I don't see any single payor systems in the world making more medical innovations than private ones (i.e. The US).
lol, well it's hard to draw any distinctions when you only have one example of a developed country without universal healthcare huh?
🙂
Is America innovative because of private insurance? No. If anything, quality research comes from our robust university and medical school system, which are both private and public in funding and operation. Industry does do research, albeit biased or buried when they don't like the results. Economic opportunity does play a larger role on the D end of R&D, but economic opportunities would not decrease with universal government health coverage, with the exception of a shift away from the private insurance industry which has very little to do with innovation.
We have the world's best medical care, admittedly to those who have access.
It depends on what you're looking at. On one hand, we have among the highest cancer survival rates for breast and prostate cancer, but Japan and France do better on some other ones. On the other hand, we also have among the highest rate of medical error.
However it's not like we turn people away who are in an emergency. The only stories I've ever heard of people being turned away from a doctor is for a regular checkup with a PCP (they have medicare, medicaid or no insurance) or for long term cancer treatment. This needs to change, but I have a feeling it would stifle the innovation we have in this country because someone needs to pay for it.
How do you figure that?
Medicare, or a single payor (which would likely be reimbursed something similar to what was proposed for the public option, Medicare + 5%), would not pay enough to fund these innovations. I don't have a source, but if other single payor countries aren't innovating like the US, there has to be a reason. Don't get me wrong, someone people still will - as they do in those countries. But defintely not at the same rate as what the US is producing.
Has to be a reason? Sure. Is it the robustness of private insurance? Definitely not. Could it have to do with more economic opportunities in America and that we have a huge number of research institutions? Possibly.
And it's not just "innovation" that we want. A new technology that does not improve clinical outcomes is mostly a waste of money. If the government were the main purchaser, and if the government had an evidence-based formulary, then that could put pressure on companies to develop drugs that are actually new and useful, and not stuff like Caduet. It's not that Caduet is bad, it was just a waste of time and resources to develop something that is a combination of two medications you would be taking at the same time anyway and spending money to market it instead of spending that money on developing something new. Our system favors marketing over innovation.
Statistics such as infant mortality are pretty bad to use to try to estimate how good a healthcare system is. From what I understand, the US is low in the infant mortality ranking because physicians here often try to save babies that other countries don't. In some other countries, they will just label a very premature baby as just a miscarriage/abortion and don't even count it in the infant mortality statistic. With such variability on what countries report, how can you use something like that to compare healthcare systems?
That can't be the whole explanation, though it is addressed in my next source below. In 1960, America was 12th in infant mortality, in 1990 we were 23rd, in 2004 we were 29th. The 2004 infant mortality for African Americans was 13.6/1000, while the figure for Whites was 5.8/1000. While pre-term babies are a significant contributor to infant mortality, the rate of pre-term babies by race does not account for the difference between Blacks and Whites.
http://www.cdc.gov/nchs/data/databriefs/db09.htm
Meanwhile, neighborhood health centers have been demonstrated to significantly reduce African American infant mortality.
http://books.google.com/books?id=zXSou7qnv_MC&pg=PA136&dq=community+health+centers+reduced+infant+mortality#v=onepage&q=community%20health%20centers%20reduced%20infant%20mortality&f=false
The infant mortality differential between Blacks and Whites cannot be completely attributed to the proportion of babies we try to save. Prenatal care seems to play a significant role.
The fact remains that we cannot easily compare countries, but it is likely that our figures would be much better with wider access to care.
Life expectancy is also a poor choice. Our society is pretty unhealthy. What percentage of Americans are obese? Diabetic? With hypertension and CV disease? All these problems are a cultural/societal problem. They are NOT solely the fault of the healthcare system. Even with all these, I think I read in a different thread that if you take away stuff like trauma and MVAs, the US actually has the highest life expectancy. I think this was in the "The Truth about healthcare statistics" thread where Instatewaiter points out the flaws of the WHO rankings.
One way to account for that and look more at the role of healthcare is to look at life expectancy upon achieving 65. IIRC America's position was, indeed, improved using that criteria (e.g. better than the UK and Germany) but still worse than Canada, Japan, France, etc.
I am an attorney who has represented hundreds of consumer bankruptcy clients. The 60 percent figure is way too high. While the percentage of filers having medical bills may approach that figure, the percentage of bankruptcies actually CAUSED by medical expenses is probably 20 percent or less.
The biggest cause, by far: overextension on credit cards.
I have not looked at the statistics in depth, but you are taking a very wrongheaded approach to refuting that stat. Your personal experience in the field is not necessarily reflective of the overall population.
Then again, it also misses the point. How many personal bankruptcies from healthcare costs are acceptable?
mega, how do you feel about drug innovation then? it seems like in a single payer system, for better or worse, bringing costs down will be the primary objective. then would an expensive but very crucial drug like herceptin not be considered?
There is no reason that less cost-effective drugs could not be paid for out of pocket or by supplemental insurance, such as they have in France. Canada is the only country where redundant supplemental insurance is disallowed, but supplemental insurance for that which is not covered by the government is still significant there. People will still be willing to pay whatever they can come up with to stay alive, but with the government being a huge organized buyer of all basic care, that can bring down costs via sheer bargaining power and savings on administrative overhead. It is also true that it does not have to be a question of all or nothing. For example in France they charge different rates of coinsurance based upon the strength of evidence that a drug is effective.
and what are the incentives for drug companies to produce more drugs that save lives?
That's more an issue of regulation. Currently, the drug companies are basically customers of the FDA, which charges them user fees to expedite the process and minimize patent usage during trials. (which makes me wonder, wtf are they thinking making the patent clock start ticking while the drugs are still in trials?) The drug companies are allowed to compare "new" drugs to placebos, instead of existing treatment at standard doses. Thus they have less need to take the risk involved in developing new drugs, at least not as often as they would if me-too drugs that offer no extra clinical benefit to any population versus existing rx were not approved.
the cancer survival rate in america is signficantly higher than in canada, and i'd attribute that to our cutting-edge drugs.
Cutting-edge drugs? Are they not available in these other countries? I've never seen what you said before so proof would be helpful.
places like europe and canada can freeload off of our innovative drugs and get generic versions of it to keep their costs down, although their costs are also skyrocketing anyways. but when america becomes a single payer system, who will innovate? will the NIH produce drugs? i've never heard of one drug produced through the NIH, only very necessary but preliminary scientific background.
Um, yeah, note that not all of these "innovative" companies are even American. In fact, many of the large ones are in, gasp, countries with socialized medicine!
😱 http://en.wikipedia.org/wiki/List_of_pharmaceutical_companies
Do you mean scapegoat?
