US has best healthcare if you're not poor?

[VA Hopeful Dr]

Please, don't get started. It's already been addressed by the CDC. Even when you exclude births before 22 weeks, we still do worse than many of our European peers (almost double the mortality rates of Norway and Sweden, for example). And when you break it down by gestational period, we actually do better than most of our peers in births before 27 weeks. Where we struggle most (comparatively) is in births after 37 weeks. See Table 2 from the report.

This line is particularly egregious:

Bull****. Of the 19 countries in that report, 14 report births the same we do (i.e. all live births). France's cutoff is 22 weeks and 500 grams, by the way.

It's frustrating to see this excuse get trotted out over and over, when the evidence doesn't support it.

I actually like that report. It states quite clearly that our higher mortality rate is due almost exclusively to our higher pre-term delivery rate even though we are better at pre-term deliveries than just about anyone else.

As someone who used to deliver babies, I can tell you that the majority of pre-term deliveries are due to factors outside of our (doctor's) control - advanced maternal age, poor lifestyle choices, and most especially drug use. A large amount of the remaining pre-term deliveries are due to the US being much less willing to just let a pregnancy go if there is concern about a complication.

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[VA Hopeful Dr]

Assuming those numbers are correct, the 5.5k in teh states buys more than 5.8k does in europe and you know it , but that is a different story.

Exactly, 1 pound sterling has the buying power of 1 dollar (more or less) so that 3.4k pounds has the spending power of 3.4k dolalrs.

 

[Nephronlearner]

The topic of the thread isn't which system is better for the patient, but how high the quality of the system is for those that have access to it.

If you look at outcomes, the US does not perform all that poorly. We've got the best 5-year cancer survival rates in the world for most types of cancer, the fourth best stroke survival rates in the world, and comparable outcomes to other industrialized countries when looking at overall health outcomes. This is despite the large number of Americans lacking adequate care. If our outcomes are that good despite having many millions of uninsured, it only stands to reason that if they were insured, our outcomes would likely be superior to most other countries in even more metrics.

We've got great health care, if you can afford it. There's a reason people fly here from all around the world for procedures and cancer treatment- because it's the best care out there and it's available when you want it, if you can pay.

http://www.webmd.com/heart-disease/news/20040920/us-tops-canada-in-post-heart-attack-care I can't find a solid multinational study on post-MI care.

Solid stroke results, far superior to many countries with socialized medicine.

http://content.healthaffairs.org/content/23/3/89.long We've got comparable outcomes to other developed nations despite much poorer access to care
http://healthreformquestions.com/american-health-care-facts.php Site that goes over a bunch of the data on the topic.

This is exactly what I have been saying all along. US system is good, certainly one of the best (maybe even the best but it's too hard to judge) in the world to those who can afford it - the only thing where it could, in my opinion, improve is access to care.

You can say this because the rest of the world has continually bailed you out over time. The US isn't alone in this- Russia has played a large part over history as well. I just find it funny Europe in general is so critical of the nations that essentially are the only reason it still exists and isn't just one nation.

Your distaste for Europe does explain why you get so insulted when someone says not everything is awful here but still... events from 70 years ago have little relevance to current healthcare costs.

The difference doesn't need to be astronomical. Even if you lose an extra 10% of your disposable income to taxes, that's going to kill when you factor in how much it could have compounded until retirement. For a physician, 10% can be 20k a year plus of lost income that could've gone toward retirement, a HUGE amount when compound interest and yearly contributions are considered.

But a lot of that money would be spent on healthcare costs. Again, not saying life isn't slightly better overall in the US, it may be (depending on the region in Europe and US obviously), but simply pointing out that things aren't as black/white as some people are trying to present them.

Assuming those numbers are correct, the 5.5k in teh states buys more than 5.8k does in europe and you know it , but that is a different story.

True, the cost of living is somewhat higher (due to higher VAT) and that is indeed a different story. 1 pound in London would buy more than 1 dollar in New York though (according to this):
http://www.workgateways.com/working-cost-of-living.html
http://www.nerdwallet.com/cost-of-living-calculator/city-life/new-york-manhattan

But I don't see the 'astronomical' difference in standard of living, especially taking into consideration that taxes in England (and the rest of Europe) cover the healthcare costs.

