moment we start adopting price controls is the moment we stop innovating as we have - we will be slower at finding new treatments, not to mention at reducing the future cost of currently expensive breakthrough treatments.

http://news.heartland.org/newspaper-art ... form-bills
U.S. preeminence in research is indicated by the number of Nobel Prizes awarded for medicine, and by roughly $30 billion in annual research spending via the National Institutes of Health versus $4 billion in all of Europe.

“Of the 95 recipients in the past 40 years, 57 (60 percent) were from the United States, while 40 (42 percent) were from the European Union countries, Switzerland, Canada, Japan, or Australia—countries whose combined population is more than double that of the United States,” the authors write...

“Innovation is best measured by looking at advances that have withstood the test of time and are widely regarded as having had important positive effects on health care,” the authors write.

The researchers took a list of 30 major innovations in diagnostics and therapeutics and ranked their importance based on feedback from 225 leading primary physicians.

“[Of the] 27 innovations for which a country was identified, work performed in the United States significantly contributed to the invention or advancement of 20, including nine of the top 10.” Regarding drugs, “Sixteen of the 29 representative drug classes were developed in the United States, while 15 were developed in the EU or Switzerland.”

A key factor explaining these vast differences is the role market-based compensation plays in the United States, the authors note.

“Single-payer and other centrally organized health care systems, like those in much of Europe, are characterized by a great deal of monopsony [buyer] power that pushes down compensation. Prices for prescription drugs in Europe are 35 percent to 55 percent lower than in the United States,” they explain.
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Re: The timing of the health care law

Post by living_stradivarius » Tue Apr 10, 2012 5:08 pm

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http://www.ncpa.org/pub/ba649


10 Surprising Facts about American Health Care

Brief Analyses | Health


No. 649

Tuesday, March 24, 2009

by Scott Atlas

Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world. Economists, government officials, insurers and academics alike are beating the drum for a far larger government rôle in health care. Much of the public assumes their arguments are sound because the calls for change are so ubiquitous and the topic so complex. However, before turning to government as the solution, some unheralded facts about America's health care system should be considered.

Fact No. 1: Americans have better survival rates than Europeans for common cancers.[1] Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

Fact No. 2: Americans have lower cancer mortality rates than Canadians.[2] Breast cancer mortality is 9 percent higher, prostate cancer is 184 percent higher and colon cancer mortality among men is about 10 percent higher than in the United States.

Fact No. 3: Americans have better access to treatment for chronic diseases than patients in other developed countries.[3] Some 56 percent of Americans who could benefit are taking statins, which reduce cholesterol and protect against heart disease. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons and 17 percent of Italians receive them.

Fact No. 4: Americans have better access to preventive cancer screening than Canadians.[4] Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate and colon cancer:

Nine of 10 middle-aged American women (89 percent) have had a mammogram, compared to less than three-fourths of Canadians (72 percent).
Nearly all American women (96 percent) have had a pap smear, compared to less than 90 percent of Canadians.
More than half of American men (54 percent) have had a PSA test, compared to less than 1 in 6 Canadians (16 percent).
Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with less than 1 in 20 Canadians (5 percent).
Fact No. 5: Lower income Americans are in better health than comparable Canadians. Twice as many American seniors with below-median incomes self-report "excellent" health compared to Canadian seniors (11.7 percent versus 5.8 percent). Conversely, white Canadian young adults with below-median incomes are 20 percent more likely than lower income Americans to describe their health as "fair or poor."[5]


Fact No. 6: Americans spend less time waiting for care than patients in Canada and the U.K. Canadian and British patients wait about twice as long - sometimes more than a year - to see a specialist, to have elective surgery like hip replacements or to get radiation treatment for cancer.[6] All told, 827,429 people are waiting for some type of procedure in Canada.[7] In England, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.[8]

Fact No. 7: People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand and British adults say their health system needs either "fundamental change" or "complete rebuilding."[9]

Fact No. 8: Americans are more satisfied with the care they receive than Canadians. When asked about their own health care instead of the "health care system," more than half of Americans (51.3 percent) are very satisfied with their health care services, compared to only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).[10]

Fact No. 9: Americans have much better access to important new technologies like medical imaging than patients in Canada or the U.K. Maligned as a waste by economists and policymakers naïve to actual medical practice, an overwhelming majority of leading American physicians identified computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade.[11] [See the table.] The United States has 34 CT scanners per million Americans, compared to 12 in Canada and eight in Britain. The United States has nearly 27 MRI machines per million compared to about 6 per million in Canada and Britain.[12]

Fact No. 10: Americans are responsible for the vast majority of all health care innovations.[13] The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other single developed country.[14] Since the mid-1970s, the Nobel Prize in medicine or physiology has gone to American residents more often than recipients from all other countries combined.[15] In only five of the past 34 years did a scientist living in America not win or share in the prize. Most important recent medical innovations were developed in the United States.[16] [See the table.]

