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US Lags Sister Nations in Cutting Preventable Deaths
US Lags Sister Nations in Cutting Preventable Deaths
Megan Brooks
August 29, 2012 — The United States lags behind France, Germany, and the United Kingdom in the rate of potentially preventable deaths and in the pace of improvement in preventing deaths that could have been avoided with timely and effective healthcare, also known as "amenable mortality," according to a study released today.
"Despite spending about twice as much per person each year on health care as France, Germany or the UK...the US is increasingly falling behind these countries in terms of progress in lowering the potentially preventable death rate," Karen Davis, president of the Commonwealth Fund, which supported the study, said in a statement.
"The good news," she said, "is that the Affordable Care Act is already beginning to close the gaps in access to care. When fully implemented, it will cover nearly all Americans, with the potential to put our country on track to improve to levels seen in the best-performing countries," she said.
The authors of the study, published online August 29 in Health Affairs, are Ellen Nolte, director of Health and Healthcare at RAND Europe, and Martin McKee, professor of European Public Health at the London School of Hygiene & Tropical Medicine in the United Kingdom.
Higher Amenable Mortality in the United States
The authors examined trends and patterns in "amenable mortality" in the United States compared with France, Germany, and the United Kingdom between 1999 and 2007. Causes of potentially preventable deaths included treatable cancers, diabetes, cerebrovascular disease, and hypertension.
In a nutshell, the authors found that the rate of decline in amenable mortality in the United States was slower than that in France or Germany, and especially slow compared with that in the United Kingdom. As a consequence, amenable mortality rates in the United States in 2007 were nearly twice as high as those in France, which had the lowest levels of the 4 countries, they say.
"Although US men and women had the lowest mortality from treatable cancers among the four countries, deaths from circulatory conditions — chiefly cerebrovascular disease and hypertension — were the main reason amenable death rates remained relatively high in the United States," the authors write.
Overall, during the study, amenable mortality rates among men fell by 18.5% in the United States compared with 36.9% in the United Kingdom. Among women, the rate of potentially preventable deaths fell by 17.5% in the United States but by 31.9% in the United Kingdom.
The authors also looked at potentially preventable death rates for people younger than 65 years and people aged 65 to 74 years.
Although the pace of improvement was slower in the United States for both age groups, the lag was most pronounced among American men and women younger than 65 years, who are more likely to be uninsured than the Medicare-eligible 65-and-older set, they note.
According to the report, by 2007, the potentially preventable death rate among US men younger than age 65 years was 69 per 100,000, which is considerably higher than in the United Kingdom (53/100,000), Germany, (50/100,000), and France (37/100,000). Potentially preventable death rates for men in this age group have declined more rapidly in all 3 countries since 1999 than in the United States, the authors say.
Among women younger than 65 years, the potentially preventable death rate dropped from 64 to 56 per 100,000 in the United States, from 61 to 46 per 100,000 in the United Kingdom, from 49 to 40 per 100,000 in Germany, and from 42 to 34 per 100,000 in France.
For both women and men younger than 65 years, US potentially preventable death rates remain higher than the other 3 countries.
The Case for Reform
"Our findings indicate that younger Americans do not appear to benefit from health care to the same extent as do their older compatriots or Europeans," the authors write.
"Our analyses," they continue, "confirm our hypothesis that the relative impact of health care in the United States varies by age group as a result of age-dependent differences in access to health care. We show that the lagging progress of the United States compared to other countries, as measured by amenable mortality, is largely driven by elevated amenable mortality among those younger than age 65."
"These findings strengthen the case for reforms that will enable all Americans to receive timely and effective health care," the authors conclude. France, Germany, and the United Kingdom all provide universal coverage to their populations, regardless of age.
http://www.medscape.com/viewarticle/769999?src=nldne
See the full text at: http://content.healthaffairs.org/content/early/2012/08/20/hlthaff.2011.0851.full
Megan Brooks
August 29, 2012 — The United States lags behind France, Germany, and the United Kingdom in the rate of potentially preventable deaths and in the pace of improvement in preventing deaths that could have been avoided with timely and effective healthcare, also known as "amenable mortality," according to a study released today.
"Despite spending about twice as much per person each year on health care as France, Germany or the UK...the US is increasingly falling behind these countries in terms of progress in lowering the potentially preventable death rate," Karen Davis, president of the Commonwealth Fund, which supported the study, said in a statement.
"The good news," she said, "is that the Affordable Care Act is already beginning to close the gaps in access to care. When fully implemented, it will cover nearly all Americans, with the potential to put our country on track to improve to levels seen in the best-performing countries," she said.
The authors of the study, published online August 29 in Health Affairs, are Ellen Nolte, director of Health and Healthcare at RAND Europe, and Martin McKee, professor of European Public Health at the London School of Hygiene & Tropical Medicine in the United Kingdom.
