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OT- why socialized medicine isn’t the answe
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this is stupid, somebody could've at least ordered an xray or CT and seen the tumor.
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They didnt. They declines repeat requests for mri from kid and family. Kaiser works by denying care. She had red flags for the disease.
This is n=1.
Check out C-section rates, USA vs. Scandinavia
Which Countries Have The Highest Caesarean Section Rates? [Infographic]
Also, US has highest maternal mortality rates among developed countries:
U.S. has highest maternal death rate among developed countries
Absolutely frightening.
Would not want to be pregnant here in the U.S....
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The article also commented on average times to start treatment for all NHS cancer patients being approximately twice as long as in the US.
And socioeconomic factors of ghetto moms on drugs, and their lack of compliance, makes a major impact on maternal mortality in the US, more than the medicine itself.
I agree.
Lots of ghetto moms on drugs and lack of compliance in other developed countries though, right?
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C section rate taken alone is not a health measure.
You also have to compare maternal age and pre-pregnancy health.
Here's a hint, we are much worse at both of those than most other places
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Hi
Exactly. It’s complicated. You have to understudy everything, not just the simple sound bite.
I agree.
So the reason why maternal age and pre pregnancy health is terrible is lack of universal health care.
I mean come on, it's all over the news that family planning clinics will no longer get Federal funding, planned Parenthood is getting hit, etc.
So the increased maternal mortality rate and c section rates are indirectly tied in poor pre pregnancy health, etc.
Same thing with CABGs, etc. Countries like the UK understand that giving everyone free healthcare means everyone has access to GP which means everyone has access to getting a HBa1C and therefore getting on Metformin, lifestyle education, etc. Instead of here where patients get no healthcare until they have a 3 vessel clot and end up having a 100k CABG...
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The health department does free visits for birth control, and there are a lot more of them than Planned Parenthood's.
Primary Care is inexpensive. Worse case, lots of FQHCs out there.
But if you talk to the docs that work there, many of the patients who get essentially free care still have terrible numbers because they just don't care.
Would universal health Care make things some better? Maybe, but it's hardly a pancea.
US Burden of Diseases, Injuries, and Disease Risk Factors, 1990-2016
Check out this article published couple months ago in JAMA.
There are parts of life Kentucky where life expectancy is 70...
India has an overall life expectancy of 68..
Too much disparity in our healthcare. Sure, life and health is good if you are making 6 figures and living in the Upper East Side, but...
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Check out this article published couple months ago in JAMA.
There are parts of life Kentucky where life expectancy is 70...
India has an overall life expectancy of 68..
Too much disparity in our healthcare. Sure, life and health is good if you are making 6 figures and living in the Upper East Side, but...
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Dude, I'm primary care - you don't have to tell me any of this.
But I'm also a guy who used to run a clinic that was like 80% low-income patients. Ran my own pharmacy where most DM/HTN meds were less than $2/month. I still have patients who didn't take their meds, still ate at Bojangles.
My favorite was a security guard. Had state employee health plan, the best plan in the state. Had 3 strokes. I saw him every week for 6 months. Never got his diabetes under control because he refused to stop eating at Bojangles twice a day.
No amount of socialized medicine is going to fix that.
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How many people here wait for care for months or years because they can’t afford it?
Dude, you're missing my point.
I never said socialized medicine is Utopia. Universal Health Care, however, guarantees access for all. At the end of the day it's up to you to see your doctor, whether you're in Arkansas or Manchester or Stockholm. Socialism isn't dictatorship. You still have the freedom to make your own choices. If you want to eat 10 donuts everyday in Canada or England, no one will stop you.
But at least in the rest of the developed world, if you have back pain and need actively want help, you will get it. Except here, where you have to jump through 3 hoops to get an epidural "approved".
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That was my point exactly. The medical knowledge of the physicians and available tech is just as good or better in America than Europe. The patient demographics are quite different here.
We have far more ghetto moms and rural billy bobs that both have the worst personal lifestyles imaginable and don’t follow any doctors orders. When those patients die earlier, it’s their fault not their doctors.
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Absolutely right! But, there is a very vocal group of individuals on this forum who advocate for socialized pain medicine.
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Well and I'm not so blind as to admit that it might have benefits in some areas. Don't y'all routinely bemoan that fact that no insurance pays for stuff like pain psych? But, of course, the problem is that if we went single payer and the payment authority decided not to pay for it than that's that.
For most of primary care (outside of inhalers), I can find cheap ways to do things such that even the uninsured can get adequate care. Specialty care is often another ball game.
Do you honestly think that socioeconomic status correlates with healthy lifestyle? Yes, obesity is more prevalent in poorer income people because unhealthy food is cheaper (ie. Fast food). But if they had decent insurance, saw their doctor and our country provides healthier, cheaper food alternatives (this is a separate discussion), guess what, our insurance premiums go down and we are not forking out $$$ for their CABG or Fusion because of obesity.
I agree with your statement that "rural Billy bobs" can be pathetic in their lifestyle. No doubt. But I've also come across a lot of Billy bobs that actually want help, but can't get it because they have terrible insurance, etc.
