The propaganda out there tells you that the minute you don't have health insurance and you get sick, you're kicked to the curve. Not true. I have health problems and I have no insurance and I'm getting very good treatment.
Who is paying for your treatment?
Then how do you explain these figures? According to the American Heart Association, Canadians are 17% more likely that U.S. citizens to die from a heart attack. 30% of U.S. heart attack patients have had angioplast as opposed to 11% of Canadian patients. 13% of U.S. heart attack patients have had bypass surgery, as opposed to a mear 4% of patients in Canada.
The North American Association of Central Cancer Registries found that cancer patients treated in the U.S. are more likely to survive that cancer patients treated in Canada.Canadians have a higher rate of colorectal and stomach cancer. Colon cancer patients are more likely to die in Canada than in the U.S.
In Canada 24% of emergancy room patients had to wait more than 4 hours. In the United States the number was half that. In Canada 57% of patients had to wait more than 4 weeks to see a specialist. In the United States on 23% of patients did. In Canada 21% of patients had to wait more than three weeks for a biopsy. In the U.S. less than 1% did. In Canada 50% of hip replacement surgery candidates have to wait more than 6 months for their surgery. No recorded patient in the United States has ever had to wait that long.
Canada has 4.6 MRI machines per 1...
Somebody found Wikipedia...
Simple:
Canadians live longer than Americans
Canadians have low infant mortality than Americans
Canadians lose less years due to preventable disease than Americans
Canadian health system is ranked 30th in the world
American health system is ranked 37th in the world
Total Health Expenditures Per Capita, U.S. and Selected Countries, 2003
Canadian Health system costs $2998/person
American Health system costs $5711/person
Even if the systems performance was EQUAL - the Canadian system costs 50 cents on the dollar and includes EVERYONE.
Hmm that statement is so silly it kinda made it hard to listen to anything else you have to say.
If you know of another way to increase profits I am curious to hear it...
I saw the original post - I am sorry if you are offended.
You cannot use Walter Reed as an example of the failure of a public system and then upon learning that it was privatized use it as a failure of a public system.
The people that privatized Walter Reed did so for ideological reasons - not because they saw themselves a stewards of the public good... that is why elections are important.
I agree that it is hard to take a new position on something you feel strongly about - I often continue to argue my original position after I have been convinced that I am wrong about something so that I can learn the full extent of the other position.
I have no agenda here. I do not profit from the system you have in the USA.
I am merely attempting to educate you (and others) on a different way of doing things - because there are soooo many misconceptions about single payer public health care in the USA.
out of curiosity how long has canada had free health care now?
Saskatchewan introduced universal health coverage in 1946.
I haven't read in detail all the posts on this discussion of sickness care, so I apologize if this hasn't already been pointed out.
The US does not have single payer sickness care, but it does not have a free market sickness care system either. Sickness care in the United States is close to pure socialism/single payer, but not quite there yet.
It is single payer if you are age 65 or over, you can't get sickness care coverage except through Medicare by law at that age. HMOs exist because of the HMO acts of the 1970s, I believe the last one was in 1976. Medical licensing restricts the supply of doctors, which forces high salaries. And advertising is heavily restricted and regulated by the FDA, which makes it illegal to claim that your substance can treat or cure affliction or disease X unless the FDA gives you permission to state that, permission only granted to large pharmaceuticals that can afford to lobby(aka bribe) the FDA.
The problem of Canada and European nations with the single payer/"universal" sickness care is one of rationing. By making sickness care "free" you have the problem of too much demand, and not enough supply. This problem is "solved" by rationing, which causes the long wait times as mentioned by some posters. Rationing also leads to people being denied sickness care, or getting substandard care.
Note I have been saying sickness care throughout this, not health care. That is because when people talk about health care, they are really talking about sickness care.
Health care includes the following-
Avoid accidents, don't take unnecessary risks.
Eat good nutritious food in moderation.
Supplement with vitamins/minerals those nutrients you can't get through food.
Exercise.
Get 7-8 hours of sleep each night, most important, get some sleep before midnight.Health care is a responsibility of individuals, not governments.
Canadians live longer than Americans
Canadians have low infant mortality than Americans
Canadians lose less years due to preventable disease than Americans
Canadian health system is ranked 30th in the world
American health system is ranked 37th in the world
Total Health Expenditures Per Capita, U.S. and Selected Countries, 2003
Canadian Health system costs $2998/person
American Health system costs $5711/person
Even if the systems performance was EQUAL - the Canadian system costs 50 cents on the dollar and includes EVERYONE.