Higher Amenable Mortality in the United States
The authors examined trends and patterns in "amenable mortality" in the United States compared with France, Germany, and the United Kingdom between 1999 and 2007. Causes of potentially preventable deaths included treatable cancers, diabetes, cerebrovascular disease, and hypertension.
In a nutshell, the authors found that the rate of decline in amenable mortality in the United States was slower than that in France or Germany, and especially slow compared with that in the United Kingdom. As a consequence, amenable mortality rates in the United States in 2007 were nearly twice as high as those in France, which had the lowest levels of the 4 countries, they say.
"Although US men and women had the lowest mortality from treatable cancers among the four countries, deaths from circulatory conditions — chiefly cerebrovascular disease and hypertension — were the main reason amenable death rates remained relatively high in the United States," the authors write.
Overall, during the study, amenable mortality rates among men fell by 18.5% in the United States compared with 36.9% in the United Kingdom. Among women, the rate of potentially preventable deaths fell by 17.5% in the United States but by 31.9% in the United Kingdom.
The authors also looked at potentially preventable death rates for people younger than 65 years and people aged 65 to 74 years.
Although the pace of improvement was slower in the United States for both age groups, the lag was most pronounced among American men and women younger than 65 years, who are more likely to be uninsured than the Medicare-eligible 65-and-older set, they note.
According to the report, by 2007, the potentially preventable death rate among US men younger than age 65 years was 69 per 100,000, which is considerably higher than in the United Kingdom (53/100,000), Germany, (50/100,000), and France (37/100,000). Potentially preventable death rates for men in this age group have declined more rapidly in all 3 countries since 1999 than in the United States, the authors say.
Among women younger than 65 years, the potentially preventable death rate dropped from 64 to 56 per 100,000 in the United States, from 61 to 46 per 100,000 in the United Kingdom, from 49 to 40 per 100,000 in Germany, and from 42 to 34 per 100,000 in France.
For both women and men younger than 65 years, US potentially preventable death rates remain higher than the other 3 countries.
The Case for Reform
"Our findings indicate that younger Americans do not appear to benefit from health care to the same extent as do their older compatriots or Europeans," the authors write.
"Our analyses," they continue, "confirm our hypothesis that the relative impact of health care in the United States varies by age group as a result of age-dependent differences in access to health care. We show that the lagging progress of the United States compared to other countries, as measured by amenable mortality, is largely driven by elevated amenable mortality among those younger than age 65."
"These findings strengthen the case for reforms that will enable all Americans to receive timely and effective health care," the authors conclude. France, Germany, and the United Kingdom all provide universal coverage to their populations, regardless of age.
http://www.medscape.com/viewarticle/769999?src=nldne
See the full text at: http://content.healthaffairs.org/content/early/2012/08/20/hlthaff.2011.0851.full
I think part of the issue for everyone (those of us living in countries with Universal Insurance) is that we hear the scary stories or the gaps in other's systems. I mean, I could recite post after post in the pregnancy forums of women who cannot get prenatal care in the US due to lack of insurance. They ignore potentially serious issues as they second guess themselves due to what it would cost them. I know one family in particular who had what they thought was great insurance. Baby was diagnosed in utero with a very serious heart condition. Insurance wouldn't cover the necessary surgery at birth because it became considered "pre existing". The baby did have 2 surgeries and ultimately sadly passed away and the parents were left with massive massive debt. So we all hear the negative.
I don't know the answer to the problem. I suspect that probably taking the best of both types of systems is the answer for all of us. However, that would require common sense on the part of the politicians - something they seem to lack..lol. (and I mean ours too). I fully admit that our system needs tweaking and some parts probably a major overhaul. I do think though that as a starting point, everyone needs to be covered. Then go from there. At least that is how I see it.
I don't know the answer to the problem. I suspect that probably taking the best of both types of systems is the answer for all of us. However, that would require common sense on the part of the politicians - something they seem to lack..lol. (and I mean ours too). I fully admit that our system needs tweaking and some parts probably a major overhaul. I do think though that as a starting point, everyone needs to be covered. Then go from there. At least that is how I see it.
Interesting article and it could almost cause me to change my mind, but a couple things came to mind as I read it all.
I know the main article is primarily about preventable death, but what about providing care for those conditions that preventive testing will not find?
The health care system in UK is often held up as an "example" of how efficient a government run system can be. That's all well and good, yet, I see, on a daily basis on the thyroid forum, that in UK, there are a lot of people who can't even get adequate testing and/or certain medications to diagnose/treat a simple thyroid condition. The tests are inexpensive, as is the medication, yet, because they don't fit into the NHS guidelines patients don't have access to them, so they remain ill. This is in spite of many studies, a lot of which are done in UK, that prove that adequate testing/medication could/would be beneficial.
In UK, they have the "standard of care" and no one is allowed to deviate. Even if a patient does find a doctor willing to order specific tests, labs are not allowed to perform them, without special permission from NHS, which is usually withheld. We see a lot of patients who are kept very ill because of this, yet they are offered any number of other tests, antidepressants, etc that they don't need. Many of them have to pay privately, for the care they need; those that can't afford to pay privately, are out of luck.
