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Old 06-22-2014, 06:49 PM
 
8,144 posts, read 6,002,296 times
Reputation: 10554

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Quote:
Originally Posted by modernist1 View Post
Your statement about the Yugo is ridiculous. Do you really think that's typical of the vehicles and skilled ambulance services in rich developed countries such as Germany, Japan, Australia, France, the UK etc? As for your pointing out that the EMTs get paid around 30 bucks an hour. In accordance with apparent ambulance charges here, I'd say they seem to be grossly underpaid.
You inferred comparison where there is none. I didn't say that it was typical of other countries. Just pointed out three of the reasons why an ambulance ride is so expensive. In the UK or any other country, an ambulance ride is expensive as well. It's just that the NHS or whatever agency in the country is the one who sees the bill. As the 'consumer' of the service, it is split 30 million ways, so the end user never sees the true cost of it.

Quote:
Originally Posted by Bamford View Post
8 minutes response is fairly good in sparsely populated places such as Wales, the NHS has well trained paramedics and is a very good emergency service, it's also free.

Emergency medical services in the United Kingdom - Wikipedia, the free encyclopedia

Furthermore Ambulance Services that fail to meet targets have to answer to the Care Quality Commission.

Care Quality Commission
I'll have to defer to you on the demographics of Wales. as for answering to the CQC.. Ok.. What enforcement powers do they have? Is it like over here, where someone screws up, they're fired, the new guy is brought in and screws up.. Is fired. No *REAL* accountability? I'd hope their compensation was tied to their targets, to be honest. Think that's probably the best way to make sure that the job gets done.
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Old 06-22-2014, 08:01 PM
 
90 posts, read 150,322 times
Reputation: 91
Quote:
Originally Posted by Bamford View Post
8 minutes response is fairly good in sparsely populated places such as Wales, the NHS has well trained paramedics and is a very good emergency service, it's also free.
No such thing as "Free".
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Old 06-22-2014, 08:44 PM
 
Location: San Francisco
2,266 posts, read 1,373,004 times
Reputation: 3731
Quote:
Originally Posted by Labonte18 View Post
You inferred comparison where there is none. I didn't say that it was typical of other countries. Just pointed out three of the reasons why an ambulance ride is so expensive. In the UK or any other country, an ambulance ride is expensive as well. It's just that the NHS or whatever agency in the country is the one who sees the bill. As the 'consumer' of the service, it is split 30 million ways, so the end user never sees the true cost of it.



I'll have to defer to you on the demographics of Wales. as for answering to the CQC.. Ok.. What enforcement powers do they have? Is it like over here, where someone screws up, they're fired, the new guy is brought in and screws up.. Is fired. No *REAL* accountability? I'd hope their compensation was tied to their targets, to be honest. Think that's probably the best way to make sure that the job gets done.
And I responded with how the cost of an ambulance ride is absurdly disproportionate (an understatement) - see a paltry thirty bucks an hour. Is a few mile journey across town - including the training, equipment and all) really as costly as a flight across the other side of the world (yes, even with three hundred other passengers on board)? If so, something is seriously wrong (why when you phone the cops or fire service - aren't you presented with a bill for hundreds of dollars?)
Incidentally, in the UK, there's a well developed private medical industry for those who want it. My understanding is that the average insurance rate is considerably less than in the US.
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Old 06-23-2014, 01:02 AM
 
Location: Myrtle Creek, Oregon
11,047 posts, read 11,455,634 times
Reputation: 17205
Quote:
Originally Posted by lycos679 View Post
European countries are notorious for not spending money on unsalvageable babies. The UK isn't really an exception to this. American insurance companies would do the same if they could, but they would get hit with expensive lawsuits so they don't.
I'm confused. If this is the case, why is the infant mortality rate in the USA so much worse than it is in Europe? Is it just that the accepted standard of care in America is lower?
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Old 06-23-2014, 01:23 AM
 
Location: Myrtle Creek, Oregon
11,047 posts, read 11,455,634 times
Reputation: 17205
Quote:
Originally Posted by Listener2307 View Post
How come none of this ever affected me? Or anyone I know?