And vice versa. A lot of $$ ibankers that will not listen to their doc about lifestyle choices.
We can both cherry pick patients from both socioeconomic levels to prove our point. I get it, socialized is not perfect. But at least in universal healthcare, anyone human that wants help will get it.
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Unless the government decides that help isn't cost effective.
If you're super bored, read this: A radically patient-centered proposal to fix health care in America
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socialized pain medicine does not have to be 1. epidurals or other ill defined procedures 2. opioids opioids opioids 3. disability payments. I would prefer the govt dole out 1. exercise and free yoga pants (size 10 and under, of course) 2. cognitive behavioral therapy/mental health therapy 3. return to work and improve ones socioeconomic status.
socioeconomic class does correlate with longevity, in case anyone was wondering....
Trend in life expectancy at birth and at age 65 by socio-economic position based on the National Statistics Socio-economic Classification, England and Wales - Office for National Statistics (yes, it is for Wales, but nevertheless...)
Trends in Mortality Differentials and Life Expectancy for Male Social Security-Covered Workers, by Socioeconomic Status (and yes, no prediction for the future, but 5.8 additional years if you are in upper SEC)
Research ties economic inequality to gap in life expectancy (2.8 years in this article)
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The one from Wales actually is pretty interesting, because if memory serves they're covered by the NHS...
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They are. So it disproves the left wing theory that lower life expectancy being about money and more about Billy bob and ghetto mom being lazy, dumb, or just having learned helplessness from the socialistic nanny state.
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did you read the article? even click on it once?
maybe it was too confusing for you. to summarize, they looked at early 80s and 2007-2011. there were gains in average life expectancy between the 2 time eras for all SEC, but those in the higher managerial SEC had a much greater increase in life expectancy than those in the lower SEC.
maybe it was too confusing for you. to summarize, they looked at early 80s and 2007-2011. there were gains in average life expectancy between the 2 time eras for all SEC, but those in the higher managerial SEC had a much greater increase in life expectancy than those in the lower SEC.
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That wouldn't be my interpretation at all, actually.
Mine is that socialized medicine doesn't narrow the SES life expectancy gap.
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Sorry, that’s what I’m actually trying to say.
Free healthcare can’t make people eat healthy, exercise, follow good sleep hygiene, or be smart enough to comply with physicians orders.
Educated, wealthier patients tend do those things more often than less wealthy people, which is independent of any healthcare system.
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Honestly, I'd wager its almost entirely due to diet. Because rich people probably ignore us more, or at least that's been my experience. Often rich/poor see the same doctors. No amount of money makes Metformin work better. The biggest difference is diet. There's some, admittedly weak, research that tends to back this up.
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Agree that diet is huge.
Still think rich tend to also get more cardiovascular exercise than the poor, who are stoned on the couch or a poor but reasonable person just too exhausted from working 2 minimum wage jobs to do so. The second part also ties into regular quality sleep which has significant health benefits as well.
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Which is why the endpoint isn't "equal" healthcare, but also "equal" wealth, education, housing...
This Wales study that Ducttape posted confirms that socialized medicine narrows SES life expectancy.
First of all, I hope everyone understands that the NHS in the UK is 4 separate systems, meaning 4 different gov'ts are running it, with 4 separate budgets:
UK health systems
Now it is a FACT that Wales has much worse health than England:
Warning as most adults overweight
"Dr Haboubi, who is also chair of the National Obesity Forum for Wales and runs the country's only NHS-funded obesity clinic, said last month that the problem was "huge, massive, worse than England, worse than anywhere in the UK and among the worst in the western world, I would argue". "The worst is probably the USA but we're certainly not far behind," he said."
I know people like to say that the U.S has much worse "socioeconomic issues" than other countries. Well clearly obesity in Wales is close to what the U.S sees.
Health in Wales | Child obesity rates higher in Wales than in England
"A report published on 31 July 2014 shows that over a quarter of five year olds in Wales have an unhealthy body mass index compared to just over a fifth of five year olds in England."
But thanks to socialized healthcare, NHS Wales = NHS England for the most part:
How does health in Wales compare?
"NHS Wales 'no better or worse' than rest of UK, says OECD"
National life tables, UK - Office for National Statistics
Life Expectancy in Wales: 78
Life Expectancy in England: 79
Now without NHS Wales/universal healthcare, obviously I can only speculate, but I think Life Expectancy in Wales would be a few years lower, like in the low to mid 70s.
So how was Wales able to keep up with England, despite having worse health?
The gov't decided to step it up on healthcare NHS Wales funding:
Reasons to move to Wales? Well there's the healthcare, the house
"The healthcare is better, for a start. The NHS in Wales spends more per person than in England, just over £2,000 compared with £1,900. Prescriptions are free, too, while in England there is a £7.65 charge. "
(Yes, you read that right. free prescriptions. No need to battle with the pharmacy or insurance company for a prior auth for cymbalta).
Keep in mind, 10 years ago in Wales, funding was cut badly for the NHS. And with healthcare outcomes getting a hit, Wales gov't decided to crank up the $$$ spending, which then helped bridge the gap between England and Wales.