Then how do you explain these figures? According to the American Heart Association, Canadians are 17% more likely that U.S. citizens to die from a heart attack. 30% of U.S. heart attack patients have had angioplast as opposed to 11% of Canadian patients. 13% of U.S. heart attack patients have had bypass surgery, as opposed to a mear 4% of patients in Canada.
The North American Association of Central Cancer Registries found that cancer patients treated in the U.S. are more likely to survive that cancer patients treated in Canada.Canadians have a higher rate of colorectal and stomach cancer. Colon cancer patients are more likely to die in Canada than in the U.S.
In Canada 24% of emergancy room patients had to wait more than 4 hours. In the United States the number was half that. In Canada 57% of patients had to wait more than 4 weeks to see a specialist. In the United States on 23% of patients did. In Canada 21% of patients had to wait more than three weeks for a biopsy. In the U.S. less than 1% did. In Canada 50% of hip replacement surgery candidates have to wait more than 6 months for their surgery. No recorded patient in the United States has ever had to wait that long.
Canada has 4.6 MRI machines per 1...
Somebody found Wikipedia...
Simple:
Canadians live longer than AmericansCanadians have low infant mortality than Americans
Canadians lose less years due to preventable disease than Americans
Canadian health system is ranked 30th in the world
American health system is ranked 37th in the world
Total Health Expenditures Per Capita, U.S. and Selected Countries, 2003
Canadian Health system costs $2998/person
American Health system costs $5711/person
Even if the systems performance was EQUAL - the Canadian system costs 50 cents on the dollar and includes EVERYONE.
Let me ask you something. Have you looked into some of the reasons why the U.S. is lacking in these areas? It's more of a culture thing than anything else. We Americans take poor care of ourselves. Look how obese we are. We also have a tendency to only go to the doctor unless we're near death's door(even if the insurance is paying for it). We also have a violent crime rate in America that affects our average lifespan. These reasons contribute greatly to the figures you are stating.
Actually I have access to Lexus/Nexus and a few other academic journal search engines.
Somebody found Wikipedia...
Yes but that was cut from wikipedia.
It is ok I like wikipedia...
|
out of curiosity how long has canada had free health care now?
In 1946 Saskatchewan became the first province to adopt a government-supported model, thanks to Tommy Douglas, who was voted the Greatest Canadian of All-Time, and who also successfully pushed for welfare and pensions.
1961 was the year every province adopted government-funded medical programs, revisions were made in 1966, and in 1984 we removed user-fees and extra billing.
So, about 45 years.
|
Let me ask you something. Have you looked into some of the reasons why the U.S. is lacking in these areas? It's more of a culture thing than anything else. We Americans take poor care of ourselves. Look how obese we are. We also have a tendency to only go to the doctor unless we're near death's door(even if the insurance is paying for it). We also have a violent crime rate in America that affects our average lifespan. These reasons contribute greatly to the figures you are stating.
True story. I literally have to be dragged to the doctor to be seen. If I need stitches, I just grab super glue. The United States has a pretty unhealthy culture over all, esspecially when it comes to our weight. Of course it could be that we think too much.
Let me ask you something. Have you looked into some of the reasons why the U.S. is lacking in these areas? It's more of a culture thing than...
There are many variables. The OECD considers these when doing it's comparative analysis and rankings.
For example:
Canada has a very low population density - so medical resources are more difficult to deploy.
Canada has long cold winters (snow shoveling causes heart attacks).
Canadians are sedentary (hockey night in Canada anyone?).
Canada has poor medical services in isolated norther communities
Canada has difficulty attracting doctors to poor isolated northern communities.
Canada has illegal immigration.
Canada has a diverse racial and ethnic population.
Canada is fat and eats terribly (but still handsome)
The one thing that boggles my mind - if you are in favor of free markets why on earth would you pay twice as much for worse results?
Let me ask you something. Have you looked into some of the reasons why the U.S. is lacking in these areas? It's more of a culture thing than...There are many variables. The OECD considers these when doing it's comparative analysis and rankings.
For example:
Canada has a very low population density - so medical resources are more difficult to deploy.
Canada has long cold winters (snow shoveling causes heart attacks).
Canadians are sedentary (hockey night in Canada anyone?).