If we go to such a system, what's to say that we wont' run into the same issues. We also have "standards of care" and if a doctor is performing to the standard, s/he is supposedly doing all s/he can and treatment is considered adequate, even if that standard of care leaves the patient ill. The difference between our system and UK's (we've seen this in some parts of Canada, as well), is that all we have to do is find the doctor that's willing to test/treat "above" the standard of care and we can get well.
I'm using myself and thyroid as an example, because I know it so well, have actually experienced the "standard of care" issue, and was left ill, because my doctor had achieved the standard of care, meaning the labs he was willing to run, showed me as "normal", even though I was still ill. I had to find a doctor willing to test/treat above the standard, in order to get well. While I am adding one more (inexpensive) test and a (inexpensive) medication to my treatment, it costs less in the long run, because I feel well, so I don't have to keep going to the doctor and getting tests/treatments for individual symptoms, which is what the standard of care promotes.
I would imagine that there are other conditions that may be equally as hard to obtain adequate testing/treatment for, as well. This is what I see from experience.
What happens if our system ends up like that in UK, where they become so inflexible that people are left ill, for lack of simple tests or adequate medication? We already see this with some of our members who are treated by VA, as well as those on Medicaid, because treatment is paid for by the government. They often end up with a multitude of diagnoses and medications that they really don't need, which is actually more expensive because it involves more doctor visits and additional (often expensive) medications.
We all know that, ultimately, we do already pay for those who can't afford care or insurance. That's a "non point".
I know the main article is primarily about preventable death, but what about providing care for those conditions that preventive testing will not find?
The health care system in UK is often held up as an "example" of how efficient a government run system can be. That's all well and good, yet, I see, on a daily basis on the thyroid forum, that in UK, there are a lot of people who can't even get adequate testing and/or certain medications to diagnose/treat a simple thyroid condition. The tests are inexpensive, as is the medication, yet, because they don't fit into the NHS guidelines patients don't have access to them, so they remain ill. This is in spite of many studies, a lot of which are done in UK, that prove that adequate testing/medication could/would be beneficial.
In UK, they have the "standard of care" and no one is allowed to deviate. Even if a patient does find a doctor willing to order specific tests, labs are not allowed to perform them, without special permission from NHS, which is usually withheld. We see a lot of patients who are kept very ill because of this, yet they are offered any number of other tests, antidepressants, etc that they don't need. Many of them have to pay privately, for the care they need; those that can't afford to pay privately, are out of luck.
If we go to such a system, what's to say that we wont' run into the same issues. We also have "standards of care" and if a doctor is performing to the standard, s/he is supposedly doing all s/he can and treatment is considered adequate, even if that standard of care leaves the patient ill. The difference between our system and UK's (we've seen this in some parts of Canada, as well), is that all we have to do is find the doctor that's willing to test/treat "above" the standard of care and we can get well.
I'm using myself and thyroid as an example, because I know it so well, have actually experienced the "standard of care" issue, and was left ill, because my doctor had achieved the standard of care, meaning the labs he was willing to run, showed me as "normal", even though I was still ill. I had to find a doctor willing to test/treat above the standard, in order to get well. While I am adding one more (inexpensive) test and a (inexpensive) medication to my treatment, it costs less in the long run, because I feel well, so I don't have to keep going to the doctor and getting tests/treatments for individual symptoms, which is what the standard of care promotes.
I would imagine that there are other conditions that may be equally as hard to obtain adequate testing/treatment for, as well. This is what I see from experience.
What happens if our system ends up like that in UK, where they become so inflexible that people are left ill, for lack of simple tests or adequate medication? We already see this with some of our members who are treated by VA, as well as those on Medicaid, because treatment is paid for by the government. They often end up with a multitude of diagnoses and medications that they really don't need, which is actually more expensive because it involves more doctor visits and additional (often expensive) medications.
We all know that, ultimately, we do already pay for those who can't afford care or insurance. That's a "non point".
If everyone, across the board (low income, middle income, high income, astronomical income) paid a 0.5% "Universal Healthcare" tax... you could pay for the program.
But again, I fear that the lowest income brackets (mostly minorities), would cry foul if you told them they were going to be taxed for this.
As I said, it's all good and well when 'someone else' is paying for something, but when it's coming out of your own pocket, that's where the fight will be.
I'll agree with you that a 'tax' is the way to pay for it... now all we have to do is distribute said tax evenly amongst the earning Americans in the country.
But again, I fear that the lowest income brackets (mostly minorities), would cry foul if you told them they were going to be taxed for this.
As I said, it's all good and well when 'someone else' is paying for something, but when it's coming out of your own pocket, that's where the fight will be.
I'll agree with you that a 'tax' is the way to pay for it... now all we have to do is distribute said tax evenly amongst the earning Americans in the country.
