We have the best health care in the world....

[Rubicon]

Hmm... Me thinks you're again confusing stuff... The medical innovations are from private companies, that happen to be based in US... Oddly enough, most of the top scientists making these innovations... well, they are not from US but imports.

And those companies are based in US solely because your government values corporations above citizens.

Not everyone agrees with such a simple assessment of the situation.

"In the financial realm, American bio-techs have better access to capital than their European competitors. In recent years European biotech companies have had access to only one-fifth of the private equity available to their U.S. rivals, restricting their sources of funding and, consequently, their research. Moreover, U.S. biotechs have access to 10 times as much debt financing as their European counterparts.

Ultimately, lost or constrained innovation impacts public health. Access to new drugs, for instance, is far superior for American consumers than European ones. For cancer patients, access to new drugs is crucial: a report by the Swedish Karolinska Institute, published in the Annals of Oncology, found that "The United States has been the country of first launch for close to half of the oncology drugs brought to the market in the past 11 years." The authors of the report observe that "Nearly half of the observed improvement in the 2-year cancer survival rate between 1992 and 2000 at 50 US cancer centers could be attributed to the use of new cancer drugs," evidence that America's embrace of new medicines translates into saved human lives.

Some of the key ingredients of America's thriving biopharmaceutical sector: a system of free pricing of drugs (almost inconceivable in Europe); great dynamism in the bio-tech sector due to a pool of active venture capital; direct-to-consumer advertising of prescription drugs; flexible labor laws and an entrepreneurial spirit; an active and often symbiotic connection between academic scientists and private industry; and a limited role of the state in the R&D process, with private R&D preferred over the large-scale sponsoring of research by the state."

http://www.aei.org/publications/pubI...pub_detail.asp


Edit: If you take the time to read the article you will see that it is not a cheer piece for the American system but is a look at the problems in the European system and how it can be improved.

[hemas]

Not everyone agrees with such a simple assessment of the situation.

"Some of the key ingredients of America's thriving biopharmaceutical sector: a system of free pricing of drugs (almost inconceivable in Europe); great dynamism in the bio-tech sector due to a pool of active venture capital; direct-to-consumer advertising of prescription drugs; flexible labor laws and an entrepreneurial spirit; an active and often symbiotic connection between academic scientists and private industry; and a limited role of the state in the R&D process, with private R&D preferred over the large-scale sponsoring of research by the state."

http://www.aei.org/publications/pubI...pub_detail.asp

Thank you for proving my point of valuing corporations over citizens.


Oh, and interestingly enough... Building of BioPharma production capacity has been about anywhere else, 'cept the US.

[Rubicon]

Thank you for proving my point of valuing corporations over citizens.

You didn't even read the article, so your conclusions are short sighted.

"The authors of the report observe that "Nearly half of the observed improvement in the 2-year cancer survival rate between 1992 and 2000 at 50 US cancer centers could be attributed to the use of new cancer drugs," evidence that America's embrace of new medicines translates into saved human lives."

[hemas]

You didn't even read the article, so your conclusions are short sighted.

"The authors of the report observe that "Nearly half of the observed improvement in the 2-year cancer survival rate between 1992 and 2000 at 50 US cancer centers could be attributed to the use of new cancer drugs," evidence that America's embrace of new medicines translates into saved human lives."

Didn't need to... as you already proved my point in your actual post.

[Rubicon]

Didn't need to... as you already proved my point in your actual post.

If the government "caring" is the crucial ingredient in a higher standard of living, then you might have a point. But that is a premise I don't accept and I think you would have a hard time argueing that point convincingly.

[hemas]

If the government "caring" is the crucial ingredient in a higher standard of living, then you might have a point. But that is a premise I don't accept and I think you would have a hard time argueing that point convincingly.

I've always seen the governments main function to care for the citizens and have their loyalty to them, not corporations.

I'm all for corporations to develop stuff to improve the quality of human life. But not at the cost of workers or test subjects...