Reality Check: Is NHS funding worse in Wales?
"Between 2009-10 and 2012-13, health spending was cut in real terms by about 3.6% in Wales. During the same period, the English health budget was increasing, albeit at under 1% a year in real terms, which was less than the average yearly growth of 4% seen under the previous Labour government."
"However, since 2012-13, health spending in Wales has increased from £6bn to close to £7bn in 2016-17. The Wales Audit Office notes an average 2.9% annual increase in real terms during this period."
Now don't get me wrong, NHS Wales is FAR from perfect.
"In 2016, England performed better in key diagnosis areas such as hernia, pneumonia and heart disease, while waiting times for important procedures are shorter than in Wales. Welsh patients have to wait three times as long for hip operations, for example.
But on other key procedures such as heart bypasses and kidney transplants, the waits were shorter. Cancer diagnoses were similar in the two countries."
But overall, its comparable to England in outcomes.
So in summary, Wales has poorer health generally, but relatively equal health outcomes, thanks to NHS gov't funded healthcare.
So if we apply this to the U.S, we can help equalize healthcare outcomes between states.
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That's true, ****ty healthcare for all would make it equal...
I definitely agree that diet plays a huge role.
There is mixed evidence if healthier diet is more expensive or cheaper:
https://www.hsph.harvard.edu/news/press-releases/healthy-vs-unhealthy-diet-costs-1-50-more/
"The healthiest diets cost about $1.50 more per day than the least healthy diets"
But....
Healthy food is cheaper than junk food, new study says
"Pound for pound, healthy food is cheaper than junk food, according to new research from the U.K."
My argument is that CONVENIENT healthy food is much more expensive than unhealthy food. Its much easier and cheaper to go through a drive through and get 3 Junior Cheeseburgers for $3 than a Wendy's salad for $7. If you want to feed 3 kids, I'll get 9 Junior Cheeseburgers ($9) vs. 3 salads ($21) and save the $12.
So now if everyone had insurance, at least everyone has access to see a PMD. And the PMD can educate the patient on healthier eating, telling them to stop going to fast food, cook food more, go for a walk, exercise, etc.
Of course, I'm sure a lot of patients will shrug off this advice. But a lot also listen...even if only 1 out of 10 patients listen, thats a victory for the country (10%, or potentially 1 million avoiding a CABG or CVA or STEMI, assuming roughly 50 million don't have insurance, and 10 million who get it, see a doctor). Conservative values I think, but whatever.
90% of patients are shocked when I say the AHA recommends 150 minutes a week of low intensity exercise or 75 minutes of high intensity.
Also shocked when I tell them that lying in bed staring at tv until 11pm can impact their sleep hygiene.
And with Universal Healthcare, I could even easily refer patients to a registered dietitician for more expertise on healthy eating. But yes, this is up to the patient. I will offer it, its up to the patient to pursue it. But those who do pursue it, will benefit, and thanks to universal access, benefited because they were given the chance.
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Which firms profit most from America’s health-care system
"The most controversial source of excess spending, though, is rent-seeking by health-care firms. This is when companies extract outsize profits relative to the capital they deploy and risks they take. Schumpeter has estimated the scale of gouging across the health-care system. Although it does not explain the vast bulk of America’s overspending, the sums are big by any other standard, with health-care firms making excess profits of $65bn a year. Surprisingly, the worst offenders are not pharmaceutical firms but an army of corporate health-care middlemen."
Also, can't forget SOSd(f). If you're sucking of the SOSd(f), you've basically got blood on your hands...
"The most controversial source of excess spending, though, is rent-seeking by health-care firms. This is when companies extract outsize profits relative to the capital they deploy and risks they take. Schumpeter has estimated the scale of gouging across the health-care system. Although it does not explain the vast bulk of America’s overspending, the sums are big by any other standard, with health-care firms making excess profits of $65bn a year. Surprisingly, the worst offenders are not pharmaceutical firms but an army of corporate health-care middlemen."
Also, can't forget SOSd(f). If you're sucking of the SOSd(f), you've basically got blood on your hands...
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Absolutely. Diet, exercise, smoking, etoh, drugs, etc are more a measure of our culture than our national healthcare system.
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Why Your Health Insurer Doesn't Care About Your Big Bills
"ProPublica and NPR are examining the bewildering, sometimes enraging ways the health insurance industry works by taking an inside look at the games, deals and incentives that often result in higher costs, delays in care, or denials of treatment. The misunderstood relationship between insurers and hospitals is a good place to start."
"ProPublica and NPR are examining the bewildering, sometimes enraging ways the health insurance industry works by taking an inside look at the games, deals and incentives that often result in higher costs, delays in care, or denials of treatment. The misunderstood relationship between insurers and hospitals is a good place to start."
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"As bad as NYU is, Aetna is equally culpable because Aetna's job was to be the checks and balances and to be my advocate," said Michael Frank, seen at his home in Port Chester, N.Y."
The guy is an idiot, to think an health insurance is "to be my advocate"...LOL
The guy is an idiot, to think an health insurance is "to be my advocate"...LOL