Well now el, if I had ALL the answers I would not be sitting here would I? It should be a tax just like medicare and be deducted out of the paycheck. Im guessing a percentage would be the fair way to do it. I dont know how other countries do it, adgal could probably provide more insight into that then I can I would imagine.
I never said anything about putting the burden on the one percent, like I said, all for one and one for all. Tax.
I never said anything about putting the burden on the one percent, like I said, all for one and one for all. Tax.
Myth 5: We Just Cannot Afford to Cover Everyone
This myth is founded on the belief that you have to pay more to get more; because the United States already spends too much on healthcare expenditures, the nation cannot afford to cover even more of its citizens. But clearly this logic cannot be entirely sound: every other industrialized nation in the world offers universal coverage, and all accomplish it with lower national health expenditures than the United States. Much of our nation's healthcare money is spent on costs that arise directly from a multipayer system with limited coverage. It is vital to identify these spending sinks to find the funds that will provide for universal coverage. Painless cost control measures reduce costs without a resultant decrease in quality of care. Established targets for painless cost control include providing preventive care, training more generalists, controlling drug prices, decreasing unnecessary procedures, and reducing administrative costs in health insurance.
On average, Americans pay more for the same medications than do patients in other countries.[44,45] This disparity has been defended by the assertion that the United States supports the world by developing more new pharmaceuticals, and therefore these research costs result in higher drug prices. This altruistic rationalization is unfounded: combined, the European nations produce on average the same number of new pharmaceuticals per year as the United States.[1] Drug prices can be lowered by preventing pharmaceutical companies from advertising directly to the public, by increasing use of generic drugs, and by collective bargaining though a centralized healthcare system.
End-of-life extreme care is another area of financial inefficiency. Thirteen percent of Medicare's total funds are spent on healthcare provided during the final 60 days of life. Although we pride ourselves on providing cutting-edge technology to our patients, there is clearly a point where technology no longer provides the best care for our patients' needs. Lower-cost measures that increase the quality of remaining life should take precedence over high-cost measures that only extend quantity not quality of life.
Another potential method of cost-control lies in reducing the number of unnecessary medical procedures performed in the United States. The rate of coronary angioplasty in the United States is 300% the rate in Canada, with no associated increase in life expectancy. In 2002, 26% of all births in the United States were by cesarean section.[46] This rate is twice that seen in the next highest country.
Despite these figures, the cost problem in the United States is not solely a matter of overutilization. Other countries with far lower healthcare expenditures have longer hospital stays, perform more imaging, and prescribe more medications than the United States.[44,45] And so even more significant than overuse is overpricing. The United States spends more on healthcare without providing more services than other countries do. This suggests that the difference in spending is largely attributable to higher prices of goods and services: hospitals are more expensive and patients are treated more intensively.[9]
Higher prices for medical goods and services are generated by the incredible complexity of the US system. Whereas in other countries governments bargain directly with suppliers, in the US health system money flows from patients to providers through a vast network of middlemen. This highly fragmented system weakens buying power and results in overall higher prices of goods.
Real-life lessons on cost control can be gleaned from Taiwan's experience. In 1995 Taiwan transitioned from a US-style system to a single-payer system with universal coverage, similar to the Canadian system. Before the switch in 1995, less than 60% of the population was insured. By 2001, 97% of the population had health coverage.[47] What is remarkable is that this marked expansion in coverage was accomplished with essentially no change in national healthcare expenditures.[47]
It is important to recognize that, in one form or another, we already pay for the health costs of the uninsured. The Institute of Medicine estimates that the value of covering the uninsured is $65 to $130 billion per year.[48] A substantial portion of the cost of universal coverage, approximately half, is already in the system and is being spent by the government on the healthcare costs of the uninsured.[49] It is a matter of redirecting funds to create the greatest good for the most people.
http://www.medscape.com/viewarticle/573877
This myth is founded on the belief that you have to pay more to get more; because the United States already spends too much on healthcare expenditures, the nation cannot afford to cover even more of its citizens. But clearly this logic cannot be entirely sound: every other industrialized nation in the world offers universal coverage, and all accomplish it with lower national health expenditures than the United States. Much of our nation's healthcare money is spent on costs that arise directly from a multipayer system with limited coverage. It is vital to identify these spending sinks to find the funds that will provide for universal coverage. Painless cost control measures reduce costs without a resultant decrease in quality of care. Established targets for painless cost control include providing preventive care, training more generalists, controlling drug prices, decreasing unnecessary procedures, and reducing administrative costs in health insurance.
On average, Americans pay more for the same medications than do patients in other countries.[44,45] This disparity has been defended by the assertion that the United States supports the world by developing more new pharmaceuticals, and therefore these research costs result in higher drug prices. This altruistic rationalization is unfounded: combined, the European nations produce on average the same number of new pharmaceuticals per year as the United States.[1] Drug prices can be lowered by preventing pharmaceutical companies from advertising directly to the public, by increasing use of generic drugs, and by collective bargaining though a centralized healthcare system.