I'm 69. Never had any delay in getting whatever I needed, and never met anyone else who did. One Friday we (surgeon and gastroenterologist and I) decided to take the gall bladder out.
Did it Tuesday.
I'm 67. Last March I started pissing blood. I called a urologist, and managed to get an appointment in only 3 weeks. He took a look inside my bladder, ruled out bladder cancer, and sent me for a CT scan, with a follow-up appointment another 3 weeks later. Sure enough it was kidney stones, too large to pass, so he scheduled shock wave lithotripsy for the 29th of April, 7 weeks after I first noticed symptoms. The procedure gave me a flaming rash in the skin over my kidneys and and a kidney infection that gave me a 4 degree fever. Antibiotics brought the fever down, but I ran out of antibiotics before I returned to normal. I called for a refill, which they "forgot" to phone in to the pharmacy. Two weeks later I'm in for x-rays and another appointment, only to find out that the shock waved didn't work, so they have to go in with a laser, and I still have leukocytes and blood in my urine, which means the infection is not cleared up. They cultured a urine sample and gave me an appointment for a week later to get the results. 14 hours before the appointment they left voice mail saying my appointment had been cancelled and I was no longer their patient. They were transferring me to another urologist, whom I have never met and never heard of, who was setting up his office. When he gets his office set up (no phone number for me to contact) he will call me to schedule an appointment.

So that's where I sit. Next week will be 3 months that I have been pissing blood, with no effective treatment, no idea what they are going to do about the kidney infection, and no idea when, if ever, I can expect further treatment. Welcome to the excellence of the American medical system. It stinks.

Yes, I have an excellent health insurance policy. It apparently doesn't help. They are about to find out that I am reasonably affluent and well able to afford an attorney, because I am flaming angry at the shoddy health care I have received so far. I have no trouble at all agreeing that American health care does not measure up to the standard of care in the rest of the world.
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Old 06-23-2014, 02:11 AM
 
Location: San Francisco
2,266 posts, read 1,373,004 times
Reputation: 3731
Quote:
Originally Posted by Larry Caldwell View Post
I'm confused. If this is the case, why is the infant mortality rate in the USA so much worse than it is in Europe? Is it just that the accepted standard of care in America is lower?
Infant mortality in the US is high compared with most other western countries.

Infant Mortality: U.S. Ranks 29th
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Old 06-23-2014, 02:12 AM
 
Location: San Francisco
2,266 posts, read 1,373,004 times
Reputation: 3731
Quote:
Originally Posted by Larry Caldwell View Post
I'm 67. Last March I started pissing blood. I called a urologist, and managed to get an appointment in only 3 weeks. He took a look inside my bladder, ruled out bladder cancer, and sent me for a CT scan, with a follow-up appointment another 3 weeks later. Sure enough it was kidney stones, too large to pass, so he scheduled shock wave lithotripsy for the 29th of April, 7 weeks after I first noticed symptoms. The procedure gave me a flaming rash in the skin over my kidneys and and a kidney infection that gave me a 4 degree fever. Antibiotics brought the fever down, but I ran out of antibiotics before I returned to normal. I called for a refill, which they "forgot" to phone in to the pharmacy. Two weeks later I'm in for x-rays and another appointment, only to find out that the shock waved didn't work, so they have to go in with a laser, and I still have leukocytes and blood in my urine, which means the infection is not cleared up. They cultured a urine sample and gave me an appointment for a week later to get the results. 14 hours before the appointment they left voice mail saying my appointment had been cancelled and I was no longer their patient. They were transferring me to another urologist, whom I have never met and never heard of, who was setting up his office. When he gets his office set up (no phone number for me to contact) he will call me to schedule an appointment.

So that's where I sit. Next week will be 3 months that I have been pissing blood, with no effective treatment, no idea what they are going to do about the kidney infection, and no idea when, if ever, I can expect further treatment. Welcome to the excellence of the American medical system. It stinks.

Yes, I have an excellent health insurance policy. It apparently doesn't help. They are about to find out that I am reasonably affluent and well able to afford an attorney, because I am flaming angry at the shoddy health care I have received so far. I have no trouble at all agreeing that American health care does not measure up to the standard of care in the rest of the world.
Pertinent and outrageous. I wish you the best.
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Old 06-23-2014, 02:34 AM
 
Location: Gorgeous Scotland
4,123 posts, read 4,576,248 times
Reputation: 3262
Quote:
Originally Posted by Bamford View Post
8 minutes response is fairly good in sparsely populated places such as Wales, the NHS has well trained paramedics and is a very good emergency service, it's also free.

