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Old 11-03-2010, 01:15 PM
 
14,247 posts, read 17,913,622 times
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In reality, the various western European health care systems are pretty good as is the US system. There isn't that much difference between the overall quality of health care they have or we have and the statistics bear that out. The main difference is that we pay two to three times per person more than they do for an equivalent quality of care.
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Old 11-03-2010, 01:22 PM
 
Location: Cincinnati
3,336 posts, read 6,939,098 times
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Quote:
Originally Posted by stan4 View Post
A. I was discussing countries that are always brought up - Norway, Sweden - both countries with tiny populations, France, Germany...all of which were doing fine and were great to hold up as 'models' until they, too, started to feel the pain of being overrun with immigration they didn't want (Germany in particular).

B. A lot of those countries' healthcare systems are falling apart and unsustainable - why doesn't anyone want to talk about that? About the HUGE private market that is springing up? Or about the fact that care MUST be rationed in order for this model to stand a chance?

C. None of the 30-odd countries comes close to ours in terms of population - or even half (Japan coming closest with 127 million and then Germany with 82 million). The entire European union is about 400 million people.

D. Unless YOU work very closely or in healthcare, it is you who does not have all the facts in hand to realize that our government is absolutely horrendously inefficient and poor at doling out health care.

E. And it's clear you never read the whole health care bill, because if you did, you would realize that it solves NOTHING. It does not improve access to care, it does not improve costs, it does not create any accountability...all it does is cost money we can't afford.
Well, at least we're talking in more detail. I appreciate your point-by-point response. Here are my responses:

A. I was referring to the 32 countries doing better than us, the nordic countries are among them, but it really is a huge diversity of countries.

B. Health care rationing. I am not familiar with what rationing has taken place. Whatever has occurred has resulted is still resulting in better overall outcomes than we have in the United States. Regarding private markets, I don't see the springing up of private markets to fill gaps in public health care as a bad thing. In any case, many of these countries have entirely private but highly regulated systems and in others it is entirely public.

C. Population. I think we need to get into more specific arguments about why a large population makes health delivery troublesome. I would think the opposite - that we could enjoy some economies of scale.

D. The current health care bill leaves everything in for-profit and non-profit hands, much to the chagrin of people like me who are further to the left on the health care issues and want to see single payer. I don't believe much of anything is left in government hands besides creating and enforcing the regulations. I think government does have a natural role in health care because the concept behind non-regulate private insurance is entirely flawed because it bankrupts people who are in poor health.

E. I agree that the health care bill is flawed. In my opinion they made far too many concessions to the right who didn't even vote for it. But will it result in better health outcomes? Yes. Will it prevent the 62% of bankruptcies that are the direct result of health care bills, thereby improving overall economic health. Yes.
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Old 11-03-2010, 01:23 PM
 
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Basically the heathcare bill is going to have a tough road ahead as it stands. Not the funding avialable or likely to chnage and sat5ates that are counted on to implement it more i control of republicans with the governor gains and state house gains.People are going to see why Nelson(D) of nebraska demanded a exemption in medicaid cost for his state .
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Old 11-03-2010, 05:22 PM
 
41,813 posts, read 51,019,001 times
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Quote:
Originally Posted by progmac View Post
What facts aren't PC? You're the one wanting to exclude blacks from the dataset, not me. Unlike you, I consider blacks to be my fellow Americans. Hell, they have been here longer than my family, and we go back quite a ways.
I'm not trying to exclude them but instead point out a fact. Is the problem here that it's blacks? From what I'm reading it's a bit of a mystery since it's the entire population.

Why would this be important? European countries have no where near the black population of the US. If the US has a race that makes up large percentage of the population that is predisposed to high infant moratality rates then certainly you would need to consider that.

Again it's about understanding how you arrived at the statistic, for you perhaps it's sufficient knowing "what the statistic is" but I want to know "why the statistic is".
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Old 11-03-2010, 05:34 PM
 
1,733 posts, read 1,821,523 times
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Quote:
Originally Posted by stan4 View Post
No. What's stupid is comparing countries with populations of 5 or 10 million with that of 300,000,000.
What's more stupid is comparing countries with relatively homogeneous populations to that of a huge melting pot of huge demographic and fiscal diversity.
You know, I see that argument quite a bit. But I never hear it.

"It is not comparable because the USA is bigger" is something I see on the net. People throw it around, but never accompany it with any kind of reasoning for why size makes the USA incomparable. It is just an article of faith among some.