[flyby]

hey rubicon, america has the worst health care system in the world. it will never match up to canada's or europe's standards. you cannot convince me otherwise. how does this make you feel?

[Rubicon]

I've always seen the governments main function to care for the citizens and have their loyalty to them, not corporations.

In the US the functions of our government are laid out in our constitution and "caring" in no where in there. The idea of the bureaucrats in Washington caring for us is something that has not been a part of the American psyche until very recently. I like what we have historically had. I'm glad you are happy with what you have.

I'm all for corporations to develop stuff to improve the quality of human life. But not at the cost of workers or test subjects...

You seem to be talking about something specific, but I don't know what it is. So I'm not sure how this relates to the structure of health care in the US vs other places.

[Rubicon]

hey rubicon, america has the worst health care system in the world. it will never match up to canada's or europe's standards. you cannot convince me otherwise. how does this make you feel?

It doesn't.

Do you have anything to contribute to the conversation?

[LittleYellowFriend]

[emtnate]

You need a new dentist

Well I go to the dentist that is covered by my insurance that was taking new patients. Although, I don't have any fillings or cavities, I just go for my cleanings and exam. I had to wait to get in. No big deal, because I just schedule my next appointment while I was there.

About switching insurance companies, sure I could do that, if I could afford to spend half my pay check on private insurance that still had shitty coverage. I'm better now, my wife works for the county government and they treat us well. While we have no co-pays for office visits and everything is subject to a moderate deductible, they do have their own GP for all county employees, and his visits are free. Longest I've waited for him is about 2 weeks.

Being in my profession, I also have a ton of physicians I can seek advise from. I'm glad I was able to switch from the old insurance company with my job.

I don't think socialized healthcare is the best thing for Americans. I like the idea of it, but if it is anything like medicare / medicaid it will never work right on a large scale. Major reform needs to be made with the private companies. The vast majority of our health care dollars are spend on the last 2 weeks of someone's life when their on a vent and feeding tube. More money needs to be allowed by the HMO for preventive care. I think that change is starting. Like my wife's employment, the house doc for check ups, they even include a ymca membership for the insured. If the major companies would start more programs like these, costs all around would be lower.

All I want to see is affordable health care for all Americans. We have the technology, but it is not easily accessible for all Americans. I'm also afraid that we are slipping with breakthroughs.

I see professions like my own and other allied health providers becoming more and more important as ways to keep costs low. In England, medics can assess the patient and take them to a clinic, ER, or treat and release at home. People who abuse their equivalent of 911 can also loose their privileges to use it. We don't have the legal protection to make some of those decisions, yet. We can wake up a diabetic and not transport, but I still have to take someone with a stomach ache to the ER instead of an out-patient clinic. I do think this will change.

[Swine]

Yeah, America has the worst health care in the world, except for all the others. People never know how good they got until it is gone.

Tsk Tsk... we're not the worst. At last review we're in 37th place.

http://www.who.int/inf-pr-2000/en/pr2000-44.html

Admittedly that was in 2000; however, isn't it pretty much accepted that France has "the best" health care system? Oh shit, where are my freedom fries.

[Jim S]

Boy does this get old. See my previous posts on health care. Having not read the entire thread I may make an ass out of myself--not the first nor last time on TGR-- but here are some reasons ER care is so expensive:

1. ER staff often shotgun and over order tests IMHO
2. Some causes for 1 above are lack of staff, our litiginous society, ignorance*, patients insist on getting studies. "The mom wants the child to have a CT of the brain even thought it's not needed." My response: "What if the mom want 2g of morphine or want her sons' leg removed for a blister?" When did patients start to dictate what the doctor does?
3. Ignorance: every day I shake my head and am appalled at how many studies are ordered that are not needed because they are dumb or the patient is not examined by a doctor but by a triage nurse how is not as educated as an ER M.D.
4. ERs may never turn away a patient. So all the uninsured and folks who lie about insurance; you guys are paying for them
5. Materials are expensive. A simple spinal tap tray costs hundreds of dollars.
6. etc, etc, etc....ad nauseum.

