Sicko: concerns about US medicine

[Gut Shot]

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Thanks, Gut Shot, for sharing all those great links!

You're welcome.

 

[gujuDoc]

You can't prevent people from eating McDonalds 3 times a day. The best free healthcare in the world can't prevent our obesity problem due to poor diet and lack of exercise.

The breakdown here is at a very basic level.. personal responsibility for your own well-being.Taxing the middle-class isn't going to solve the health crisis that people burden themself with.

HOW TRUE!!!! I wrote a long response to one of the posts thinking about this exact issue but then decided not to hit submit.

But this is right on. I really hate it when a poor person says they can't afford to get vegetables or healthy food for their kid. If they can afford to go to mcdonalds 3 times a day they can damn well afford a few vegetables and fruits. You don't need to make a gormet meal for your kids, but you should be able to make things that are somewhat healthy or if you do feel the need to go to mcdonalds get their salads rather then very greased up fried foods.

Same thing with smokers, and alcohol abusers, and overeating in general(not just fastfood but people like my father who refuses to take personal responsibility for his health).

The sad thing too is that even if you try to educate many people on good health practices, they still don't give a damn and do whatever suits them only.

 

[gujuDoc]

Its true that it's a great thing that our heathcare systems problems have been discussed recently - but I really hate giving that credit to M^2....it just makes me feel all dirty and used.

Also regarding the $24,000 elective injury to the canadian citizen. I love how Moore actually thinks are system is flawed because if he got this ELECTIVE surgery done in the US where he is NOT a citizen and does NOT have insurance it wouldn't be free to him. It's free in his country because he pays taxes for it there! not here! I'd find it hard to believe that I could go to Canada right now as a non-citizen and get elective surgery done free.

And this bolded portion highlights something people fail to realize.

NOTHING IS FREE IN LIFE!! Something that is supposedly free comes at a cost in some form or another. In a way you are still paying healthcare bills if you are paying taxes to get these supposedly free services.

 

[limpkitty]

But, it's a fact that mcdonalds is much cheaper than produce, especially in the inner city where there aren't that many grocery stores.

And, the fact is that, just by bringing administrative costs down to the level of medicare, we could afford to cover all of the uninsured in this country. Private medical insurance is much less effecient than public coverage, because of the immense numbers of administrators whose job it is to approve (and as often, not) payments. And, the administrative cost, and actual outcomes, are even better in the VA system.

Also, there's a big difference between socialized medicine, where doctors work for the government, and a single-payer system, which is what Moore, and almost all other progressives, advocate for.

Finally, I think it's shameful that you all attack poor people for not being healthy and say we need more prevantative care. You try living in the ghetto and eating healthy and getting plenty of exercise while you're working a job that pays 6 dollars an hour.

 

[limpkitty]

And this bolded portion highlights something people fail to realize.

NOTHING IS FREE IN LIFE!! Something that is supposedly free comes at a cost in some form or another. In a way you are still paying healthcare bills if you are paying taxes to get these supposedly free services.

Of course it's not free and nobody ever said it was. But it is cheaper and associated with better outcomes.

 

[gujuDoc]

But, it's a fact that mcdonalds is much cheaper than produce, especially in the inner city where there aren't that many grocery stores.

And, the fact is that, just by bringing administrative costs down to the level of medicare, we could afford to cover all of the uninsured in this country. Private medical insurance is much less effecient than public coverage, because of the immense numbers of administrators whose job it is to approve (and as often, not) payments. And, the administrative cost, and actual outcomes, are even better in the VA system.

Also, there's a big difference between socialized medicine, where doctors work for the government, and a single-payer system, which is what Moore, and almost all other progressives, advocate for.

Finally, I think it's shameful that you all attack poor people for not being healthy and say we need more prevantative care. You try living in the ghetto and eating healthy and getting plenty of exercise while you're working a job that pays 6 dollars an hour.

So if you have to go to mcDonalds, at least get the salads or healthier things there. And I'm sorry, but even if produce is more expensive then McDonalds I find it hard to believe fast food is all a person can afford.

 

[gujuDoc]

But, it's a fact that mcdonalds is much cheaper than produce, especially in the inner city where there aren't that many grocery stores.

And, the fact is that, just by bringing administrative costs down to the level of medicare, we could afford to cover all of the uninsured in this country. Private medical insurance is much less effecient than public coverage, because of the immense numbers of administrators whose job it is to approve (and as often, not) payments. And, the administrative cost, and actual outcomes, are even better in the VA system.

Also, there's a big difference between socialized medicine, where doctors work for the government, and a single-payer system, which is what Moore, and almost all other progressives, advocate for.

Finally, I think it's shameful that you all attack poor people for not being healthy and say we need more prevantative care. You try living in the ghetto and eating healthy and getting plenty of exercise while you're working a job that pays 6 dollars an hour.

I don't deny that there are people out there who can't afford much, but I really refuse to believe a fast food restaurant is the only thing they can afford. I know of homeless people who eat better then some of the poor people you refer to. Granted they go to shelters to get that food, the point is, there are many people I've known who have lived on minimum wage jobs and eaten better then McDonalds 3 times a day that have not ended up 300 pounds from lack of taking responsibility for their lives.

I didn't live in a box like you think. The highschool I went to was set in the ghetto and most of those people were so called poor people, yet many of them have been able to eat right.

At the clinics where I volunteer on Mondays, the majority of the kids are innercity poor kids. The only ones who seem to be severely obese and unhealthy tend to be certain latino kids whose parents over feed them or feed them very unhealthy foods. So, no I don't think its impossible to feed decent food. Yeah you may not be able to afford every single thing but there are ways to make things happen.

I really don't think there's an excuse for the trends in obesity whether poor or rich and if I offend you for that, then I'm truly sorry.

 

[LifetimeDoc]

Albiet the whole argument about taking care of yourself, eating right is far from the original point of this thread. But, not everyone is as intelligent or able to make smart choices about their life without consulting with friends or professionals that can.

People tend to spend money on the here and now, and will sacrifice things that might affect them in the future. Do you spend money on the high-cost (yes, fresh food is costly unless you are lucky enough to have farmers markets or places to buy cheap produce) good food or do you spend your budget on other things? What ends up happening is those that are of limited means will squander their health because they have to bear the brunt of the up-front cost and just ignore health care altogether. Later on, the taxpayers have to pay to fix whatever health problem they have.

In a society that has free basic health-care for all, a citizen doesn't have to choose between going to a physician/nurse/whatever for advice (whether they actually take the advice or not). Yeah, the health care may not be great like the insurance of a well-paid American, but it's better than nothing at all. (And note, if you are scared of socialized medicine there is nothing stopping you from buying your own health insurance). I love how the anti-universal health care scare mongers love to trot out the statistics that people in national health care countries have to wait longer than those in the USA. They neglect to average in those people who don't have insurance, and thus have to wait an infinite number of weeks/months to get that MRI or CT scan or see a specialist.

 

[NCF145]

http://drslounge.studentdoctor.net/showthread.php?t=416028

Another thread about sicko.

 

[limpkitty]

I love how all you people criticize moore for relying on anecdotes, then you go out and talk about your obese uncle who doesn't watch what he eats and give that as an example that we need more personal responsibility. People in other countries don't talk of personal responsibility, and they eat healthier and have healthier habits than us, I wonder if there's a connection.