Conclusion. Despite serious challenges, such as escalating costs and the uninsured, the U.S. health care system compares favorably to those in other developed countries.

Scott W. Atlas, M.D., is a senior fellow at the Hoover Institution and a professor at the Stanford University Medical Center. A version of this article appeared previously in the February 18, 2009, Washington Times.
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nut-job
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Re: The timing of the health care law

Post by nut-job » Tue Apr 10, 2012 5:27 pm

The claim that the US dominates the development of medical technology is overstated. Looking at the list of top medical technology/pharmaceutical companies, there is more money invested in research by European companies than by US companies. The two highest profile diagnostic tools, CAT scanners and MRI were first developed in the UK. Where the US has a big advantage is in publicly funded research, mainly the National Institutes of Health. That's not tied to market competition.

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Re: The timing of the health care law

Post by living_stradivarius » Tue Apr 10, 2012 5:36 pm

nut-job wrote:The claim that the US dominates the development of medical technology is overstated. Looking at the list of top medical technology/pharmaceutical companies, there is more money invested in research by European companies than by US companies.
Numbers please. I provided comparative figures above - you might also want to do so to back your claims. More money invested does not mean better returns, though I doubt your claim is accurate (See http://www.nature.com/nrd/journal/v6/n4 ... d2293.html, http://www.theatlantic.com/daily-dish/a ... es/227252/). Considering the higher taxes and fees involved in Europe and the fact that these European companies profit the most from selling to American health care providers and other countries, it wouldn't be all too surprising either. No American market? No European big pharma. Furthermore, Europe has a higher overall tax rates and substantially lower military budgets. Of course they have more government money to spare for selective forms of R&D at the expense of overall technological innovation and oh, say, the general economy.
The two highest profile diagnostic tools, CAT scanners and MRI were first developed in the UK.
Incorrect: http://en.wikipedia.org/wiki/Raymond_Vahan_Damadian
Again, piggybacking off of US innovation.
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nut-job
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Re: The timing of the health care law

Post by nut-job » Tue Apr 10, 2012 6:03 pm

I simply looked at Wikipedia's article on the pharmaceutical/medical technology industry and added up the research budgets of the 5 biggest players (3 of which are European). Whether an exhaustive tabulation would confirm this trend, I don't know.

The first commercial CAT scanner was made by EMI, the first commercial MRI machine by Toshiba. The Nobel Prize for MRI went to Lauterbur (US) and Mannsfield (UK). Damadian's machine used technology which was not incorporated in the mature machines, which use the magnetic field gradient and mathematical formalism introduced by Lautebur and Mannsfield.

Medical research is an international enterprise. Your insistence on dismissing non-US work as "piggybacking" is just stupid.

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Re: The timing of the health care law

Post by living_stradivarius » Tue Apr 10, 2012 6:10 pm

I simply looked at Wikipedia's article on the pharmaceutical/medical technology industry and added up the research budgets of the 5 biggest players (3 of which are European). Whether an exhaustive tabulation would confirm this trend, I don't know.
Link, please.
nut-job wrote:The first commercial CAT scanner was made by EMI, the first commercial MRI machine by Toshiba. The Nobel Prize for MRI went to Lauterbur (US) and Mannsfield (UK). Damadian's machine used technology which was not incorporated in the mature machines, which use the magnetic field gradient and mathematical formalism introduced by Lautebur and Mannsfield.
If Damadian did not make his discoveries with NMR, none of the above would have happened. Furthermore, Americans are actually using making better use of the technology because we actually bothered to follow through with ongoing R&D that made previous versions less expensive and more accessible:
Fact No. 9: Americans have much better access to important new technologies like medical imaging than patients in Canada or the U.K. Maligned as a waste by economists and policymakers naïve to actual medical practice, an overwhelming majority of leading American physicians identified computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade.[11] [See the table.] The United States has 34 CT scanners per million Americans, compared to 12 in Canada and eight in Britain. The United States has nearly 27 MRI machines per million compared to about 6 per million in Canada and Britain.[12]
nut-job wrote:Medical research is an international enterprise. Your insistence on dismissing non-US work as "piggybacking" is just stupid.
The numbers don't lie. The US is the linchpin of medical innovation. The assumption that non-US work would somehow magically exist without US innovation is blatantly false.
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Re: The timing of the health care law

Post by lennygoran » Wed Apr 11, 2012 6:04 am

living_stradivarius wrote:
The assumption that non-US work would somehow magically exist without US innovation is blatantly false.
I'm having trouble understanding what this has to do with timing of the health care law--I as just an average not particuliarly knowledgeable citizen have always assumed the US has been very innovative--how you measure the best wouldn't be for me to say but could you or some one else explain how we can come up with a more user friendly national health care system--that's the innovation I'm looking for. Regards, Len

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