End-of-life extreme care is another area of financial inefficiency. Thirteen percent of Medicare's total funds are spent on healthcare provided during the final 60 days of life. Although we pride ourselves on providing cutting-edge technology to our patients, there is clearly a point where technology no longer provides the best care for our patients' needs. Lower-cost measures that increase the quality of remaining life should take precedence over high-cost measures that only extend quantity not quality of life.
Another potential method of cost-control lies in reducing the number of unnecessary medical procedures performed in the United States. The rate of coronary angioplasty in the United States is 300% the rate in Canada, with no associated increase in life expectancy. In 2002, 26% of all births in the United States were by cesarean section.[46] This rate is twice that seen in the next highest country.
Despite these figures, the cost problem in the United States is not solely a matter of overutilization. Other countries with far lower healthcare expenditures have longer hospital stays, perform more imaging, and prescribe more medications than the United States.[44,45] And so even more significant than overuse is overpricing. The United States spends more on healthcare without providing more services than other countries do. This suggests that the difference in spending is largely attributable to higher prices of goods and services: hospitals are more expensive and patients are treated more intensively.[9]
Higher prices for medical goods and services are generated by the incredible complexity of the US system. Whereas in other countries governments bargain directly with suppliers, in the US health system money flows from patients to providers through a vast network of middlemen. This highly fragmented system weakens buying power and results in overall higher prices of goods.
Real-life lessons on cost control can be gleaned from Taiwan's experience. In 1995 Taiwan transitioned from a US-style system to a single-payer system with universal coverage, similar to the Canadian system. Before the switch in 1995, less than 60% of the population was insured. By 2001, 97% of the population had health coverage.[47] What is remarkable is that this marked expansion in coverage was accomplished with essentially no change in national healthcare expenditures.[47]
It is important to recognize that, in one form or another, we already pay for the health costs of the uninsured. The Institute of Medicine estimates that the value of covering the uninsured is $65 to $130 billion per year.[48] A substantial portion of the cost of universal coverage, approximately half, is already in the system and is being spent by the government on the healthcare costs of the uninsured.[49] It is a matter of redirecting funds to create the greatest good for the most people.
http://www.medscape.com/viewarticle/573877
But again, just WHO is going to be taxed?
Just TRY and convince the 47% of Americans (that don't pay taxes now) to be taxed for this.
I guess what I'm saying is, it's all good and well to say "Taxes will pay for it", but WHO are you going to tax?
You can't put the burden solely on the shoulders of the 1%, because that won't be nearly enough. The middle-class and the lower-class is going to have to contribute as well. But that isn't an option, because the lower-class won't agree to it.
It's all good and well when someone ELSE is paying for it, but when YOU have to pay some, that's where the rubber meets the road.
See what I'm saying?
Just TRY and convince the 47% of Americans (that don't pay taxes now) to be taxed for this.
I guess what I'm saying is, it's all good and well to say "Taxes will pay for it", but WHO are you going to tax?
You can't put the burden solely on the shoulders of the 1%, because that won't be nearly enough. The middle-class and the lower-class is going to have to contribute as well. But that isn't an option, because the lower-class won't agree to it.
It's all good and well when someone ELSE is paying for it, but when YOU have to pay some, that's where the rubber meets the road.
See what I'm saying?
In order to have universal healthcare, it would have to be handled as a tax. As it should be. All for one and one for all so to speak. Shared responsibility.
Healthcare REFORM is something that has been needed for quite some time.
That said, there is NO compromise with the Left on this issue. They want "universal healthcare", and they want it right now. No and's, if's, or but's. Their way or the highway.
And curious... rather than compromise, the left would rather play the martyr and say NO (in which case nothing gets done).
In it's current form, as presented by BO, universal healthcare is unsustainable and unfinanceable. Just WHO do you think is going to pay for it? The 1%??? Even if you too 100% of the money the 1% earn, you'd fall short of financing universal healthcare.
Financing of healthcare, on a national level, will take comprehensive tax reform, all the way up and down the income tree. From the lowest earners, to the highest earners.
Tell me, you guys on the Left... in order to get a universal healthcare system in place, would you be willing to tax the 47% of Americans that currently pay ZERO income-tax? If so, this program is EASILY fundable.
I seriously doubt you'll concede that point, and have the "poor" pay taxes, so it's moot.
Or what about a tax increase on the middle class to pay for it? How about that?
But no... the 1% can foot the bill, right?
That said, there is NO compromise with the Left on this issue. They want "universal healthcare", and they want it right now. No and's, if's, or but's. Their way or the highway.
And curious... rather than compromise, the left would rather play the martyr and say NO (in which case nothing gets done).
In it's current form, as presented by BO, universal healthcare is unsustainable and unfinanceable. Just WHO do you think is going to pay for it? The 1%??? Even if you too 100% of the money the 1% earn, you'd fall short of financing universal healthcare.