I hate this "blame the victim" attitude that you all have, it sickens me that so many of this country's future doctors hold the attitiude that the sick owe all their problems to themselves.

The correct way to takle obesity is through increased education and oppurtunites for exercise, as well as laws to prevent corporations from selling so much unhelathy food to people, not by advocating "personal resonsibility", whathever the hell that means.

 

[NCF145]

I love how all you people criticize moore for relying on anecdotes, then you go out and talk about your obese uncle who doesn't watch what he eats and give that as an example that we need more personal responsibility. People in other countries don't talk of personal responsibility, and they eat healthier and have healthier habits than us, I wonder if there's a connection.

I hate this "blame the victim" attitude that you all have, it sickens me that so many of this country's future doctors hold the attitiude that the sick owe all their problems to themselves.

The correct way to takle obesity is through increased education and oppurtunites for exercise, as well as laws to prevent corporations from selling so much unhelathy food to people, not by advocating "personal resonsibility", whathever the hell that means.

Here is a nice little anecdote for you from Mike Huckabee:

" Frankly, Michael Moore is an example of why the health care system costs so much in this country. He clearly is one of the reasons that we have a very expensive system. I know that from my own personal experience," said Huckabee, who lost more than 110 pounds and became an avid runner after he was diagnosed with diabetes.

"I know how much more my health care cost when I didn't take care of myself than when I do take care of myself, not only in terms of doctor visits but regular diseases, illnesses, chronic things that come up, monthly prescription bills," Huckabee said. "All of those things have gone dramatically down since I've taken care of myself and worked to live a healthier lifestyle."

I hate this "blame the victim" attitude that you all have, it sickens me that so many of this country's future doctors hold the attitiude that the sick owe all their problems to themselves.

Not all patients are responsible for their problems, but it doesn't take a genius to realize that a majority of the smokers, alcoholics, drug abusers, non-compliant morbidly obese patients and non-compliant patients in general are responsible for most (if not all) of their diseases.

 

[limpkitty]

is a woman who gets breast cancer responsable for it b/c she has boobs? because that's the kind of arguement you're making

 

[NCF145]

is a woman who gets breast cancer responsable for it b/c she has boobs? because that's the kind of arguement you're making

That is a horrible analogy, because a woman has no control over the growth of her breasts. The argument we are making is that many of the chronic problems in the US are a result of the lifestyles that people choose to live. You don't like it when people blame the patient. If you want to take that stance then that is fine, I believe it to be an extremely ignorant one, but to each his own.

 

[Gut Shot]

The argument we are making is that many of the chronic problems in the US are a result of the lifestyles that people choose to live.

I don't think anyone can argue with that conclusion, although its relevance to the structural problems in the US healthcare system is debatable. The solution to smoking, drinking, bad diet and lack of exercise isn't to continue down the current path of poor access to expensive care.

 

[NCF145]

The solution to smoking, drinking, bad diet and lack of exercise isn't to continue down the current path of poor access to expensive care.

I agree with this. I would like to see a study that shows whether or not people who have access to healthcare change their lifestyles in order to live a healthier life.

 

[novawildcat]

your 50% figure is inaccurate.

or an inaccurate representation, anyway. you should look at the actual wording of that study.

the 50% figure wasn't from that study. I was citing something I simply read before.

"Medical bills make up half of bankruptcies"

http://www.msnbc.msn.com/id/6895896/



I have looked at the actual wording of the study. So far in this thread, hardly anyone has used any actual cold hard facts to back up their points, only anecdotal stories and personal opinion.


Here is some more food for thought for everyone.

Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from the bottom) for 16 available health indicators. Countries in order of their average rating on the health indicators (with the first being the best) are Japan, Sweden, Canada, France, Australia, Spain, Finland, the Netherlands, the UK, Denmark, Belgium, the US, and Germany....Common explanations for this poor performance fail to implicate the health system. The perception is that the American public "behaves badly" by smoking, drinking, and perpetrating violence. The data show otherwise, at least relatively. The proportion of females who smoke ranges from 14% in Japan to 41% in Denmark; in the US, it is 24% (fifth best). For males, the range is from 26% in Sweden to 61% in Japan; it is 28% in the US (third best). The data for beverage consumption are similar: The US ranks fifth best. Thus, although tobacco use and alcohol use in excess are clearly harmful to health, they do not account for the relatively poor position of the US on these health indicators...The US also has relatively low consumption of animal fats (fifth lowest in men aged 55-64 years in 20 industrialized countries) and 3rd lowest mean cholesterol concentrations amoung men aged 50-70 years among 13 industrialized nations.

-Journal of the American Medical Association, July 26, 2000-Vol. 284, No. 4


So why do Americans have such poor health again when compared to people in Japan or Europe when Americans Japanese, and European people all have unhealthy life style habits? Simply blaming poor life style choices for the poor health in this country isn't acurately painting the whole picture. The health care situation in this country is definitely one contributor to the poor health in this country.

 

[pguin]

The solution to smoking, drinking, bad diet and lack of exercise isn't to continue down the current path of poor access to expensive care.

I understand what you're saying and healthcare needs to change but actually their might be an argument that free access to healthcare at anytime might encourage people to maintain their self-destructive ways.

Smokers can go and get a chest x-ray all the time and try to catch lung cancer early.
Why would you not drink and worry about the health of your liver...you'll just get a transplant when the time comes.
Sure you are unhealthy and in pain because you dont exercise and are overweight but why change when you can just take some free narcotics for the pain and get your stomach stapled and perhaps open heart surgery down the road.

I know these are extreme scenarios and most people would think that noone would possibly think like this...but I promise you that many many people do and it would probably increase if healthcare became free. I know some people abusing the system isn't a reason to not provide healthcare to others but it does give another variable to look at.

 

[Gut Shot]

Simply blaming poor life style choices for the poor health in this country isn't acurately painting the whole picture. The health care situation in this country is definitely one contributor to the poor health in this country.

Thank you for that. The lifestyle/poor choice retort has been the last refuge in this debate for some time. As I have said in the past, lifestyle does impact one's health and one's healthcare costs, but those are relatively small potatoes in the giant f*cked up pot pie of our healthcare system.

If you haven't seen it, you may be interested in Barry Schwartz's book The Paradox of Choice. Not having much background in psychology, I found the chapter on decision making to be fascinating. In particular was Tversky and Kahneman's availability heuristic, "where people base their prediction of the frequency of an event or the proportion within a population based on how easily an example can be brought to mind."

I believe this heuristic is (at least in part) why people are so prone to pin blame for our system's woes on the fat, the lazy, the smokers, the drug abusers and the alcoholics. We all have friends, family members and acquaintances who fit into those descriptions, and the vividness of our own experiences colors our predictions about larger matters. It's probably why people who work in ER's often have such bad attitudes towards junkies (even though treatment of narcotic addiction is overall quite successful) and why I think everyone has cancer (even though relatively few people do).

Therein lies the danger of the anecdote. Anyone can drum up some horror story about the healthcare system in the US, Canada, Britain, Japan, etc., but does the data bear it out? The dry, unexciting truth of the matter is that the healthcare measures which actually best preserve and prolong life are the most boring: control of blood pressure, blood sugar and blood lipids.

Cheers!

