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Comparing apples to apples means that you are comparing the same things...which this is not...
Also consider that countries with a national health plan ration care and limit access..again, not something I hope I EVER have to deal with in my lifetime....
Every system rations care and limits access. The US does it through insurance 'plans' and pricing.
Every system rations care and limits access. The US does it through insurance 'plans' and pricing.
Not in the way they do in a NHP...when you have to wait months to years for care and have no say in who you go to or any control over the procedure, etc., that is limiting and rationing..not sure why you think this happens in the US...because it doesn't...
Not in the way they do in a NHP...when you have to wait months to years for care and have no say in who you go to or any control over the procedure, etc., that is limiting and rationing..not sure why you think this happens in the US...because it doesn't...
That simply isn't true. I don't think you have a good understanding of how some of these systems work. I have personally lived in Switzerland and the UK and I know how their systems work. Access to care is every bit as good as access in the USA. But it is a lot cheaper.
That simply isn't true. I don't think you have a good understanding of how some of these systems work. I have personally lived in Switzerland and the UK and I know how their systems work. Access to care is every bit as good as access in the USA. But it is a lot cheaper.
That simply is not true---try getting an elective, but necessary surgery in the UK or Switzerland...see how long it takes you. I see this every day from people that are trying to get the same surgery I just had. They can't pick their doctor, can't pick their equipment, it's a 3 month, at least, wait just to get in for the initial evaluation and then 18 months-2 YEARS to wait for the actual surgery. Me, I had my initial appointment and was scheduled for surgery 3 weeks later, but only because of MY schedule and trying to work around our summer vacation plans.
That simply is not true---try getting an elective, but necessary surgery in the UK or Switzerland...see how long it takes you. I see this every day from people that are trying to get the same surgery I just had. They can't pick their doctor, can't pick their equipment, it's a 3 month, at least, wait just to get in for the initial evaluation and then 18 months-2 YEARS to wait for the actual surgery. Me, I had my initial appointment and was scheduled for surgery 3 weeks later, but only because of MY schedule and trying to work around our summer vacation plans.
Look …. first of all the systems in the UK and Switzerland are different.
Switzerland has a private health-insurance system which is regulated by government. Just like in the USA, you get to choose your doctor and choose your medical facility based on the type of insurance plan you have. In cities like Geneva you have a choice between state owned hospitals (Hopital Cantonal) or private clinics (Hopital de la Tour, Grangettes). Insurance plans generally cover both. Access is, therefore, very similar to access in the USA. The main difference is that the cost is a lot less than in the USA.
The UK has a state run system (NHS) and a parallel private system. If it looks like you might have to wait for elective surgery then you always have the option of paying extra to go private and get to the front of the line. And a lot of people choose to do this because the NHS tends not to focus on elective treatment but rather on urgent or immediately necessary care. Even so, it still works out a whole lot cheaper than in the USA.
In your post you throw out a bunch of numbers which are wholly out of context and facts which are quite simply wrong. But the fundamental problem is that you are trying to excuse the failings in the US system, and specifically the outrageous cost of our system, by pretending that somehow all the other systems are worse. Unfortunately for you, the facts do not support your argument.
Health Care Rationing is alive and well in the U.S.
Quote:
Originally Posted by golfgal
Comparing apples to apples means that you are comparing the same things...which this is not...
Also consider that countries with a national health plan ration care and limit access..again, not something I hope I EVER have to deal with in my lifetime....
Time to wake up. Health care is rationed in America BIG time. Just not rationed with a considered approach. From the President of the Dallas County Medical Society:
Quote:
In healthcare reform, the Rationing R word is so devastatingly toxic, so nuclear that it has tanked many political careers and many attempts at healthcare reform. Hillary Clinton's efforts at healthcare reform in the early '90s initially come to mind. Thunderous echoes of "Death Panels" are still fresh and reverberate across the spectrum of digital media discourse. Perhaps no issue in American politics so polarizes our nation.
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A veritable economic tsunami of crushing costs of medical care is crashing toward us. The numbers speak for themselves and are very sobering.
-------------- Rationing is alive and well in the US healthcare system in 2012. Those who feel that rationing is absent in our country are just kidding themselves. It is an illusion that many so desperately try to protect. Rationing is so commonplace and familiar that we don't recognize it as such. Rationing of health care occurs because we have limited resources, be it providers, money, supplies, or hospitals.. The most obvious example is transplantation, which has faced rationing for decades. In cardiac transplantation, for example, 2,000 to 2,200 hearts are transplanted each year in the United States, although the actual potential recipient pool of end-stage heart failure patients dwarfs this number at a conservatively estimated 100,000. Each week around the country, transplant teams of physicians, nurses and coordinators present potential candidates for listing in an exquisitely regulated organ rationing system .
--------------- The most common examples of rationing in US healthcare however are implicit, and, as such, are not readily recognized. Or perhaps more realistically, the truth is that we don't want to consciously and publically acknowledge that rationing is occurring. To borrow a quote from the movie "A Few Good Men," "You don't want the truth because deep down in places you don't talk about at parties,..." Prior-authorizations and co-payments are rationing tools designed to discourage and limit the delivery of care. Rationing takes place whenever an insurance company denies a treatment. Self-rationing occurs when a patient chooses an over-the-counter remedy for symptoms instead of going to the doctor where they will have to pay a co-pay. Access to our broader healthcare network is rationed under the guise of money and time. We're all familiar with the expression, "Time is money." That is exactly how we pay for the health care we receive — by spending our money and our time — and often-in combinations in inverse proportions. Those who have money (or access to money through insurance) receive health care, while those who don't go without or must wait a long time to access the system. And the more money you have, the more healthcare services you can consume, and faster. Those who have no money or are covered by poorly paying insurance plans must pay for their care with their time, be it a long wait in an ED or a long wait for an appointment to see a private physician or one in a charity clinic. Many physicians limit the number of patients they see from poorly paying plans such as Medicaid, with openings for new patients available only months in the future.