Canada has poor medical services in isolated norther communities
Canada has difficulty attracting doctors to poor isolated northern communities.
Canada has illegal immigration.
Canada has a diverse racial and ethnic population.
Canada is fat and eats terribly (but still handsome)The one thing that boggles my mind - if you are in favor of free markets why on earth would you pay twice as much for worse results?
Because your system isn't as good as you make it out to be.
True story. I literally have to be dragged to the doctor to be seen. If I need stitches, I just grab super glue. The United States has a pretty unhealthy culture over all, esspecially when it comes to our weight. Of course it could be that we think too much.
That is awesome - I can't wait to tell my wife that I my weight is a function of my genius!
Somehow I don't think she will find it comforting!
None of these statistics address what I said.
Why do Canadians live longer than Americans? It could be because they sleep longer than Americans, or because they go to bed earlier.
By having better health care(sleep) you avoid getting sick, and thereby make sickness care less important in determining your lifespan.
Why do Canadians lose less years due to preventable disease than Americans? It could be because they eat more nutritious food in moderation than Americans do or supplement better vitamins and minerals, it could have nothing to do with their sickness care.
Why does Canada's sickness care system cost less? Because of rationing, or because of better health(not sickness) care.
Why does Canada have lower infant mortality rates than the US? It could be because of better nutrition of the mothers, it could be because vaccine policies are different, it...
Really... that is your argument... *sigh*
The data is relevant because it is impossible to think critically without data.
The data is collected and evaluated by the OECD - an organization of democratic states that is tasked with gathering data by those states, to provide governments support for making DEMOCRATIC MARKET BASED REFORMS to various systems (health, medical, infastructure etc).
The OECD is for free markets. In the case of health care their data supports single payer universal systems.
Because your system isn't as good as you make it out to be.
I am not inventing the data.
The best way to fix the problem is to change the mindset of people, rather than turning the whole system over to the government. Our cultural perception is that doctors should live in big fancy houses, drive big fancy cars, and live extravegant lifestyles. In order to change the way health care works in this country, we should change the way people view the role of healers in our society, rather than just playing musical chairs with who runs the system.
Totally disagree that doctors' salaries are the problem. My father-in-law is a GP and lives comfortably, but nothing close to extravagantly. (Cosmetic surgeons in private practice who do the nip/tuck stuff are the ones who make the big bucks.) Most of the incredible costs for health care go directly to Humana, United Healthcare, etc. -- they collect high insurance premiums from companies, then refuse reimbursement for care whenever possible, passing the cost on to the patient. From experience, getting my wife's insurance to cover anything she needs typically requires 3-4 rounds of appeals and letters from the doctors, and after all that the insurance will typically opt not to cover something like 50% of the absurd costs that they cite. These companies reap tremendous profits. The pharmaceutical giants make out like bandits as well. We'd be better off having the doctors charge whatever they wanted and eliminating insurance altogether -- we'd be back to a free-market economy then.
|
|
The data is relevant because it is impossible to think critically without data.The data is collected and evaluated by the OECD - an organization of democratic states that is tasked with gathering data by those states, to provide governments support for making DEMOCRATIC MARKET BASED REFORMS to various systems (health, medical, infastructure etc).
The OECD is for free markets. In the case of health care their data supports single payer universal systems.
Do you know if they looked at the fact that Canada has a smaller and more densely concentrated population that the United States? Both of those factors would increase a persons access to health care which would then in turn see an increase in health related statistics such as life span and infant mortality.
Because your system isn't as good as you make it out to be.I am not inventing the data.
Stats don't always show the real picture. You need to look into some of the reasons behind the stats instead of the raw numbers themselves.
..its a right.see, this is where the term "rights" gets my blood a boil. there are no "rights", period. and the "right" you refer to entails the taking of wealth someone has earned to give to someone who has NOT earned it. so where do the earner's "rights" come in?
this isn't a discussion about "rights". this is a discussion about the redistribution of wealth because someone thinks life is supposed to be "fair". because, franky, i don't think anyone has the "right" to what I have earned. period. when an individual "redistributes" wealth, its called "theft". when a government does it, its called "taxes".
people have a "right" to help themselves to the contents of my wallet? i don't think so...
I always find this line of argument interesting. I believe its based on a very easy to make fallacy. When you say there are no "rights" I'm not sure you're being entirely accurate. For example, if soldiers kicked in your door and dragged you to a military prison without due process or access to counsel, you'd probably feel your rights had been impinged upon. Maybe not. I'd certainly feel your rights had been impinged upon.