 

[Gut Shot]

I understand what you're saying and healthcare needs to change but actually their might be an argument that free access to healthcare at anytime might encourage people to maintain their self-destructive ways.

I don't think the data will bear you out on this.

Smokers can go and get a chest x-ray all the time and try to catch lung cancer early.

They can try, but screening for lung cancer has never been demonstrated to be effective. By the time a mass is visualizable on CXR it's too late. One trip to a primary care physician will put an end to this fantasy.

Why would you not drink and worry about the health of your liver...you'll just get a transplant when the time comes.

That person will likewise be disappointed:

...but I promise you that many many people do and it would probably increase if healthcare became free.

From Bodenheimer's High and Rising Health Care Costs. Part 1: Seeking an Explanation:

Patient Cost Sharing

An influential school of thought advocates that consumers should be responsible for a greater share of their health care costs. Employers are requiring employees to pay more for health insurance premiums, deductibles, and copayments (17). A deductible is the sum of money patients must pay to physicians or hospitals each year before the insurance company begins to pay for those services. A copayment is a small fee (often $5 or $10) that patients must pay for each health service received. Co-insurance is similar to a copayment but is the percentage (rather than a specific amount) of the cost of a service that the patient is responsible to pay. Taking the place of health maintenance organization (HMO) plans with no deductible and minimal copayments are products with $2500 deductibles and 25% co-insurance. Medical savings account plans may have deductibles reaching $10 000 (43, 44).

Advocates of the patient cost-sharing strategy cite as evidence the 1970s RAND Health Insurance Experiment, which compared health expenditures of patients receiving free care with those of similar patients paying for 25%, 50%, or 95% of their care out-of-pocket. Cost-sharing patients had an upper limit on their costs. The study found that patients receiving free care utilized more services and had higher expenditures than cost-sharing patients (45, 46). For example, people responsible for 50% of their costs up to $1000 had total health care expenditures about 10% below those receiving free care. Of note, expenditures for HMO patients receiving free care were 38% lower than those for patients in the free-care, fee-for-service group, suggesting that the replacement of fee-for-service insurance with capitated systems is more effective than patient cost sharing in reducing expenditures (46).

The effectiveness of patient cost sharing as a cost control mechanism has been challenged by other analysts (42, 47) and by the RAND investigators themselves (31, 46). From 1950 to 1984, the spread of health insurance coverage (that is, the reduction in patient responsibility for health care costs) explains only 5% to 10% of spending growth (31, 32, 46). Moreover, the United States has one of the highest levels of patient cost sharing among developed nations yet has the highest expenditures per capita.

Another fact buttresses the argument that patient cost sharing is marginally effective in containing costs: Seventy percent of health care expenditures are incurred by 10% of the population (48). It is likely that patients in the high-cost 10% (that is, those who suffer an acute catastrophe or prolonged chronic illness) are far too sick to impose limits on their care because they must pay for part of that care. Thus, 70% of health expenditures may be unaffected by shifting costs to patients. The RAND experiment did not study high-cost patients because the study excluded elderly persons, and study participants were not responsible for costs above $1000 per year (46). The RAND study found that patient cost sharing reduced the likelihood of seeing a physician but had little effect on the costliness of an illness once care was sought (49). Compared to the micro-world of one not-very-sick patient deciding whether to spend some money on a physician visit, patient cost sharing in the macro-world may remove only a thin slice from a large, expanding pie.

 

[smq123]

I hate this "blame the victim" attitude that you all have, it sickens me that so many of this country's future doctors hold the attitiude that the sick owe all their problems to themselves.

The correct way to takle obesity is through increased education and oppurtunites for exercise, as well as laws to prevent corporations from selling so much unhelathy food to people, not by advocating "personal resonsibility", whathever the hell that means.

You're joking, right?

Obviously, many people (especially in the inner cities) learned poor eating habits from their parents and friends. And good produce is difficult to find in some inner city grocery stores.

But the only way you'll get anywhere with patient care is by stressing the idea of personal responsibility. If you don't get them to realize that they should take care of themselves BECAUSE it will benefit THEM, then your patient-doctor relationship is going to disintegrate into a teacher trying to lecture a disobedient student. That's not helpful.

 

[leftmid]

So why do Americans have such poor health again when compared to people in Japan or Europe when Americans Japanese, and European people all have unhealthy life style habits? Simply blaming poor life style choices for the poor health in this country isn't acurately painting the whole picture. The health care situation in this country is definitely one contributor to the poor health in this country.

Do you or anyone know if the absolute or relatively poor health care situation in this country is the result of problems in the health care provided by primary care physicians or specialists, or both? There might be so over-utilization of care by specialists to the point that the cost for a universal coverage is prohibitive. Sometimes I have a feeling that it’s the liability that prevents doctors from their best performance for the buy.

Do you or anyone know how many doctors does a patient need to see for the same illness, here in comparison to each of those 12 countries in the study?

 

[pguin]

I don't think the data will bear you out on this.



They can try, but screening for lung cancer has never been demonstrated to be effective. By the time a mass is visualizable on CXR it's too late. One trip to a primary care physician will put an end to this fantasy.

I know that it wont work and that it's a fantasy to believe that a physician can solve everything. However, just because you and I can see the flaw in this theory doesn't mean that an uneducated cocaine addict sees the flaw. Also the Patient cost sharing story you posted actually goes along with what I was trying to say. It specifically says that forcing the patients to pay a share reduced the number of visits but not the cost of treatment if the person turned out to be sick. The point is that people will go see physicians for every little thing that goes wrong - this ends up costing a lot of money even if the doctor just sends them home.

 

[novawildcat]

The dry, unexciting truth of the matter is that the healthcare measures which actually best preserve and prolong life are the most boring: control of blood pressure, blood sugar and blood lipids.

Cheers!

Interesting that you said this. This is completely true. You should definitely read this study by the National Bureau of Economic Research

http://www.nber.org/aginghealth/spring07/w13013.html

It finds that with control of cholesterol and high blood pressure obesity has little to no impact on rates of mortality. Smoking is much more lethal than obesity and represents 150% more risk of death over 10 years than obesity. Considering this fact and keeping in mind that people in Europe smoke MUCH more than people in America, how is it that Americans have such poorer health than Europeans? People blame poor life style habits and obesity for the poor health of Americans, and while obesity is a huge problem, life style habits aren't solely responsible for the reason why Americans have some of the worst health in the industrialized world.

 

[Gut Shot]

The point is that people will go see physicians for every little thing that goes wrong - this ends up costing a lot of money even if the doctor just sends them home.

No, the point is that reducing patient cost will increase utilization, but when contextualized this increase is not very significant.

 

[novawildcat]

Do you or anyone know if the absolute or relatively poor health care situation in this country is the result of problems in the health care provided by primary care physicians or specialists, or both?

Personally I don't think the poor health of Americans due to the health system is because of doctors or specialists, but it is because accessible and affordable health care is not available. When 10-20% of your entire population can't even afford health care because they have no insurance,the view of the overall health of the entire population is going to be suffer. It isn't the physicians causing the problems, it is the way the health care system is set up.

There might be so over-utilization of care by specialists to the point that the cost for a universal coverage is prohibitive.