[Rubicon]

Tsk Tsk... we're not the worst. At last review we're in 37th place.

http://www.who.int/inf-pr-2000/en/pr2000-44.html

Admittedly that was in 2000; however, isn't it pretty much accepted that France has "the best" health care system? Oh shit, where are my freedom fries.

From your link:

"WHO’s assessment system was based on five indicators: overall level of population health; health inequalities (or disparities) within the population; overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts); distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system); and the distribution of the health system’s financial burden within the population (who pays the costs)."

That isn't a measure of how good the health care system is. It is a measure of how socialistic the health care system is.

I should hope we score low by that measure.


Here is some more reading on that report by the WHO:

"The World Health Organization primarily faults the United States for not requiring mandatory insurance or offering social welfare programs to all citizens--in other words, for being a free country with independent citizens.

Interestingly, the WHO completely failed to broadcast that America's health system ranked first in responsiveness to patients' needs for choice of provider, dignity, autonomy, timely care, and confidentiality. In other words, where it matters most to patients, the U.S. system excels."

http://www.cchconline.org/publications/whoart.php3

[emtnate]

When did patients start to dictate what the doctor does?

You already answered that in your last sentence. It's part of our litigious society. Apparently the patients know better than the doc they are seeking advice from. Thank the internet diagnosis for making this trend worse.

[*]ERs may never turn away a patient.

Unless they're full and on diversion when we come get you. Then I have to explain that I am taking you to a different hospital, or you can wait in triage. People never seem to understand.

[Rubicon]

For anyone who missed it the first time.



Interestingly, the WHO completely failed to broadcast that America's health system ranked first in responsiveness to patients' needs for choice of provider, dignity, autonomy, timely care, and confidentiality. In other words, where it matters most to patients, the U.S. system excels."

http://www.cchconline.org/publications/whoart.php3

[emtnate]

I agree with that statement. I think we do a decent job in all those areas. Maybe not always the most timely in my city for everyone, but for the truly life-threatening sick or injured, care is quick. One motocross racer in town is alive and out of the hospital now because we had trackside medics breathing for him, a 5 min transport to a trauma facility, and an on-call neurosurgeon that was at the hospital about 15 mins after the patient arrived.

I read an article in a journal recently about ems patients in Tokyo where the ambulance crews having to drive around for 40 mins or more searching for a hospital that would accept the patient. Apparently that is common there, and I don't think that would happen often here.

Those areas are the ones that matter most to patients.

[Swine]

While I can see your perspective, I still wonder about "overall level of population health". Do you dismiss that as merely another socialist criterion? I suppose you could... especially if "care" from the government is a premise you reject. It seems you would argue that the only measure is how technologically advanced our drugs, machines, labs et. al. are, as well as the level of education, training etc. of medical personnel. Fair enough; looks like we disagree more on a social-philosophical level. I don't doubt we have some of the best resources in the world.

[Rubicon]

Those areas are the ones that matter most to patients.

I agree.

There is a lot of room for improvement. But on the things that matter most, our system(you and every other medical professional) does it better than anyone else in the world. That's the best argument I can think of for working to improving the system we have rather than turning it over to the government and hopeing for the best.

[Swine]

For anyone who missed it the first time.



Interestingly, the WHO completely failed to broadcast that America's health system ranked first in responsiveness to patients' needs for choice of provider, dignity, autonomy, timely care, and confidentiality. In other words, where it matters most to patients, the U.S. system excels."

http://www.cchconline.org/publications/whoart.php3

From the same article I linked earlier...

Responsiveness: The nations with the most responsive health systems are the United States, Switzerland, Luxembourg, Denmark, Germany, Japan, Canada, Norway, Netherlands and Sweden. The reason these are all advanced industrial nations is that a number of the elements of responsiveness depend strongly on the availability of resources. In addition, many of these countries were the first to begin addressing the responsiveness of their health systems to people’s needs.