Financing of healthcare, on a national level, will take comprehensive tax reform, all the way up and down the income tree. From the lowest earners, to the highest earners.
Tell me, you guys on the Left... in order to get a universal healthcare system in place, would you be willing to tax the 47% of Americans that currently pay ZERO income-tax? If so, this program is EASILY fundable.
I seriously doubt you'll concede that point, and have the "poor" pay taxes, so it's moot.
Or what about a tax increase on the middle class to pay for it? How about that?
But no... the 1% can foot the bill, right?
Well, I don't think it was meant that way. I mean, nothing wrong with your hospitals and Dr.s'. I'm sure you have the bad, the good and the exceptional just like everywhere else. However, the actual system is not necessarily effective, or at least not for all. It just isn't and I don't think that can be disputed.
improvement in preventing deaths that could have been avoided with timely and effective healthcare, also known as "amenable mortality," according to a study released today.
See the word 'effective' healthcare, that can be seen as putting down Dr's and hospitals.
See the word 'effective' healthcare, that can be seen as putting down Dr's and hospitals.
Well, I guess you didn't absorb anything from the article - or perhaps you didn't read it.
There was nothing that remotely put down our doctors or our hospitals.
It was all about access and affordability - which I thought was quite obvious.
This latest excerpt was advancing universal coverage and a single-payer plan.
There was nothing that remotely put down our doctors or our hospitals.
It was all about access and affordability - which I thought was quite obvious.
This latest excerpt was advancing universal coverage and a single-payer plan.
Do you think this information is putting down Dr;s or hospitals? Or even the US? I'm not reading it that way at all.
Look, the US is one of the best countries in the world. And I totally understand that any implication otherwise could make you defensive. Heck, I am a proud Canadian and will also defend my country. However, I also recognize it is less then perfect and that we here can learn from what other countries are doing. I think to not do that sets us backwards as opposed to propelling us forward.
You are clearly a proud American. That is fantastic...you should be. There is much to be proud of. But that doesn't mean that they way you guys do everything is perfect and perhaps there are things to be learned from the way others do them. It's not an attack at all.
Look, the US is one of the best countries in the world. And I totally understand that any implication otherwise could make you defensive. Heck, I am a proud Canadian and will also defend my country. However, I also recognize it is less then perfect and that we here can learn from what other countries are doing. I think to not do that sets us backwards as opposed to propelling us forward.
You are clearly a proud American. That is fantastic...you should be. There is much to be proud of. But that doesn't mean that they way you guys do everything is perfect and perhaps there are things to be learned from the way others do them. It's not an attack at all.
This article is not clear enough to make an informed decision one way or another. What if this is Dr's fault? Or patient fault?
medscape issues no actual facts in this article. If they want to bash America fine they can do what they want but I am not doing to put down Dr's or hospitals like other like to do.
medscape issues no actual facts in this article. If they want to bash America fine they can do what they want but I am not doing to put down Dr's or hospitals like other like to do.
Abstract and Introduction
Myth 1: The US Healthcare System Is the Best in the World
Myth 2: There Will Always Be a Certain Segment of the Population That Remains Uninsured
Myth 3: The Uninsured Have Equal Access to Medical Care Through the Emergency Room
Myth 4: A Free Market Is the Best Way to Get the Highest Quality Health Insurance for the Lowest Cost
Myth 5: We Just Cannot Afford to Cover Everyone
"...Conclusion
In the effort to ameliorate the problems with our healthcare system, recently several programs for reform have been launched. Although well intentioned, these proposals have limited ability to affect change. For example, employer-mandated plans, such as the one recently instituted in Massachusetts, require individuals to purchase private sector insurance coverage. Pretax dollars are used to purchase policies, and a small portion of the cost is covered by an employer contribution. Although this proposal forces individuals to purchase insurance (under fear of tax penalties), it does not guarantee the existence of affordable plans. Serious concerns exist over the long-term financial viability of the program. As enrollment costs continue to rise, insurance companies can give the illusion of affordability by excluding services. Forcing consumers to purchase stripped-down plans does little to improve the quality of healthcare.
Another attempt at reform is through the creation of health savings accounts. Individuals can shelter part of their income from taxes by making deposits in such accounts and using these funds toward medical bills. By definition such programs favor individuals who are in higher tax brackets since they have more to gain from diverting pretax dollars. Obviously, individuals in these higher tax strata are not the appropriate targets for healthcare reform.
Adding graduated increases in coverage, although politically more palatable, has largely failed to impact the lives of the uninsured. Incremental plans such as the State Children's Health Insurance Program (SCHIP) are worthwhile but have failed to defray the ever-rising number of uninsured. Although SCHIP is responsible for a modest decrease in the number of uninsured children by 25% from 1996 to 2005, it has come at higher costs than anticipated.[50] The program is facing funding shortfalls in several states.