Did you know that in 1991 a bill was proposed for universal health care coverage and the Congressional Budget Office (CBO) believed that:

Enactment of HR 1300 [bill for universal health care] would raise national health expenditures at first, but would reduce spending about 9 percent in 2000. As the program was phased in, the administrative savings from switching to a single-payer system would offset much of the increased demand for health care services.

-Estimates of proposed health care proposals from the 102nd Congress

Quite literally, the CBO believed that universal health care through the govt would actually save money in the long run.


what ever happened to that bill?

Sometimes I have a feeling that it's the liability that prevents doctors from their best performance for the buy.

Even when you consider liabilty and states with tort reform you find that

Evidence from states indicates that premiums for malpractice insurance are lower when tort liability is restricted than they would be otherwise. But even large savings in premiums can have only a small direct impact on health care spending--private or governmental--because malpractice costs account for less than 2 percent of that spending.

-Congressional budget office http://www.cbo.gov/ftpdoc.cfm?index=4968&type=0



People don't want to admit it, but the fact that MILLIONS of Americans simply don't have affordable and accessible health care is one of the biggest reasons why Americans have such poor overall health.

 

[armybound]

Interesting that you said this. This is completely true. You should definitely read this study by the National Bureau of Economic Research

http://www.nber.org/aginghealth/spring07/w13013.html

It finds that with control of cholesterol and high blood pressure obesity has little to no impact on rates of mortality. Smoking is much more lethal than obesity and represents 150% more risk of death over 10 years than obesity. Considering this fact and keeping in mind that people in Europe smoke MUCH more than people in America, how is it that Americans have such poorer health than Europeans? People blame poor life style habits and obesity for the poor health of Americans, and while obesity is a huge problem, life style habits aren't solely responsible for the reason why Americans have some of the worst health in the industrialized world.

what is it you're suggesting is the cause of America's obesity problem? genetics?

you don't seem to think that any of the commonly known causes of obesity (poor diet, lack of exercise) are actually responsible for it. I might be misreading what you're saying, but I'm not really getting it.

 

[riversoul]

I agree with preventive medicine. Moore went on a little spiel about how Europeans are so much healthier. I think he was trying to say that it's because their healthcare systems are so much better.. simply not the case. Americans are fat. Americans are lazy. This causes a lot more healthcare problems than we need. Proper diet & exercise are preventive medicine that would save a lot of lives. Look at Moore's list of top killers in the US.. diabetes, cardiovascular disease, stroke.. all can be somehow tied to poor diet and exercise if you think about it. Stroke and diabetes mellitus can be argued, but still, you have to realize that a good way to save a lot of healthcare dollars is for Americans to simply eat better and get off their butts. It's that simple.

I wasn't saying you particularly were saying it's the solution, I was referring to people who say socialized medicine is the cure.

The part I didn't make clear was about socialized medicine and how people have to pay for the government-given insurance (through taxes) and often have to take out private insurance as well. This means they have to buy 2 insurance plans to get the same payout (private insurance). I guess people think that private insurance completely goes away when there's a socialized system in place, but it's not true.

I have been told (by a friend who works in hospital reimbursement) that Medicare and Tricare pay really poorly. I can't back it up with any figures though, sorry.

Saying you'll simply take profit away from an industry is a bit of a slippery slope. Why don't we steal Big Oil's profit to subsidize gas prices? Well, the US has a capitalist economy, and people don't get punished for pulling a profit. Now if you want to expand the US government health insurance, I'd be all for it.. but it should be opt-in. People should be able to choose to have it instead of forcing everyone to pay some fixed amount of their salary for it, whether they want it or not. In my opinion, anyway.

I also completely agree with enhancing preventive medicine to reduce future medical costs. As part of my health policy class at UC Irvine, I had to formulate an ideal health care plan for a subset of the population. The following is a brief recap of what i wrote.

In my plan, called HighHealth, the target population is adolescents in California. In my opinion, we have to drill and instill good eating and exercise habits into the minds of hopefully malleable teenagers so they can carry on those healthy behaviors through the rest of their lives. Doing so would entail bringing the healthcare system to the high school, and having family practice and preventive care physician residents, plus nutritionists and physician assistants work AT the high schools, with medical offices AT the high schools. The focus would be on maximizing the number of RESIDENT physicians at the high school, so that you don't have to pay them as much and costs are CHEAPER, with maybe one or two "ATTENDINGS" who act as the primary authority at the high school. Funding for this would come mainly from state funds, tuition, and donations. The only students' primary care doctor would be the one at the high school. Insurance for primary care, physical examinations would work through the school, with payments coming from tuition. In this case, there would now be tuition at public schools. for low-income families, there would hopefully be financial assistance from state taxes and charitable donations. Surgeries and any other specialized care would take place at hospitals, with costs being payed by the parents' existing health insurance.

In order to drill and instill behaviors, teens would have to pass physical requirement tests (like in the military, but of course not as strenuous), and have healthy physical paramaters (such as BMI) in order to move on to the next grade level and graduate from high school. Also, there would be mandatory healthy lifestyle classes taught by the healthcare professionals (more intense and comprehensive P.E. classes). Also, there would be financial incentives (scholarships, honors, decreased insurance costs for parents etc) for those who show excellent improvement in their physical health if they were unhealthy during their freshman year. Lastly, there would be an increase in the quality and quantity of recreational facilities and programs at the schools so that everyone, not only jocks, would be inclined to participate.

Of course, those who are disabled or have other physical ailments would not be required to participate in such a curriculum. The biggest problem would most like be funding (as is the case with almost any new healthcare initiative). Also, there is quite a gamble being placed on the hope that the students who graduate will CONTINUE to practice healthy behaviors. There could possibly be programs like HighHealth at universities and companies to help ensure that the teens will stay healthy. Programs like these would help to reduce net healthcare costs in the future, but by no means eliminate costs altogether of course.

 

[KeyzerSoze]

I live in Canada, and I think "Sicko" portrays a completely wrong version of Canadian healthcare. A day doesn't go by that the Canadian media complains about the lack of money and resources in our system. The wait times are not 45 minutes...try all night. If you are going to die, lose a limb, or eyesight, you will be seen immediately however (thank God). Most Canadians also have private health insurance (often included as job benefits) apart from the so-called "free" care that we receive as citizens. I use my health insurance to pay for prescriptions and things that are not covered by the social plan, which would be extremely expensive without it. Because of Canada's large size, it is tough to centralize care to a few main facilities in big cities as countries like France or Sweden can do. Driving 500 miles for specialty care is not unheard of. We have to pay to send doctors and nurses to the most remote regions of the country and then build hospitals or fly patients out for proper care. It is extremely inefficient considering the shortage of resources (our tax money). The grass isn't necessarily greener on the other side, and not a day goes by I don't hear about the impending collapse of socialized healthcare in Canada.

👍

 

[novawildcat]

what is it you're suggesting is the cause of America's obesity problem? genetics?

you don't seem to think that any of the commonly known causes of obesity (poor diet, lack of exercise) are actually responsible for it. I might be misreading what you're saying, but I'm not really getting it.

What I am trying to say is that poor life style isn't the sole cause of the poor overall health of Americans. The poor overall way the health care system is set up in America is to blame as well. Obesity is a problem in America, but it is also a problem in all industrialized nations. Simply blaming poor life styel habits, like getting obese, is simply brushing under the carpet the reason why Americans have such poor health. What I am trying to point out is the fact that people in places like Europe and Japan have very unhealthy life style habits like smoking, but still tend to have better over all health than Americans. Why is that?