-------------- We do ration health care in this country, and we must come to grips with that reality. We must acknowledge that our system of rationing is one of the most unfair and most inefficient in the world. "Fairness" arguments are made from both sides of the consumer spectrum. We all are familiar with arguments of how "unfair" it is that some people have limited access to health care and others do not. But passionate arguments also can be made about how "unfair" it is to spend 30 percent of our limited healthcare financial resources (Medicare) on patients in the last year of life, and that these dollars could be spent more "fairly" and "efficiently."
Another type of inefficiency in healthcare rationing in the United States is the ubiquitous "prior authorization" song and dance that we physicians must go through for most any diagnostic or therapeutic procedure we want to do for our patients, just short of blowing their nose. Every day, my fax machine is filled with medication pre-auth form requests that drive me crazy. These "processes" are put in place to serve as barriers that limit (ration) the diagnostic and therapeutic services that we provide for our patients. Our time is much better spent providing care as opposed to dealing with this inefficient rationing exercise. As I like to say, "more patient, less paper." The real question I pose for society, politicians and physician providers is, are we going to keep our head buried in the sand, ignore the facts and accept this underground system of implicit rationing with all its issues of fairness and inefficiency? Truly, American-style medical rationing is the dirty little secret of US healthcare, our own medical version of "don't ask, don't tell." Or are we going to drag this issue out of the closet and face reality that we do ration care in the US, albeit implicitly? We must address this problem openly and directly by replacing our current system of implicit rationing with a system of explicit rationing through government funded health plans which would set limits on what would be paid for that is more efficient, transparent, and dare I say more fair.
I'm tired of hearing misinformed people say there is no medical care rationing in this country. Just ask physicians. They know. We are already dealing with rationing.
Look …. first of all the systems in the UK and Switzerland are different.
Switzerland has a private health-insurance system which is regulated by government. Just like in the USA, you get to choose your doctor and choose your medical facility based on the type of insurance plan you have. In cities like Geneva you have a choice between state owned hospitals (Hopital Cantonal) or private clinics (Hopital de la Tour, Grangettes). Insurance plans generally cover both. Access is, therefore, very similar to access in the USA. The main difference is that the cost is a lot less than in the USA.
The UK has a state run system (NHS) and a parallel private system. If it looks like you might have to wait for elective surgery then you always have the option of paying extra to go private and get to the front of the line. And a lot of people choose to do this because the NHS tends not to focus on elective treatment but rather on urgent or immediately necessary care. Even so, it still works out a whole lot cheaper than in the USA.
In your post you throw out a bunch of numbers which are wholly out of context and facts which are quite simply wrong. But the fundamental problem is that you are trying to excuse the failings in the US system, and specifically the outrageous cost of our system, by pretending that somehow all the other systems are worse. Unfortunately for you, the facts do not support your argument.
You still are not comparing apples to apples. Compare ACTUAL costs, out of pocket-or via taxes of CITIZENS in the US and elsewhere, not total costs on average for people using the government systems..which in the US is MOSTLY the elderly. You have a larger pool, therefore yes, your costs ON AVERAGE are lower, what is that cost for the 65 and older population....
You still are not comparing apples to apples. Compare ACTUAL costs, out of pocket-or via taxes of CITIZENS in the US and elsewhere, not total costs on average for people using the government systems..which in the US is MOSTLY the elderly. You have a larger pool, therefore yes, your costs ON AVERAGE are lower, what is that cost for the 65 and older population....
You are trying to cherry pick your costs. The only meaningful comparison is total cost per capita and that number has already been posted up. Different countries pay for health care in different ways. Usually it is a mix of taxation plus individual payments (insurance premiums plus out of pocket). In the USA you can add employer contributions to that.
Your ACTUAL costs are the insurance premiums you pay, the co-pays, deductions and out of pockets you pay, the subsidy you are getting from your employer (if you get one) and the part of the taxes you pay that goes to support government health care. That is your actual cost.
Which ever way you slice it or dice it, the average per capita cost of health care in the USA is more than double the OECD average. Now that would be okay if health care outcomes were twice as good. But they are not. Health care in the USA is very good. But it is also very good in other developed countries. We are not getting any benefit from all the extra spending.
That simply isn't true. I don't think you have a good understanding of how some of these systems work. I have personally lived in Switzerland and the UK and I know how their systems work. Access to care is every bit as good as access in the USA. But it is a lot cheaper.
How they work? Let's start with a 70% + income tax! Which simply IS true!
...The UK has a state run system (NHS) and a parallel private system. If it looks like you might have to wait for elective surgery then you always have the option of paying extra to go private and get to the front of the line. And a lot of people choose to do this because the NHS tends not to focus on elective treatment but rather on urgent or immediately necessary care. Even so, it still works out a whole lot cheaper than in the USA...
And people *do* wait - even for some things I wouldn't consider "elective":
And - since you have experience with the system - about how much would a family of 4 earning $50k/year pay into the basic system (in the form of taxes and the like)? Do employers have to chip in something as well? About how much would a decent private policy for that parallel private system cost that family of 4? And - finally - are those private policies "rated" in terms of age - health status - etc.? I found some references to underwriting on the basis of age - but not health status. Robyn
P.S. Does the NHS focus on preventive care?
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Health Care Rationing is alive and well in the U.S.