Completely failed? Well, they didn't say the U.S. was number 1, but they did mention it and list us first.

[Jim S]

Unless they're full and on diversion when we come get you. Then I have to explain that I am taking you to a different hospital, or you can wait in triage. People never seem to understand.

Yes. I meant they cannot turn them away because the lack insurance or because they post on Epic. When they go on divert, they turn everybody away.

[Rubicon]

While I can see your perspective, I still wonder about "overall level of population health". Do you dismiss that as merely another socialist criterion?

Nope. I dismiss that because that is a reflection of people's lifestyle choices, not the health care system.

It seems you would argue that the only measure is how technologically advanced our drugs, machines, labs et. al. are, as well as the level of education, training etc. of medical personnel.

^^^You forgot expertise and professionalism of the medical staff. But yeah, the level of care that is available plays a major role in my measure of our health care system.

The amount of effort people expend to acquire medical expertise is more than most people will expend in a lifetime, on anything. Then they practice medicine for another 30 years after that. They deserve high compensation for their services. Medical technologies are some of the most advanced technologies on earth. Huge sums of money went into their development. That money didn't materialize out of thin air. Somebody had to supply it. People shouldn't expect to have access to those technologies simply because they exist. I say this to explain why price doesn't factor into my assessment of our health care system as much as it does for some people.

That doesn't mean that we shouldn't reorganize things to cut out waste and unnecessary expenses. We should. Maybe the specter of government run health care will make the insurance companies a little more agreeable to reforming themselves. I'm not holding my breath, but one can hope.

Fair enough; looks like we disagree more on a social-philosophical level.

Yeah, that sounds about right.

[Cheesestoff]

Boy does this get old. See my previous posts on health care. Having not read the entire thread I may make an ass out of myself--not the first nor last time on TGR-- but here are some reasons ER care is so expensive:

1. ER staff often shotgun and over order tests IMHO
2. Some causes for 1 above are lack of staff, our litiginous society, ignorance*, patients insist on getting studies. "The mom wants the child to have a CT of the brain even thought it's not needed." My response: "What if the mom want 2g of morphine or want her sons' leg removed for a blister?" When did patients start to dictate what the doctor does?
3. Ignorance: every day I shake my head and am appalled at how many studies are ordered that are not needed because they are dumb or the patient is not examined by a doctor but by a triage nurse how is not as educated as an ER M.D.
4. ERs may never turn away a patient. So all the uninsured and folks who lie about insurance; you guys are paying for them
5. Materials are expensive. A simple spinal tap tray costs hundreds of dollars.
6. etc, etc, etc....ad nauseum.

Have to agree with you, my wife (4th year med student), did a two week emerg rotation in the states. She was disgusted by the amount of unnecessary tests ordered and the focus on maximizing billings. The doctors were ordering CT scans willy nilly and ruling out amazingly unlikely diagnoses. Compared to Canada there was a huge amount of waste, either due to a fear of litigation or the fact that the hospital was trying to maximize profit.

[emtnate]

Jim S,

You mean I'm supposed to treat people who post on epic? Who else can I ask "can you walk to the truck?

[hemas]

You seem to be talking about something specific, but I don't know what it is. So I'm not sure how this relates to the structure of health care in the US vs other places.

Not really about ER, about the health care in US in general.

Insurance cost a pile of money for the patient as well as for the docs. So the docs orders numerous expensive and unneeded experiments to cover his arse for ligation. So the treatment is really expensive, which means that the premiums for the patient get higher and higher. And thus the circle is complete and it continues until the patient no longer can pay the premiums for his insurance.


As for US health care. True, you after the fact practices and treatments are stellar with really good equipment and whatnot. But I would also consider preventing the formation of medical conditions as part of health care.

After all, unless I'm greatly mistaken means caring for health... which also means pre-emptive care.