Have you ever heard of the French paradox? The French have diets that are much much higher in fats than Americans, but still tend to live out longer life spans than Americans. Why is this? Is it because of the health care system?

 

[abeytt03]

The U.S. healthcare system has its flaws like every other system. Nothing is perfect. It is, however, a terrific system that can be even better. The problem boils down to the uninsured and the lack of governmentregulation. The government should do a better job regulating HMOs, while still maintaining its capitalist nature.
Also, I believe the problem of the uninsured boils down to the inabiltity of many in this country to spend wisely and responsibly. The government forces its citizens to spend responsibly in other areas by enforcing certain expenditures (i.e. car insurance). This is what the government should do by health insurance. If an individual "falls between the cracks" they should have the option of buying government health insurance for a percentage of their income. Anyone can opt for this insurance, but at a certain level, the private insurance will actually be cheaper than the government percentage rate. This would force private insurers to offer reasonable rates, while also forcing citizens to spend a certain percentage of their income on health insurance. Those who can't afford even government insurance (a specified income level) would qualify for the current "socialized" medicine plan our government offers, called medicaid.

 

[Jolie South]

What I am trying to say is that poor life style isn't the sole cause of the poor overall health of Americans. The poor overall way the health care system is set up in America is to blame as well. Obesity is a problem in America, but it is also a problem in all industrialized nations. Simply blaming poor life styel habits, like getting obese, is simply brushing under the carpet the reason why Americans have such poor health. What I am trying to point out is the fact that people in places like Europe and Japan have very unhealthy life style habits like smoking, but still tend to have better over all health than Americans. Why is that?


Have you ever heard of the French paradox? The French have diets that are much much higher in fats than Americans, but still tend to live out longer life spans than Americans. Why is this? Is it because of the health care system?

I have no proof to back this up, but. ..

To me it seems that Americans put a lot of unnecessary stress upon themselves. I think we as a society don't know how to relax. We're so worried about doing well in our careers, if our kids are perfect, if we're driving the right cars, or just being better than everyone else around us.

After living in Africa and seeing children smiling and happy with an empty tin can, I realized how much we kill ourselves for things that are so unimportant. Adults over there are also the same way.

We create so many demands and needs for ourselves. Once we attain them, we just create higher and higher standards and I believe that this contributes to our health as well.

I think that Europeans and cultures outside the US are a lot less competitive. People are happier with who they are. If they can eat and pay the bills, that's great.

Just my $.02.

 

[novawildcat]

The U.S. healthcare system has its flaws like every other system. Nothing is perfect. It is, however, a terrific system that can be even better. The problem boils down to the uninsured and the lack of governmentregulation. The government should do a better job regulating HMOs, while still maintaining its capitalist nature.
Also, I believe the problem of the uninsured boils down to the inabiltity of many in this country to spend wisely and responsibly. The government forces its citizens to spend responsibly in other areas by enforcing certain expenditures (i.e. car insurance). This is what the government should do by health insurance. If an individual "falls between the cracks" they should have the option of buying government health insurance for a percentage of their income. Anyone can opt for this insurance, but at a certain level, the private insurance will actually be cheaper than the government percentage rate. This would force private insurers to offer reasonable rates, while also forcing citizens to spend a certain percentage of their income on health insurance. Those who can't afford even government insurance (a specified income level) would qualify for the current "socialized" medicine plan our government offers, called medicaid.

But consider the people WHO DO HAVE INSURANCE.

In their multicenter study of 2498 patients hospitalized for acute myocardial infarction, Rahimi and colleagues found that self-reported financial barriers to health care services (18.1% prevalence) or medication (12.9% prevalence were common, even among the roughly 69% of patients with health insurance. At a 1-year follow-up, financial barriers to health care or to medication were associated with significantly worse recovery after myocardial infarction, manifested as higher rates of angina, increased risk of rehospitalization, and poorer quality of life.

-JAMA, March 14, 2007-vol 297 No 10

 

[musiclink213]

Have you ever heard of the French paradox? The French have diets that are much much higher in fats than Americans, but still tend to live out longer life spans than Americans. Why is this? Is it because of the health care system?

I don't think it's because of the health care system. The French don't work as much, in August, pretty much the entire country shuts down and htey all go on vacation. I also lived in Paris, taking 3 hours for dinner is not unheard of. So the food may be higher in fats, but you're not scarfing it down like a lot of restaurants almost force you to do in the US. I can't speak for other parts of the country, but in Paris, you do much more walking than the average American probably does. Cars are a luxury, not a necessity like they are in the US. Also, food portions are much smaller in France. They're not eating as much, and this goes back to the argument that eating habits and lifestyle have a lot to do with some chronic diseases.

So basically, they are less stressed, eat slower, and eat smaller portions, and walk much more. All of these things help their health, thereby increasing their lifesspan.

 

[Noeljan]

What I am trying to say is that poor life style isn't the sole cause of the poor overall health of Americans. The poor overall way the health care system is set up in America is to blame as well. Obesity is a problem in America, but it is also a problem in all industrialized nations. Simply blaming poor life styel habits, like getting obese, is simply brushing under the carpet the reason why Americans have such poor health. What I am trying to point out is the fact that people in places like Europe and Japan have very unhealthy life style habits like smoking, but still tend to have better over all health than Americans. Why is that?


Have you ever heard of the French paradox? The French have diets that are much much higher in fats than Americans, but still tend to live out longer life spans than Americans. Why is this? Is it because of the health care system?

umm japanese diet is MUCH more healthy. With the French it something called portion control. Portion control is something a lot of Americans know nothing about. People in this country think you can put whatever you want into your mouth alllll day long, sit on your big behind, smoke, and blame someone else. Two highest death causing diseases i the US? Last I checked was heart disease and cancer. Leading cause of cancerous deaths? Lung!!! 80 % of lung caused by....mutations caused by cigarette smoking
hmmm

 

[Noeljan]

I don't think it's because of the health care system. The French don't work as much, in August, pretty much the entire country shuts down and htey all go on vacation. I also lived in Paris, taking 3 hours for dinner is not unheard of. So the food may be higher in fats, but you're not scarfing it down like a lot of restaurants almost force you to do in the US. I can't speak for other parts of the country, but in Paris, you do much more walking than the average American probably does. Cars are a luxury, not a necessity like they are in the US. Also, food portions are much smaller in France. They're not eating as much, and this goes back to the argument that eating habits and lifestyle have a lot to do with some chronic diseases.

So basically, they are less stressed, eat slower, and eat smaller portions, and walk much more. All of these things help their health, thereby increasing their lifesspan.

👍

 

[Noeljan]

one more thing I wanted to add (which I did I think in the DO forum about this movie)
I feel like people only focus on the good of other healthcare systems, while TOTALLY ignoring the negatives (or things that go along with it). You can't have this perfect, free healthcare, no one pays, no one is responsible, zero wait time, etc
I know I pointed this little fact out, but while the ignorant mass points out doctors salaries in other nations (ex: many countries in Europe) they TOTALLY ignore how much more doctors work in the US. My ex was from europe , and he ALWAYS went on and on about how much doctors work in the US (compared to europre). He couldn't believe it until he was here. To him it was incredible. Oh and why did he come here, umm better technology and training. The intensity apparently pays off. People ignore that though, and act like our system sucks such a@@

 

[novawildcat]

umm japanese diet is MUCH more healthy. With the French it something called portion control. Portion control is something a lot of Americans know nothing about. People in this country think you can put whatever you want into your mouth alllll day long, sit on your big behind, smoke, and blame someone else. Two highest death causing diseases i the US? Last I checked was heart disease and cancer. Leading cause of cancerous deaths? Lung!!! 80 % of lung caused by....mutations caused by cigarette smoking
hmmm

You are shooting yourself in the foot.