I actually like that report. It states quite clearly that our higher mortality rate is due almost exclusively to our higher pre-term delivery rate even though we are better at pre-term deliveries than just about anyone else.

As someone who used to deliver babies, I can tell you that the majority of pre-term deliveries are due to factors outside of our (doctor's) control - advanced maternal age, poor lifestyle choices, and most especially drug use. A large amount of the remaining pre-term deliveries are due to the US being much less willing to just let a pregnancy go if there is concern about a complication.

Another thing I have mentioned a few times already - both life expectancy and infant mortality have more to do with access to care than actual care - any decent hospital both in the US and EU will have facilities good enough to deal with pre-mature births so any data is pretty much irrelevant.

 

[NontradCA]

I actually like that report. It states quite clearly that our higher mortality rate is due almost exclusively to our higher pre-term delivery rate even though we are better at pre-term deliveries than just about anyone else.

As someone who used to deliver babies, I can tell you that the majority of pre-term deliveries are due to factors outside of our (doctor's) control - advanced maternal age, poor lifestyle choices, and most especially drug use. A large amount of the remaining pre-term deliveries are due to the US being much less willing to just let a pregnancy go if there is concern about a complication.

Exhibit A: delivering an anecepahalic baby then calling it a miracle when it's lived 2 debilitated, painful years. That's pretty much what's wrong with our healthcare costs in a nutshell. How much money is spent on futile care?

 

[deleted480308]

@sb247, do you propose an alternative to taxation to raise funds for the needy?

yes, yes it is. You have no problem using other people's money to pay for your medical school tuition. When the system benefits you, you take full advantage of it. Don't give me that crap "I'm in the system so I have to take part in the system". If you truly believed that taxation = theft, you should be eschewing everything relating to taxation.

Taxation is not theft. It is the price of living in a civilized nation that has needs and obligations to meet to it's citizenship.

you have to find a better target for the, "but you love income tax for other things, you have to love it for all things"....I don't believe in the income tax existing at all, particularly in it's currently unfair status where the earners foot the bill for everything. I also don't agree with the paye/ibr/pslf programs existing because all they do is stick everyone else with your bill if you hold on long enough

and (with the exceptions mentioned above) the student loans get hung around your neck like a noose you can't bankrupt out of, so they end up not being a gift

 

[Mad Jack]

Please, don't get started. It's already been addressed by the CDC. Even when you exclude births before 22 weeks, we still do worse than many of our European peers (almost double the mortality rates of Norway and Sweden, for example). And when you break it down by gestational period, we actually do better than most of our peers in births before 27 weeks. Where we struggle most (comparatively) is in births after 37 weeks. See Table 2 from the report.

This line is particularly egregious:

Bull****. Of the 19 countries in that report, 14 report births the same we do (i.e. all live births). France's cutoff is 22 weeks and 500 grams, by the way.

It's frustrating to see this excuse get trotted out over and over, when the evidence doesn't support it.

I stand corrected. I'd honestly just trusted my sources too much.

We do have significantly better premature survival rates than many countries. I'm curious how the results would look if we compared infant mortality by age of the mother and income status of the parents when compared to other countries.

This is exactly what I have been saying all along. US system is good, certainly one of the best (maybe even the best but it's too hard to judge) in the world to those who can afford it - the only thing where it could, in my opinion, improve is access to care.



Your distaste for Europe does explain why you get so insulted when someone says not everything is awful here but still... events from 70 years ago have little relevance to current healthcare costs.



But a lot of that money would be spent on healthcare costs. Again, not saying life isn't slightly better overall in the US, it may be (depending on the region in Europe and US obviously), but simply pointing out that things aren't as black/white as some people are trying to present them.



True, the cost of living is somewhat higher (due to higher VAT) and that is indeed a different story. 1 pound in London would buy more than 1 dollar in New York though (according to this):
http://www.workgateways.com/working-cost-of-living.html
http://www.nerdwallet.com/cost-of-living-calculator/city-life/new-york-manhattan

But I don't see the 'astronomical' difference in standard of living, especially taking into consideration that taxes in England (and the rest of Europe) cover the healthcare costs.