Maybe (and forgive me, I DONT mean to put words in your mouth), but maybe you mean there are no metaphysically granted or inherent rights?
If so, I'd agree. But I'd also argue it doesn't matter. Because, sure, rights are an entirely human construction, determined by societies and granted to members. Yet this doesn't invalidate them. Quite the opposite. All our social constructs are just that, right? Human. I don't see how it could be any other way.
I think, when we look at the way the word "rights" is used, what we really mean is "law". We just mean it a lot. In other words, we strongly believe something should be a law and, by implication, may think less of places wherein such is not a law.
If you accept this analysis, which I do, then historicity applies. Not everything that is considered a right (something societies feel they would be negligently remiss to not offer members) today was always considered a right. For example, the 'right' of women to vote in elections. Yet I don't believe for a minute you'd argue that women should not be allowed to vote, right?
So that frames the argument, in my mind, as whether everyone in our society being given access to at least basic and emergency healthcare, regardless of personal wealth, is something that we as a society feel our members should have. Do we want to make medical treatment equal in law with voting, free speech, due process, heat in urban settings, clean water, and the like?
To this, I answer a resounding yes. I want basic health care and medical treatment to be available to all Americans the same way I want all Americans to have free speech and access to due process. And I'm willing to help pay for it. I also believe, firmly, that we as a society can absolutely afford it.
All of this speaks to affirming the goal, of course. Not to workability. But that always comes second I believe. First - is it a worthwhile goal for which America and Americans should strive? Second and third -- will it work if we have it?
So, as to theories on what healthcare for all americans means, what form it should take, whether that specific form is worth having, why we don't do it today, what the best way to do it is, and who or what is preventing us from accomplishing this goal? Well, more posts to follow. I'm a little long in the tooth as is.
But whether good, affordable, healthcare for all Americans is something we should work to giving ourselves? Yes and yes again. And, to be pre-emptive, while I think other countries have succeeded at this, it wouldn't matter if they hadn't. If we agree that no one else has good nation-wide healthcare, that doesn't mean Americans can't accomplish it. Just ask the Wright Brothers how they feel about that line of argument.
EDIT: I realize I'm coming back to this discussion late; so please give me a few moments to catch up...
|
I choose to try and live a moral and just life. I will not apologize for that.
Unfortunately the socialist paradigm you espouse is not moral.
The market fundamentalism you are espousing is amoral - and so you are choosing to live an amoral life under the pretext of worshiping money, markets, and invisible hands.
Except I do not espouse market fundamentalism.
There are more options than just that and socialism.I want to live in a society that is a great place for people to live.
Then you should pick a better economic system. Socialism is never more than an adequate place for people to live.
You prefer a society that is a great place for money to live.
Again, no. Your zero-sum view of the options is false, and thus you believe it justifies the immoral system you advocate.
What are you talking about? Universal systems have specialists.
I know. That is why your comparing people with heart trouble to people with knee trouble is flawed.
You do have that problem. By keeping 47 million people uninsured and millions more under insured - YOU DON"T LET THEM GET IN THE LINE.
Wrong. They all have the opportunity to get the money to pay for insurance, or to pay for health care directly. By not forcing them into a line at all we give them greater opportunity at all levels.
Of course it is - and the Canadian system provided better care - for everyone AT HALF THE COST.
Except it does not provide better care for everyone.
And yes I will wait for my neighbor who is in urgent need of care so that I can receive my less urgent care latter.
And that is why. By having to wait, your condition gets worse. That is not superior care, even if it is not as urgent.
And do you know who decided that... our doctors - not some bureaucrat - as you have been lied to about so many times by shareholders who want to steal your hard earned money using fear of force (denial of treatment) to redistribute the money from your wallet.
No, it is your bureaucrats deciding that. You have been lied to about that for so long by bureaucrats and political parties who have stolen your hard earned money using fear of force (denial of treatment, imprisonment, and social stigmatization) to redistribute money from your wallet.
Of course and what the Canadian - and western European models have shown is that you can have both universal health care and capitalism.
Except they have not. Your system is not capitalist but socialist. No competition for medical resources is allowed, lowering the overall quality and quantity of those resources.
Some one is getting your redistributed wealth - wouldn't you rather give them 50 cents instead of a dollar?