In the end, these paths at reform suffer from the same fatal flaw: they leave in place the existence of a multipayer, for-profit system. It is this infrastructure that is the Achilles' heel of the United States healthcare system. The crux of effective reform is the development of a simple, streamlined system of universal coverage by a single-payer.
Financial savings and good patient care flow naturally from universal coverage by a single-payer. All individuals would have access to cost-saving preventive care through generalists. Fewer people would have to rely on inefficient and expensive emergency departments for their primary care. A single-payer system maintains the bargaining power necessary to contract with pharmaceutical companies to lower the costs of medications and biotechnology. In addition, evidence-based utilization standards could be defined to guide selection of medications and procedures.
The largest source of savings in reforming our system would come from cutting the administrative costs associated with multiple private insurance carriers. Competition between for-profit insurance companies drives cost-shifting and ever-increasing out-of-pocket payments for patients. As patients' costs go up, more and more under-insured people are unable to afford healthcare. When many insurance carriers exist, they must compete for patients, and this competition is financed by massive administrative marketing costs. Many experts believe that universal coverage would likely pay for itself by creating a more efficient system.
Universal coverage and a single-payer plan could be created in different ways. Specific proposals have been published by various groups.[51] Universal coverage does not necessarily mean Medicare for all. Certainly, universal coverage could be provided by a single-payer government-run program as in Canada or the United Kingdom. Although this is the most straightforward approach, other countries have developed successful systems composed of private companies coupled with governmental organizations. For example, most of the German population receives its health insurance through sickness funds, which are nonprofit, closely regulated semiprivate organizations. The key is that these companies are required to cover a broad range of medical services and are prohibited from excluding individuals due to illness. Even in countries like Japan and Germany where health insurance is job-linked, times of unemployment, changes in workplace, and periods of self-employment do not create interruptions in healthcare coverage.
Finally, universal coverage and a single-payer plan do not exclude the option for purchasing additional private insurance. Supplemental insurance could exist that would cover nonessential medical care such as cosmetic surgery, private nursing, or even pay for expedited essential care. A new healthcare plan could be tailored to the preferences of the American population.
Myths have the ability to perpetuate themselves in the absence of supporting evidence. The myths concerning the state of the US healthcare system need to be actively dispelled-quickly. There are already overwhelming data showing the dangers of uninsurance and the benefits of universal coverage. There is no more deliberation that needs to be done. We must instead move on to making universal coverage a reality.
From: Fact and Fiction: Debunking Myths in the US Healthcare System
Posted: 06/06/2008
http://www.medscape.com/viewarticle/573877
Myth 1: The US Healthcare System Is the Best in the World
Myth 2: There Will Always Be a Certain Segment of the Population That Remains Uninsured
Myth 3: The Uninsured Have Equal Access to Medical Care Through the Emergency Room
Myth 4: A Free Market Is the Best Way to Get the Highest Quality Health Insurance for the Lowest Cost
Myth 5: We Just Cannot Afford to Cover Everyone
"...Conclusion
In the effort to ameliorate the problems with our healthcare system, recently several programs for reform have been launched. Although well intentioned, these proposals have limited ability to affect change. For example, employer-mandated plans, such as the one recently instituted in Massachusetts, require individuals to purchase private sector insurance coverage. Pretax dollars are used to purchase policies, and a small portion of the cost is covered by an employer contribution. Although this proposal forces individuals to purchase insurance (under fear of tax penalties), it does not guarantee the existence of affordable plans. Serious concerns exist over the long-term financial viability of the program. As enrollment costs continue to rise, insurance companies can give the illusion of affordability by excluding services. Forcing consumers to purchase stripped-down plans does little to improve the quality of healthcare.
Another attempt at reform is through the creation of health savings accounts. Individuals can shelter part of their income from taxes by making deposits in such accounts and using these funds toward medical bills. By definition such programs favor individuals who are in higher tax brackets since they have more to gain from diverting pretax dollars. Obviously, individuals in these higher tax strata are not the appropriate targets for healthcare reform.
Adding graduated increases in coverage, although politically more palatable, has largely failed to impact the lives of the uninsured. Incremental plans such as the State Children's Health Insurance Program (SCHIP) are worthwhile but have failed to defray the ever-rising number of uninsured. Although SCHIP is responsible for a modest decrease in the number of uninsured children by 25% from 1996 to 2005, it has come at higher costs than anticipated.[50] The program is facing funding shortfalls in several states.
In the end, these paths at reform suffer from the same fatal flaw: they leave in place the existence of a multipayer, for-profit system. It is this infrastructure that is the Achilles' heel of the United States healthcare system. The crux of effective reform is the development of a simple, streamlined system of universal coverage by a single-payer.
Financial savings and good patient care flow naturally from universal coverage by a single-payer. All individuals would have access to cost-saving preventive care through generalists. Fewer people would have to rely on inefficient and expensive emergency departments for their primary care. A single-payer system maintains the bargaining power necessary to contract with pharmaceutical companies to lower the costs of medications and biotechnology. In addition, evidence-based utilization standards could be defined to guide selection of medications and procedures.