Once again, it is a myth that it is the fat lazy smoking American that is the biggest reason why Americans are unhealthy when compared to the rest of the world. People in Europe and Japan also have very unhealthy life style habits, it isn't just Americans.

Do you know what the biggest cause of preventable death in the world is? It is smoking. Did you read what I posted before? 61% of men in Japan smoke compared to only 28% in America, 41% of women in Denmark smoke compared to only 24% in America. It is quite ironic that both of those places are deemed to have better overall health than America.

I don't think it's because of the health care system. The French don't work as much, in August, pretty much the entire country shuts down and htey all go on vacation. I also lived in Paris, taking 3 hours for dinner is not unheard of. So the food may be higher in fats, but you're not scarfing it down like a lot of restaurants almost force you to do in the US. I can't speak for other parts of the country, but in Paris, you do much more walking than the average American probably does. Cars are a luxury, not a necessity like they are in the US. Also, food portions are much smaller in France. They're not eating as much, and this goes back to the argument that eating habits and lifestyle have a lot to do with some chronic diseases.

So basically, they are less stressed, eat slower, and eat smaller portions, and walk much more. All of these things help their health, thereby increasing their li

No one is saying that poor life style habits do not contribute to poor overall health. But incase if you haven't noticed, obesity is problem among industrialized nations, not just America. What I am trying to point out is the fact that people in places like Japan and Europe have bad life style habits too, like smoking, but tend to have better overall health than Americans. Why is this? Americans spend BY FAR the most amount of money on health care but are still in pretty poor shape.

I feel like people only focus on the good of other healthcare systems, while TOTALLY ignoring the negatives (or things that go along with it). You can't have this perfect, free healthcare, no one pays, no one is responsible, zero wait time, etc

who said it would be free? It is obvious that taxes would be increased for a more socialized form of health care. But tell me, what is the difference between being taxed more for a form of socialized medicine and not being taxed but having to drown in high insurance premiums, copayments, etc. ? There really isn't a difference at all.

 

[abeytt03]

But consider the people WHO DO HAVE INSURANCE.



-JAMA, March 14, 2007-vol 297 No 10

I have. The government needs to do a better job regulating. Also, HMO's will do a better job knowing that for many middle income families the difference in price won't neccesarily be so drastic. The potential competition will engender a more efficient HMO.

 

[Noeljan]

You are shooting yourself in the foot.

Once again, it is a myth that it is the fat lazy smoking American that is the biggest reason why Americans are unhealthy when compared to the rest of the world. People in Europe and Japan also have very unhealthy life style habits, it isn't just Americans.

Do you know what the biggest cause of preventable death in the world is? It is smoking. Did you read what I posted before? 61% of men in Japan smoke compared to only 28% in America, 41% of women in Denmark smoke compared to only 24% in America. It is quite ironic that both of those places are deemed to have better overall health than America.




No one is saying that poor life style habits do not contribute to poor overall health. But incase if you haven't noticed, obesity is problem among industrialized nations, not just America. What I am trying to point out is the fact that people in places like Japan and Europe have bad life style habits too, like smoking, but tend to have better overall health than Americans. Why is this? Americans spend BY FAR the most amount of money on health care but are still in pretty poor shape.





who said it would be free? It is obvious that taxes would be increased for a more socialized form of health care. But tell me, what is the difference between being taxed more for a form of socialized medicine and not being taxed but having to drown in high insurance premiums, copayments, etc. ? There really isn't a difference at all.

Don't worry, lung cancer will catch up to them. There is about 20-30 year lag after the onset of smoking and lung cancer. This is why it is so high in US men (older population) but leveling off. This is why it is steadily increasing in US women (a good portion started to smoke in the 70's, muct later than the US men population)
I stand by my points. I don't know why you are TOTALLY IGNORING portion size and consumption, as well as activity in the US compared to these other places. It is quite ignorant.

 

[Kappy1]

One thing Moore didn't mention in his film were the wait times for tests and procedures. In some provinces in Canada it can take two and half months just to recieve an MRI. If you add the wait time of diagnostic tests plus the wait time until the actual procedure you are looking at 3-4 months for procedures. I'm sure there are plenty of patients dieing just waiting for the procedures. This is something I posted it the osteopathic forum.
Here are "hard numbers" for wait times for different procedures and tests in different provinces in Canada. For the province of Saskatchewan wait times for eye surgeries from October 2006- March 2007 show that 43% eye surgery has a wait time of 4-12 months. I hope no one there gets a cataract.
http://www.sasksurgery.ca/specialty/...logy.htm#table
click on eye surgery in red and see for yourself. In the US you could definitely get eye surgery faster.
A tonsillectomy in Alberta has the average wait time of ten weeks until surgery. I don't believe you need to wait 2 1/2 months for this surgery in the US.
http://www.ahw.gov.ab.ca/waitlist/Ca...evelOfCare=All
It also takes on average about 10 and half weeks to get an MRI in Alberta.
http://www.ahw.gov.ab.ca/waitlist/Ca...evelOfCare=All
I don't know about you but I don't want to wait that long. There are plenty of other examples.

 

[novawildcat]

. I don't know why you are TOTALLY IGNORING portion size and consumption, as well as activity in the US compared to these other places. It is quite ignorant.

I'm not ignoring it. If you read the other fact that I posted before, that with control proper control of cholesterol and high blood pressure, obesity has little to no impact on rates of mortality. This isn't to say that obesity isn't unhealthy, of course it is. You are missing and ignoring the big picture though--the fact that people all over the world have unhealthy life style habits, but for some reason Americans fair worse than almost everyone else. Choice of life style definitely has an impact on overall health, but it isn't the sole factor in determining health as well. Access to affordable health care also plays a role. When 40-50 million Americans have almost no access to affordable health care you can be damn sure that their health is going to suffer because of the way the health care system is set up, not solely because of their life style habits.

One thing Moore didn't mention in his film were the wait times for tests and procedures. In some provinces in Canada it can take two and half months just to recieve an MRI. If you add the wait time of diagnostic tests plus the wait time until the actual procedure you are looking at 3-4 months for procedures. I'm sure there are plenty of patients dieing just waiting for the procedures. This is something I posted it the osteopathic forum.
Here are "hard numbers" for wait times for different procedures and tests in different provinces in Canada. For the province of Saskatchewan wait times for eye surgeries from October 2006- March 2007 show that 43% eye surgery has a wait time of 4-12 months. I hope no one there gets a cataract.
http://www.sasksurgery.ca/specialty/...logy.htm#table
click on eye surgery in red and see for yourself. In the US you could definitely get eye surgery faster.
A tonsillectomy in Alberta has the average wait time of ten weeks until surgery. I don't believe you need to wait 2 1/2 months for this surgery in the US.
http://www.ahw.gov.ab.ca/waitlist/Ca...evelOfCare=All
It also takes on average about 10 and half weeks to get an MRI in Alberta.
http://www.ahw.gov.ab.ca/waitlist/Ca...evelOfCare=All
I don't know about you but I don't want to wait that long. There are plenty of other examples.