Emergency medical services in the United Kingdom - Wikipedia, the free encyclopedia

Furthermore Ambulance Services that fail to meet targets have to answer to the Care Quality Commission.

Care Quality Commission
My area takes longer as well. We have a local hospital which is okay for minor things or to stabilize you, but for anything serious in the middle of the night, a helicopter would be called out to take you to a Glasgow hospital. Many of the small islands would need helicopter service as well. No charge to the patient (except for paying normal taxes).
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Old 06-23-2014, 05:10 AM
 
11,780 posts, read 8,209,779 times
Reputation: 3425
Quote:
Originally Posted by Larry Caldwell View Post
I'm confused. If this is the case, why is the infant mortality rate in the USA so much worse than it is in Europe? Is it just that the accepted standard of care in America is lower?
A few reasons. Primarily because of different standards of measurement. It's like comparing rape between countries. One country will have a absurdly high number, but the reporting standard is egregiously liberal which makes cross country comparisons invalid. The US counts all babies that are born, but other countries will have a certain gestational age, weight, or days after birth requirement before the baby counts as a baby.

The other factors are:
Higher HIV rates.
More teen births which leads to a higher number (raw and per capita) of premature births.
More poverty and lower quality prenatal care for people in the lower income quadrants. Lower income people also have a higher birth rate as well.
Higher African American population. The CDC has some info on this that if you are interested.

African American women have more premature babies, higher teen pregnancy rates, higher infant mortality rates, and higher poverty rates vs the nation as a whole. If I remember correctly, the premature births were higher even for AA's after controlling for education, income, and location which indicates some other (possibly unknown) variable at play.

Once you break down infant mortality rate by gestational week the USA performs very well, with only Sweden beating us. =

In essence, we have people criticizing the US health system (as if the health system can control a premature birth) instead of criticizing the fact that we have more premature babies. According to a Congressional Research Report I read, if we had the same low birth weight distribution as Sweden then we would have an infant mortality rate in the low 3's vs the mid 6's that we currently have. So the answer is really to reduce the premature births and that can be accomplished by decreasing teens births, drug use among pregnant women, and having less poor people having babies.

All in all, infant mortality rates are poor comparisons to use.

Quote:
Originally Posted by Larry Caldwell View Post
Yes, I have an excellent health insurance policy. It apparently doesn't help. They are about to find out that I am reasonably affluent and well able to afford an attorney, because I am flaming angry at the shoddy health care I have received so far. I have no trouble at all agreeing that American health care does not measure up to the standard of care in the rest of the world.
You likely have Medicare though. Mortality rates with private insurance are better than Medicare and many DR's have been dropping Medicare patients due to lowered reimbursement rates.

Quote:
Originally Posted by modernist1 View Post
Infant mortality in the US is high compared with most other western countries.

Infant Mortality: U.S. Ranks 29th
We also count every baby, even if the baby dies after 6 hrs and is only 399 grams.

Quote:
Originally Posted by lycos679 View Post
European countries are notorious for not spending money on unsalvageable babies. The UK isn't really an exception to this. American insurance companies would do the same if they could, but they would get hit with expensive lawsuits so they don't.

Try the CDC and OECD. Why do you think there is so much variation in infant mortality rates between different countries?
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Old 06-23-2014, 05:36 AM
 
Location: Great Britain
2,739 posts, read 2,480,916 times
Reputation: 1425
Quote:
Originally Posted by Labonte18 View Post


I'll have to defer to you on the demographics of Wales. as for answering to the CQC.. Ok.. What enforcement powers do they have? Is it like over here, where someone screws up, they're fired, the new guy is brought in and screws up.. Is fired. No *REAL* accountability? I'd hope their compensation was tied to their targets, to be honest. Think that's probably the best way to make sure that the job gets done.
If a agency such as a Care Home or Health care or Ambulance trust trust is failing they can take it over and impose their own management team as part of special measures, whilst wherethere has been negligence they can go to the Civil Courts and where there is criminally negligence they will involve the police and take cases to the Crown Courts.

The CQC is to be handed even greater powers from October of this year.

The impact of new CQC powers on providers | Sponsored info | Health Service Journal
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