The largest source of savings in reforming our system would come from cutting the administrative costs associated with multiple private insurance carriers. Competition between for-profit insurance companies drives cost-shifting and ever-increasing out-of-pocket payments for patients. As patients' costs go up, more and more under-insured people are unable to afford healthcare. When many insurance carriers exist, they must compete for patients, and this competition is financed by massive administrative marketing costs. Many experts believe that universal coverage would likely pay for itself by creating a more efficient system.
Universal coverage and a single-payer plan could be created in different ways. Specific proposals have been published by various groups.[51] Universal coverage does not necessarily mean Medicare for all. Certainly, universal coverage could be provided by a single-payer government-run program as in Canada or the United Kingdom. Although this is the most straightforward approach, other countries have developed successful systems composed of private companies coupled with governmental organizations. For example, most of the German population receives its health insurance through sickness funds, which are nonprofit, closely regulated semiprivate organizations. The key is that these companies are required to cover a broad range of medical services and are prohibited from excluding individuals due to illness. Even in countries like Japan and Germany where health insurance is job-linked, times of unemployment, changes in workplace, and periods of self-employment do not create interruptions in healthcare coverage.
Finally, universal coverage and a single-payer plan do not exclude the option for purchasing additional private insurance. Supplemental insurance could exist that would cover nonessential medical care such as cosmetic surgery, private nursing, or even pay for expedited essential care. A new healthcare plan could be tailored to the preferences of the American population.
Myths have the ability to perpetuate themselves in the absence of supporting evidence. The myths concerning the state of the US healthcare system need to be actively dispelled-quickly. There are already overwhelming data showing the dangers of uninsurance and the benefits of universal coverage. There is no more deliberation that needs to be done. We must instead move on to making universal coverage a reality.
From: Fact and Fiction: Debunking Myths in the US Healthcare System
Posted: 06/06/2008
http://www.medscape.com/viewarticle/573877
I still maintain that a country cannot be a healthy one if it's citizens are not given access to health care. I think it's a huge huge big deal. And emergency health care is not enough - so much more expensive and often too late. Preventative is the key, at least in my opinion.
At a time when everyone is squalling about the insolvency of medicare, you would think this would be an obvious solution. So what happens when they cut all these people off and reduce medicaid to boot? I wonder if anyone ever thinks of the results.
We hear how great our health care is by people who've never left the country.
When I told my dentist in Bangkok about how I could not get pre-transplant testing done without insurance, he looked shocked. He said, " we don't let people just die in our country. We have different levels of hospitals, but we don't deny them care."
This was proven to me when a homeless man who I'd passed for weeks, suddenly wasn't there. Asking around, I discovered, he's been taken to the hospital for care. I saw him again, before we left.
It's sad to think so-called third world countries do a better job of caring for their people, than we do.
Thanks for posting this article.
When I told my dentist in Bangkok about how I could not get pre-transplant testing done without insurance, he looked shocked. He said, " we don't let people just die in our country. We have different levels of hospitals, but we don't deny them care."
This was proven to me when a homeless man who I'd passed for weeks, suddenly wasn't there. Asking around, I discovered, he's been taken to the hospital for care. I saw him again, before we left.
It's sad to think so-called third world countries do a better job of caring for their people, than we do.
Thanks for posting this article.
I agree completely.
There isn't much room for argument here, in my opinion. We always hear how great our healthcare system is and it is great if you can afford a good insurance plan. But, for those unable to afford health insurance our system has not been good at all and that fact is reflected in this study and in many others like it.
There isn't much room for argument here, in my opinion. We always hear how great our healthcare system is and it is great if you can afford a good insurance plan. But, for those unable to afford health insurance our system has not been good at all and that fact is reflected in this study and in many others like it.
Good article. I realize that people are resistant to change. I also realize that their number one concern if how much of that insurance they have to personally pay and how big the deductables and co pays are. Lately you are getting less coverage for more money.
Second only to jobs in America, healthcare is the biggest concern. If we do nothing, we continue to deteriorate until we HAVE to do something and that day is here. I say universal healthcare is the answer.
Second only to jobs in America, healthcare is the biggest concern. If we do nothing, we continue to deteriorate until we HAVE to do something and that day is here. I say universal healthcare is the answer.
Your behind us as well, particularly in infant mortality rates. For me, it's another argument as to why I prefer our health care system over yours. Yes, I know, in the US anyone can seek emergency room treatment. However, not only is it far more expensive to do it that way (and I'm assuming tax payers pick up the cost for that), it eliminates the ability to seek preventative treatment. We all know that the earlier many diseases and illness' are caught, the more effective the ability to treat is....and the less expensive. I still think it is in a countries best interest that everyone have access to good health care, not just those that can afford it.
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