LOL @ "plenty of people dieing just waiting for procedures". HOW MANY OF THE 40-50 MILLION UNINSURED DIE IN THE US PER YEAR BECAUSE THEY CAN'T EVEN SEE A DOCTOR BECAUSE THEY HAVE 0 HEALTH INSURANCE?

You are being very guileful with the facts that you are posting. You have only listed the wait times for non-emergency procedures, I highly doubt anyone in Canada is going to have to wait 8 weeks for a surgery from a gun shot wound.

You like to complain about wait times for people like places in Canada, but tell me this, what is the waiting time for an American without health insurance????? IT IS AN INFINITE AMOUNT OF TIME BECAUSE THEY HAVE NO HEALTH INSURANCE.


You need to read this article in Businessweek. http://www.businessweek.com/technology/content/jun2007/tc20070621_716260.htm

There is no systemized, nationwide collection of data on wait times in the U.S., making it difficult to compare delays to those in countries with national health systems, who typically track and publish data on wait times. But a 2005 survey conducted by the Commonwealth Fund of sicker adults in six highly industrialized countries found that only Canada was worse than the U.S. when it came to waiting six days or longer to schedule a doctor's appointment for a medical problem.

Of the countries surveyed, 81% of patients in New Zealand got a same or next-day appointment for a nonroutine visit, 71% in Britain, 69% in Germany, 66% in Australia, 47% in the U.S., and 36% in Canada. Those lengthy wait times in the U.S. explain why 26% of Americans reported going to an emergency room for a condition that could have been treated by a regular doctor if available, higher than every other country surveyed.

The Commonwealth survey found one area in which the U.S. assumed first place—by a wide margin: 51% of U.S. adults surveyed did not visit a doctor, get a needed test, or fill a prescription within the past two years because of cost. No other country came close to that percentage.

 

[Gut Shot]

I don't know about you but I don't want to wait that long.

Canada also covers its whole population while spending about 52% of what we do on health care (per capita). If you're concerned about waiting for a CT scan then you should move to Japan. In 2000 they had 84.4 CT scanners per million people, compared to a wussie 13.6 in the United States. While certainly your best option, there are others. Austria, Germany, Iceland, Italy, Korea, Luxemborg, Sweden and Switzerland all had more CT scanners per capita than we do.

 

[benzene21]

I'll admit, the film seemed slightly biased to me. However, I was first introduced to this subject last year in one of my philosophy classes; we read all kinds of documents for and against the US healthcare system and I have to say, I found very few strong arguments to defend the US's system. Most of the arguments I read were rich people bitching that they would not be able to get "optimum care" in a national healthcare system. Really, their doctor's would just not seem as prestigious any longer because everyone could afford them. The only real problem that I noticed through this course was that often medical resources were scarce...there might only be 3 MRI's in a region or something. but the US is freaking rich, we can afford better than that.

i'm just curious as to why people say the film "brainwashed" people. i have read alot about both sides of the argument and it is difficult to see how anyone aside from the HMOs can support our system.

I do think I will have a hard time working for the US healthcare system and will probably always question the ethics of turning a patient away because they can't pay for care...after all, at the core of being a physician is supposed to be the desire to help people. That doesn't mean just helping those who are lucky enough to be covered. But, you know, there are downsides to every career and i guess it is just something that has to be dealt with if you want to practice in the US

 

[DocWalken]

**I haven't done much research into this subject, but here's my humble opinion**
I've heard this same argument was happening 20 years ago (and probably before and since then) from someone who was in medical school then. Some U.S. doctors seem to have a lot of concern about their declining salaries and how they will all be government employees in a few years. This same group also tries to discourage students by explaining that no one should want to go through the ~10 years of medical training to be a govt. employee.
However, many other doctors are more optimistic and think that physicians' salaries rise and fall with time and that the prospect of universal health care in the U.S. seems likely now, but when you consider insurance companies and taxpayers, it is a little far fetched.

I agree with the latter. I think universal health care is a little unlikely right now. Though many other countries have set an example of a system that seems fair and perfect (especially from the outside) this may not be the best system or the most practical for the U.S. Do most Americans really want to stand in huge lines at doctors' offices or have to wait a longer time for surgery/procedures? Would most Americans be happy about paying for everyone's health care even though they can afford and are happy with their own right now? What about insurance companies? Would we just toss them on the street along with all of their employees? Won't they put up a fight?
Basically I just think there are too many factors that make this system unfavorable. While being able to stroll into a doctor's office or hospital anytime sounds great it might just not be. Universal health care still has many flaws, as will any other system.

 

[hawk126]

Nova - Thanks for the stats you've posted pertaining to lifestyle and mortality. I'd be interested to see stats detailing the cost per capita for treating chronic conditions secondary to obesity and smoking in this country (as a percentage of total healthcare costs) vs. the other industrialized nations of the world... as these statisitcs would be more pertinent to the discussion than mortality rates subsequent to smoking and obesity. However, while I look for those statistics, some "food" for thought:

According to this link: http://www.downtoearth.org/articles/obesity_america.htm obesity and smoking are responsible for more chronic conditions and mortality than any other factor in our country. This link: http://www.annecollins.com/obesity/worldwide-obesity.htm
shows that fewer adults in other western nations are obese than the estimated 1 in 4 in the United States.
This link chronicals the time frame over which more Americans have become Obese: http://www.americansportsdata.com/obesitystats.asp

Anyone notice a correlation between the time frame over which Americans have gotten fatter and the timeframe over which healthcare costs have increased? Nova, whether or not Americans partake in the unhealthy individual lifestyle choices that make us obese to a lesser degree than do citizens of other countries is irrelevant given the fact that we're just plain fatter than everyone else: 1 in 4 Americans are obese while between 10-20% of people in other industrialized countries are obese. The bottom line is that the aggregation (is this a word?) of factors contributing to the collective lifestyle of Americans facilitates obesity… no if's, and's, or Butt's (pun intended).

To me, the legitimate question is this: if you accept (as the statisitics show) that the two primary causes of mortality in our country are due to preventable behaviors, then why should we all share in the cost of treating the chronic conditions that arise secondary to these behaviors. At the risk of being branded a piss-poor human being who is blaming victims, I don't believe it's right to saddle Americans who make good decisions with the costs of treating preventable conditions that are consequences of bad ones. As an alternative, I'd be in favor of using tax payer dollars more efficiently and to a greater extent to invest in better public eduction, as it's been shown that more education correlates positively with better health.