Another thing I have mentioned a few times already - both life expectancy and infant mortality have more to do with access to care than actual care - any decent hospital both in the US and EU will have facilities good enough to deal with pre-mature births so any data is pretty much irrelevant.

You won't spend nearly that amount on healthcare costs. If you put that 10% of your income you were losing into the stock market and made 8% a year after fees in returns, you'd have $2,447,406.79 in your retirement account after 30 years of contributions. You can more than afford health insurance with that amount of cash, and any hospital bills that come up. If you're wealthy, paying higher taxes basically never makes sense if you can avoid it- taxes largely go to benefit people who are not you.

 

[NontradCA]

so it's charitable and kind to seize over 1/3 of someone's income to force them to pay other people's bills?

It is when there's representation. This is such ridiculous logic. You think people who work hard and prosper can do so without the infrastructure and support of the US? Nevermind the rich get all their money from the poor, but they're very much protected by the gov't in way of police departments and the military. Pay your damn taxes.

It's funny that conservatives are the first to talk about patriotism, but the first to dichotomize the country. Lel.

 

[Nephronlearner]

I stand corrected. I'd honestly just trusted my sources too much.

We do have significantly better premature survival rates than many countries. I'm curious how the results would look if we compared infant mortality by age of the mother and income status of the parents when compared to other countries.

You won't spend nearly that amount on healthcare costs. If you put that 10% of your income you were losing into the stock market and made 8% a year after fees in returns, you'd have $2,447,406.79 in your retirement account after 30 years of contributions. You can more than afford health insurance with that amount of cash, and any hospital bills that come up. If you're wealthy, paying higher taxes basically never makes sense if you can avoid it- taxes largely go to benefit people who are not you.

I never said you couldn't make more money. Obviously, not everyone will earn 8% a year and a part of it would be spent on things you wouldn't pay here so overall, I agree that standard of living in the US is somewhat higher but the difference isn't as large as some people seem to think.

 

[@JackShephard]

Interesting article I read today:
http://www.hindustantimes.com/india-news/50-essential-meds-to-be-given-free/article1-1231375.aspx
Health min plans to give 50 essential medicines free
After recently prescribing the need for 'bitter medicine' to resuscitate the ailing economy, the Narendra Modi government is, seemingly, working on contours of a social welfare healthcare project to sweeten the deal for the citizenry. For starters, the health ministry's vision is to provide 50 essential generic medicines, free of cost, from "birth to death" to all Indians across the nation.

"Fifty basic essential drugs address 75% of the healthcare needs of the majority, and we plan to make these available free to everyone, from birth to death," Union health minister Harsh Vardhan told HT.

The programme will be rolled out in phases, beginning with select hospitals across India, with the objective of reaching every citizen.

Once the rollout is complete, everyone will get these 50 medicines – that include traditional treatments for pain, infection, hypertension, diabetes, among others – complimentary on prescription at public hospitals and dispensaries.

"A standard list of medicines will ensure that for the same amount of money, 35% more medicines of superior quality can be procured to meet the healthcare needs of the majority," said Dr Vardhan.

"The programme will focus on efficient procurement, quality control and rational use – 50% medicines are wasted or overused, leading to complications and drug- resistance," the minister added.

Notably, as the Capital's health minister between 1993 and 98, Dr Vardhan implemented the 'Delhi model' of World Health Organization's "Essential Drug Programme" that drew up an essential drugs list with relevance to India's healthcare needs.

"Today, the out-of-pocket expenditure on health is 60% mainly because of two factors, medicines and diagnostics. Providing free medicines coupled with their rational prescription and use will lower cost to patients tremendously," said Ranjit Roy Chaudhury, national professor of pharmacology and chair of the committee for preparing the city's essential medicines list.

The Delhi model has been duplicated in 12 states in India and is promoted as a case study for developing nations by WHO.

 

[Beargryllz]

It's settled then

Implement basic income and be done with this nonsense