I would rather give them nothing.
It is telling though that you are so accepting of such redistribution that you are incapable of even questioning it.And I do not want to live in a world where jack booted stormtroopers named Smith and Friedman allow corporations to kick in my door and take all my money and give it to corporations...
Hey look I can make a strawman too!
Except I did not create a strawman. You were quite clear that the government should not allow people to become cosmetic surgeons when obstetricians were needed. That was your declaration.
So I repeat, I very much do not want to live in a world where jackbooted stormtroopers named Oppedisano kick in my door to take my money and give it to their bureaucrats to redistribute according to their corrupted morality.
not to mention that the american government has proven its complete inability to properly manage health care, look at VA clinics and the Walter Reed debacle. I'm not saying it's impossible just when I see what my government has done in the past with the very people it says are the most important, our military personel, how does that bode well for letting them try to take care of everyone elses health care?
That's an argument for a change in government, not an argument for giving up on providing healthcare for everyone in the country. My question is do we as a people think insuring everyone in the country can see doctors and receive decent medical care a worthwhile goal to fight to make a workable, beneficial reality?
Why is it that Canadians are not flocking to move to America for healthcare if their system is so bad? However, I have seen busloads of Americans flock to Canada for cheaper medications.Actually, Jim Carry, a Canadian, once said that if America went to Canadian style health care, rich Canadians would have nowhere to go to see the doctor. The reality is that many places in the world are now establishing American style health care systems for people who can afford it, du mostly to popular demand in those countries.
Would you mind providing some unbiased sources for this assertion?
One way that socialized health care systems keep their costs down is to avoid using radical treatments and new advances. Take Oregan for example, it will not pay for chemotherapy with it's medicare program, but will pay for physician assisted suicide. Why? Because chemo is a long expensive process that might not work. Killing the patient only requires the one visit and works every time. I fear that if the government takes over all healthcare, that is the direction we will be headed in.
This is an argument for properly funding nation-wide healthcare, and even suggests states alone are not equipped to address the issues. it is not an argument against strivign to put healthcare in place for all Americans. If we fear government is heading this direction, it is our responsibility, I believe, to make sure government goes in the right direction. It does not mean that we should let our fear breed inaction, does it? You don't strike me as an inactive or passive person.
My wife, baby, and I got him by a car in February. We waited 9 hours to see a doctor in the emergency room. That same week in our city, a woman died because she was too exhausted to wait in the emergency room any longer? Where's the friggin' health care I paid for. It's enough to turn a liberal off universal health care.Sorry to hear about that, Tarren. I hope everyone is okay.
Maybe if the provincial/national government took the $300 million they are going to spend on sports funding in Ontario in a bid for the Commonwealth Games (I think it is those games) we could have shorter wait times in emergency rooms. The case of the old woman sounds more like a mis-diagnosis by the staff which put her back in line when she should have been first. Personally, I've never had to deal with wait times in emergency, but I realize it is a reality.
One way that socialized health care systems keep their costs down is to avoid using radical treatments and new advances. Take Oregan for example, it will not pay for chemotherapy with it's medicare program, but will pay for physician assisted suicide. Why? Because chemo is a long expensive process that might not work. Killing the patient only requires the one visit and works every time. I fear that if the government takes over all healthcare, that is the direction we will be headed in.You can't seriously be suggesting that state-sponsored healthcase will lead to sanctioned mass murder? The doctors are the ones that make the decisions as to a persons care, then they bill the government. Not the other way around.
Personally I don't think Canada's system goes far enough. Everybody should have free access to eye and dental care - both of those can lead to serious health issues or an inability to function in regular society.
I think we should also keep in mind that no system is perfect. I know that sounds like a truism, which it is. But it also means that for every system, there will instances of failure. Anectdotal evidence (however horrible the experience -- sorry to hear about it Tarren Dei and glad everyone is alright), will always be found at both the really good and really bad ends of the spectrum. So anecdotes just don't tell us enough on which to make decisions.
How common nation wide is the problem, that's the question?
Still, answers will provide information on how to do better, not on whether all citizens should have access to healthcare the way they have access to other societal resources like education or water.
|
|
Would you mind providing some unbiased sources for this assertion?Why is it that Canadians are not flocking to move to America for healthcare if their system is so bad? However, I have seen busloads of Americans flock to Canada for cheaper medications.Actually, Jim Carry, a Canadian, once said that if America went to Canadian style health care, rich Canadians would have nowhere to go to see the doctor. The reality is that many places in the world are now establishing American style health care systems for people who can afford it, du mostly to popular demand in those countries.