To my way of thinking, the answer to the healthcare crisis in this country (in 15 sentences or less) is to give a $12,000 tax credit to those taxpayers who can prove that they're paying their own premiums, slap an excise tax on fast food and cigs, and regulate more transparency in the insurance industry and the use of electronic medical records. The decreased admin costs that result from the widespread use of e-medical records and the increase in competition created by consumerism will drive down premium costs. Those who can't afford to pay for their own insurance will qualify for the medicaid system funded by the taxes generated by the culprits of our diminished collective health. Increases in tax receipts based on corporations decreased outlay for health insurance premiums make up for the lost tax revenue due to the $12,000 credit. The solution is simple really, 🙂

 

[Nick Riviera MD]

Michael Moore raises a very important issue with “Sicko”, unfortunately he leaves himself open to attack by not presenting opposing arguments. I don’t think he ever says that healthcare in countries like France and Canada are “free”. In fact he does concede that these countries are “drowning in taxes”. Overall I think his point is a valid one: that financing healthcare through for profit insurance companies leads to many people not being covered. This system leads to predictable outcomes because it is not possible to make a profit off of a customer with heart disease or diabetes.

We are left with a system where we spend more money than any other country in the world and yet everyone is not fully covered. I think if Moore would have interviewed people from insurance companies that oppose systems like single payer health insurance, and then give an argument for why they are wrong, then it would have been a stronger documentary. In the very least people would not be able to simply write it off as ‘biased’ or ‘brainwashing’.

Clearly there is a problem with our system. One has to ask if “Market Based” healthcare is so great, why have other industrialized countries not adopted it?

 

[Noeljan]

Nova - Thanks for the stats you've posted pertaining to lifestyle and mortality. I'd be interested to see stats detailing the cost per capita for treating chronic conditions secondary to obesity and smoking in this country (as a percentage of total healthcare costs) vs. the other industrialized nations of the world... as these statisitcs would be more pertinent to the discussion than mortality rates subsequent to smoking and obesity. However, while I look for those statistics, some "food" for thought:

According to this link: http://www.downtoearth.org/articles/obesity_america.htm obesity and smoking are responsible for more chronic conditions and mortality than any other factor in our country. This link: http://www.annecollins.com/obesity/worldwide-obesity.htm
shows that fewer adults in other western nations are obese than the estimated 1 in 4 in the United States.
This link chronicals the time frame over which more Americans have become Obese: http://www.americansportsdata.com/obesitystats.asp

Anyone notice a correlation between the time frame over which Americans have gotten fatter and the timeframe over which healthcare costs have increased? Nova, whether or not Americans partake in the unhealthy individual lifestyle choices that make us obese to a lesser degree than do citizens of other countries is irrelevant given the fact that we’re just plain fatter than everyone else: 1 in 4 Americans are obese while between 10-20% of people in other industrialized countries are obese. The bottom line is that the aggregatation (is this a word?) of factors contributing to the collective lifestyle of Americans facilitates obesity… no if’s, and’s, or Butt’s (pun intended).

To me, the legitimate question is this: if you accept (as the statisitics show) that the two primary causes of mortality in our country are due to preventable behaviors, then why should we all share in the cost of treating the chronic conditions that arise secondary to these behaviors. At the risk of being branded a piss-poor human being who is blaming victims, I don't believe it's right to saddle Americans who make good decisions with the costs of treating preventable conditions that are consequences of bad ones. As an alternative, I'd be in favor of using tax payer dollars more efficiently and to a greater extent to invest in better public eduction, as it's been shown that more education correlates positively with better health.

To my way of thinking, the answer to the healthcare crisis in this country (in 15 sentences or less) is to give a $12,000 tax credit to those taxpayers who can prove that they're paying their own premiums, slap an excise tax on fast food and cigs, and regulate more transparency in the insurance industry and the use of electronic medical records. The decreased admin costs that result from the widespread use of e-medical records and the increase in competition created by consumerism will drive down premium costs. Those who can't afford to pay for their own insurance will qualify for the medicaid system funded by the taxes generated by the culprits of our diminished collective health. Increases in tax receipts based on corporations decreased outlay for health insurance premiums make up for the lost tax revenue due to the $12,000 credit. The solution is simple really, 🙂

👍👍great post

 

[hawk126]

More data pertinent to the discussion:

http://www.pwc.com/extweb/pwcpublications.nsf/docid/BB82984D3A7DF2A485257267003C98BC

PWC's data show that 43% of the year-over-year increase in the cost of healthcare in the US is attributable to greater utilization of services based, at least in part, on poor lifestyle choices. Further, at most, 14 cents out of every dollar of year-over-year increases in healthcare cost can be attributed to administrative overhead as 86 cents per dollar increase goes directly to medical services (inference by me based on the data presented). Consequently, even if we legislate high admin costs away with policy-making and regs then we still get 86% of the increase that we'd get if we just let the system sit as is. Stacking the deck to facilitate market based pressure (i.e. consumerism and increases in productivity) brings down costs... regs and policy-making can't do the job.

 

[Gut Shot]

At the risk of being branded a piss-poor human being who is blaming victims, I don't believe it's right to saddle Americans who make good decisions with the costs of treating preventable conditions that are consequences of bad ones.

I don't think you're a piss-poor human being, but I do have numerous objections to the above proposal, both philosophical and otherwise. From a practical standpoint, who is going to define good decisions vs. bad ones, who is going to parse decision-based health problems vs. situational or naturally occurring, and who is going to monitor them in every citizen?

 

[spartanwarrior]

You are shooting yourself in the foot.

Once again, it is a myth that it is the fat lazy smoking American that is the biggest reason why Americans are unhealthy when compared to the rest of the world. People in Europe and Japan also have very unhealthy life style habits, it isn't just Americans.

Do you know what the biggest cause of preventable death in the world is? It is smoking. Did you read what I posted before? 61% of men in Japan smoke compared to only 28% in America, 41% of women in Denmark smoke compared to only 24% in America. It is quite ironic that both of those places are deemed to have better overall health than America.





No one is saying that poor life style habits do not contribute to poor overall health. But incase if you haven't noticed, obesity is problem among industrialized nations, not just America. What I am trying to point out is the fact that people in places like Japan and Europe have bad life style habits too, like smoking, but tend to have better overall health than Americans. Why is this? Americans spend BY FAR the most amount of money on health care but are still in pretty poor shape.




who said it would be free? It is obvious that taxes would be increased for a more socialized form of health care. But tell me, what is the difference between being taxed more for a form of socialized medicine and not being taxed but having to drown in high insurance premiums, copayments, etc. ? There really isn't a difference at all.

Well,

I would like to ask you something. Have you ever lived in Japan sir? I doubt you have. I have lived there for two and a half years. Researched the Japanese healthcare system and having a clear idea about why the Japanese live longer than US people. It's because of their lifestyle pal, not their healthcare system. Their healthcare system is not as good as ours. The reason that you see the ubiquitous 80 year old woman or man in Japan riding a bike to get groceries or everyone walking to work, or eating a balanced diet. Yes, Japanese smoke, but not as much as Americans do in volume of cigarettes. They work just as hard as Americans. If you lived in Japan, you would know this seeing the typical salary man exhausted after 12 hours of work at the office. Complete ignorance to state things you cant back up without having lived there to see it. I have. You are wrong sir, just as you are most likely incorrect about Europe. US has the best healthcare system in the world and the difference between the US standard of living next to Japan, which is #2 in GDP, is amazing. When 15% of the country is not covered adequately or completely, that is not an excuse to say let's destory the old system, unless most are not covered. Small changes can be done, not drastic ones. Lifestyle has so much bearing on longetivity rates. Yes, readily accessible healthcare is important, but I think you drastically underestimate the significance of lifestyle habits and dieting. Easy to write that off as mundane and trivial things. 🙂