On the other hand, I never hear it. When talking to professionals, it is not an argument anyone has ever brought up. And its hardly something you see in the Lancet or any other serious publication. On the contrary. Serious discussions and publications are full of country to country comparisons.

The British, all 62 million of them compare their results to Finland of 5 million. Norway with 5 million try to match the results of the 65 million French. 80 million Germans compare themselves to 5 million Danes. And the Danes see no problem with being compared to Australia of 22 million or Canada of 34. And everyone compares themselves to the Japanese, who have a population of 127 million.

No-one is pleading special exception. And no theory has predicted some kind of "magic limit" that would apply only to the US.

And do you know how much of health care involves country to country comparison? Would you tell a health care economist his field was stupid? Would you say that to someone in Social Medicine? Someone doing epidemology? Public health? They all use country to country comparisions, are they all stupid?

Homogenous populations? Have you had a stroll around Lodon, Amsterdam or Bradford recently?

It is not 1950.

Quote:
Originally Posted by stan4 View Post
A. I was discussing countries that are always brought up - Norway, Sweden - both countries with tiny populations, France, Germany...all of which were doing fine and were great to hold up as 'models' until they, too, started to feel the pain of being overrun with immigration they didn't want (Germany in particular).
According to those lists, they are still doing fine. Outperforming the US rather handily. As is a lot of other countries on those lists. What is your point? Countries do well untill the imigrants come, and then...they continue to do well?

Quote:
Originally Posted by stan4 View Post
B. A lot of those countries' healthcare systems are falling apart and unsustainable - why doesn't anyone want to talk about that? About the HUGE private market that is springing up? Or about the fact that care MUST be rationed in order for this model to stand a chance?
No-one talks about that because its bull****. I am sorry, but that is the only word for it.

Think it through -these are economies that are in the same league as the US one. Some are at the moment even stronger. And their health care systems average half of what the US one does! How is that unsustainable? Sure, there are cost control drives, speeches and a brouhaha about things costing too much.

What that shows is that conditions that look utopian from the US are still considered poor elsewhere. That is how poorly the US sytem is doing.

And...the HUGE (capitals) private market springing up? Where? All developed countries use private provisions. Thats always been the case. The Germans use private insurers. The Netherlands uses compulasory private insurance. Norwegian patients go to private hospitals if they want, or foreign ones if the goverment can't provide immediate response to a life-threatening conditions. And the goverment pays.

And rationing care...there are not infinite resources anywhere. But not everyone rations care equally much. The US system, rations care by social status and employment. This leads to far more severe rationing of care than most other developed nations.

This is why health outcomes in the US are worse.
What you are saying is not well informed. It is taking points from the right, aimed at the stupid and willfully ignorant.

Quote:
Originally Posted by stan4 View Post
C. None of the 30-odd countries comes close to ours in terms of population - or even half (Japan coming closest with 127 million and then Germany with 82 million). The entire European union is about 400 million people.
And there is no reason why that should matter. Population density does matter, it affects delivery. But I've never known population to be considered a significant factor in that direction. Economics of scale apply, but the support the bigger populations, not the smaller..

Quote:
Originally Posted by stan4 View Post
I'm sorry...how did anyone make the giant leap between comparing birth complications and somehow using it to paint a picture of our entire health care system?

What about social factors?
Financial factors?
Cultural factors?
Parental habits and choices?

If we're allowed to judge entire systems based on one piece of data...hmmmm...let me choose one:

I can order and get an MRI for my patient within seconds of just asking for one. Day or night, 24/7. No one else can. And that is NOT special in our health care system. So we must be #1!!!! YAY!
In medicine, infant mortality rate is considered a very strong indicator of country health care development. It is not unusual to look at that indicator.

And...you seriously think its only in the US you can get an MRI quick?

Quote:
Originally Posted by stan4 View Post
Quite often I look at a patient of mine and think, "You would have been dead in x other country."

Not because they don't care...but because they don't have the resources I have at my fingertips. They have to practice way more based on statistics...if you practice just based on evidence-based statistics (which in most cases is fine, but be aware that they are about cost-control and resource allocation), I know many patients we have had that would be dead today...

Gut intuition and a higher standard saves lives, too. But if you can't get the test or procedure because you simply don't have access to it, you're f'd.
And I am sure that is a very comforting thing, to compare yourself to the third world.