How about the New York Times?
Although the government is reluctant to discuss the issue, hopscotching back and forth between private and public care has long been standard here for those who can afford it. But a few recent cases have exposed fundamental contradictions between policy and practice in the system, and tested its founding philosophy to its very limits.
One such case was Debbie Hirst’s. Her breast cancer had metastasized, and the health service would not provide her with Avastin, a drug that is widely used in the United States and Europe to keep such cancers at bay. So, with her oncologist’s support, she decided last year to try to pay the $120,000 cost herself, while continuing with the rest of her publicly financed treatment.
By December, she had raised $20,000 and was preparing to sell her house to raise more. But then the government, which had tacitly allowed such arrangements before, put its foot down. Mrs. Hirst heard the news from her doctor.
“He looked at me and said: ‘I’m so sorry, Debbie. I’ve had my wrists slapped from the people upstairs, and I can no longer offer you that service,’ ” Mrs. Hirst said in an interview.
“I said, ‘Where does that leave me?’ He said, ‘If you pay for Avastin, you’ll have to pay for everything’ ” — in other words, for all her cancer treatment, far more than she could afford.
Officials said that allowing Mrs. Hirst and others like her to pay for extra drugs to supplement government care would violate the philosophy of the health service by giving richer patients an unfair advantage over poorer ones.
Patients “cannot, in one episode of treatment, be treated on the N.H.S. and then allowed, as part of the same episode and the same treatment, to pay money for more drugs,” the health secretary, Alan Johnson, told Parliament.
“That way lies the end of the founding principles of the N.H.S.,” Mr. Johnson said.
But Mrs. Hirst, 57, whose cancer was diagnosed in 1999, went to the news media, and so did other patients in similar situations. And it became clear that theirs were not isolated cases.
In fact, patients, doctors and officials across the health care system widely acknowledge that patients suffering from every imaginable complaint regularly pay for some parts of their treatment while receiving the rest free.
“Of course it’s going on in the N.H.S. all the time, but a lot of it is hidden — it’s not explicit,” said Dr. Paul Charlson, a general practitioner in Yorkshire and a member of Doctors for Reform, a group that is highly critical of the health service. Last year, he was a co-author of a paper laying out examples of how patients with the initiative and the money dip in and out of the system, in effect buying upgrades to their basic free medical care.
“People swap from public to private sector all the time, and they’re topping up for virtually everything,” Dr. Charlson said in an interview. For instance, he said, a patient put on a five-month waiting list to see an orthopedic surgeon may pay $250 for a private consultation, and then switch back to the health service for the actual operation from the same doctor.
“Or they’ll buy an M.R.I. scan because the wait is so long, and then take the results back to the N.H.S.,” Dr. Charlson said.
In his paper, he also wrote about a 46-year-old woman with breast cancer who paid $250 for a second opinion when the health service refused to provide her with one; an elderly man who spent thousands of dollars on a new hearing aid instead of enduring a yearlong wait on the health service; and a 29-year-old woman who, with her doctor’s blessing, bought a three-month supply of Tarceva, a drug to treat pancreatic cancer, for more than $6,000 on the Internet because she could not get it through the N.H.S.
Asked why these were different from cases like Mrs. Hirst’s, a spokeswoman for the health service said no officials were available to comment.
In any case, the rules about private co-payments, as they are called, in cancer care are contradictory and hard to understand, said Nigel Edwards, the director of policy for the N.H.S. Confederation, which represents hospitals and other health care providers. “I’ve had conflicting advice from different lawyers,” he said, “but it does seem like a violation of natural justice to say that either you don’t get the drug you want, or you have to pay for all your treatment.”
Karol Sikora, a professor of cancer medicine at the Imperial College School of Medicine and one of Dr. Charlson’s co-authors, said that co-payments were particularly prevalent in cancer care. Armed with information from the Internet and patients’ networks, cancer patients are increasingly likely to demand, and pay for, cutting-edge drugs that the health service considers too expensive to be cost-effective.
“You have a population that is informed and consumerist about how it behaves about health care information, and an N.H.S. that can no longer afford to pay for everything for everybody,” he said.