Meanwhile, a hundred thousand people die each year in the US that would have survived if they had been in one of the top three countries.

Measuring the Health of Nations: Updating an Earlier Analysis - The Commonwealth Fund

I notice you like throwing out lines like "I can order an MRI.." and "a patient of mine" while at the same time demonstrating a pretty deep ignorance on the subject of health care systems.

In medical ethics, one would expect that the principles of beneficience and non-maleficience would compel a physician to check the evidence and look up the peer reviewed studies before going out strongly in an issue of this importance. Not really plowing through Grossman and Arrow, but basically, aquire fundamental knowledge on the subject.
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Old 11-03-2010, 05:48 PM
 
Location: Foot of the Rockies
90,297 posts, read 120,685,448 times
Reputation: 35920
Quote:
Originally Posted by thecoalman View Post
I'm not trying to exclude them but instead point out a fact. Is the problem here that it's blacks? From what I'm reading it's a bit of a mystery since it's the entire population.

Why would this be important? European countries have no where near the black population of the US. If the US has a race that makes up large percentage of the population that is predisposed to high infant moratality rates then certainly you would need to consider that.

Again it's about understanding how you arrived at the statistic, for you perhaps it's sufficient knowing "what the statistic is" but I want to know "why the statistic is".
Australia and New Zealand also have very diverse populations; many Asian countries are also ahead of the US. It's not our diversity that makes our infant mortality stats low.
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Old 11-03-2010, 05:52 PM
 
2,085 posts, read 2,468,198 times
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Quote:
Originally Posted by robbobobbo View Post
Midwifery is a more common practice in some other countries than it is in the USA.

The infant mortality rate in the Netherlands is 4.7 deaths per 1000 live births, the under-5 mortality rate is 5.9 deaths per 1000 births.

The Netherlands has better outcomes than the USA.

In the USA, the rate is 6.3 deaths per 1000 live births (infants), 7.8 deaths per 1000 births for under-5.

While the rate in the Netherlands may be one of the highest in Europe, almost all Western European nations, including the Netherlands, have better outcomes than the USA. You fail to mention that the European countries that score better than the Netherlands also have some form of national health care, so why you think moving away from national health care would be better, is beyond me.


Why, so more American babies can die?
How many American babies are crack babies, though?
It's the lack of health care, that is the issue.
Midwives are not as effective, as a hospital. I tell you, if it were not for the fact that I was in a hospital for both my babies being born, neither they or myself would have survived. Both births were really bad.
The Netherlands also do not have nearly as many babies being born, as here.
If socialized medicine is so great, then why do Canadians come here for treatment?
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Old 11-03-2010, 06:01 PM
 
46,943 posts, read 25,960,211 times
Reputation: 29434
Quote:
Originally Posted by Waianaegirl View Post
If socialized medicine is so great, then why do Canadians come here for treatment?
Pop quiz: Which is higher - the number of Americans going abroad for medical treatment, or the number of people traveling to the US for treatment?
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Old 11-03-2010, 06:22 PM
 
41,813 posts, read 51,019,001 times
Reputation: 17864
Quote:
Originally Posted by Katiana View Post
It's not our diversity that makes our infant mortality stats low.
I didn't say that but instead pointed out a specific racial group in this country that makes up substantial part of the population that has a higher than average rate of infants deaths. Why would you not think that is significant?
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Old 11-03-2010, 06:24 PM
 
27,212 posts, read 46,720,608 times
Reputation: 15662
Over here there are other issues like teenage pregnancies and many older woman getting babies. You have to compare apples with apples.

Over here the health care needs to be fixed not like Obama care!

Provide birth control so teenagers are not sitting in High School being 8-9 months pregnant like my son has in his class and he is a Sophomore!

For all the posters who think Europes care is so great...go there in case you need help which will clean up the waiting times in the ER! Feel free to go...I bet nobody will go! People come here for care, not the other way around...why would that be!
Quote:
Originally Posted by progmac View Post
Countries with lower infant mortality rates than the united states:

Iceland
Singapore
Japan
Sweden
Norway
Hong Kong
Finland
Czech Republic
Switzerland
South Korea
Belgium
France
Spain
Germany
Denmark
Austria
Australia
Luxembourg
Netherlands
Israel
Slovenia
United Kingdom
Canada
Ireland
Italy
Portugal
New Zealand
Cuba
Channel Islands ( Jersey and Guernsey)
Brunei
Cyprus
New Caledonia
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