Professor Sikora said oncologists were adept at circumventing the system by, for example, referring patients to other doctors who can provide the private medication separately. As wrenching as it can be to administer more sophisticated drugs to some patients than to others, he said, “if you’re a doctor working in the system, you should let your patients have the treatment they want, if they can afford to pay for it.”
In any case, he said, the health service is riddled with inequities. Some drugs are available in some parts of the country but not in others. Waiting lists for treatment vary wildly from place to place. Some regions spend $280 per capita on cancer care, Professor Sikora said, while others spend just $90.
In Mrs. Hirst’s case, the confusion was compounded by the fact that three other patients at her hospital were already doing what she had been forbidden to do — buying extra drugs to supplement their cancer care. The arrangements had “evolved without anyone questioning whether it was right or wrong,” said Laura Mason, a hospital spokeswoman. Because their treatment began before the Health Department explicitly condemned the practice, they have been allowed to continue.
The rules are confusing. “It’s quite a fine line,” Ms. Mason said. “You can’t have a course of N.H.S. and private treatment at the same time on the same appointment — for instance, if a particular drug has to be administered alongside another drug which is N.H.S.-funded.” But, she said, the health service rules seem to allow patients to receive the drugs during separate hospital visits — the N.H.S. drugs during an N.H.S. appointment, the extra drugs during a private appointment.
One of Mrs. Hirst’s troubles came, it seems, because the Avastin she proposed to pay for would have had to be administered at the same time as the drug Taxol, which she was receiving free on the health service. Because of that, she could not schedule separate appointments.
But in a final irony, Mrs. Hirst was told early this month that her cancer had spread and that her condition had deteriorated so much that she could have the Avastin after all — paid for by the health service. In other words, a system that forbade her to buy the medicine earlier was now saying that she was so sick she could have it at public expense.
Mrs. Hirst is pleased, but up to a point. Avastin is not a cure, but a way to extend her life, perhaps only by several months, and she has missed valuable time. “It may be too bloody late,” she said.
“I’m a person who left school at 15 and I’ve worked all my life and I’ve paid into the system, and I’m not going to live long enough to get my old-age pension from this government,” she added.
She also knows that the drug can have grave side effects. “I have campaigned for this drug, and if it goes wrong and kills me, c’est la vie,” she said. But, she said, speaking of the government, “If the drug doesn’t have a fair chance because the cancer has advanced so much, then they should be raked over the coals for it.”
Or the CNE's study here?
Still a failure of the government they were the decisionmakers and couldn't look past cost, how does that make it the problem of privatization and not a problem of the final decisionmakers. Privatization can work just fine if more than just the cost is looked at.The battle between the private contractor and the government employees on who provided the best services was eventually settled in favor of the government employees in 2002. Unfortunately for them, the Army Audit Agency then under the leadership of the Secretary of Defense Donald Rumsfeld, overturned that decision. Because the cost proposal from the private contractor was substantially less than that of the government employees, the decision to overturn was also supported by the Government Accountability Office (GAO). Please note however, the final decision was not based on providing equal or current service levels, it was only based on the lower cost comparison. What was not understood was that the Walter Reed Medical Center had previously been serviced by 350 government employee service providers. And this was the number of service employees prior to the beginning of the War in Iraq. The new private contractor replaced those 350 government employees with only 100 private contractors. From the beginning of that decision, the services offered and maintenance of the facility began to head down hill. When the war in Iraq began increasing the needs and numbers of wounded at the medical center, the situation quickly became critical.
Prior to that VA hospitals - when run by government - are models of efficiency and care:...
My wife, who works in the VA system, says that VA hospitals vary greatly by location. Generally, they are average in quality. Some exceptinal, some not. Walter Reed, she pointed out, is actually a DoD hospital and not VA.
I think she's right. I'm certainly not going to argue with her!
no, I'm not suggesting that at all. What I am saying is that with the current government run programs, we are seeing a trend towards the government only authorizing the quickest, cheapest option, rather than the best option. The doctors know well in advance what the government will pay for and those are the treatments they pursue. And if you do not meet certain criteria they will not consider treating you at all. That is why my wife's friend's father has been waiting for so long to have a hernia operation. He does not meet the British government's criteria for the surgery and so he will have to find the money and the doctor to have it done himself or he will not get it. Government work always lends itself to the quickest cheapest fix, not the best one.One way that socialized health care systems keep their costs down is to avoid using radical treatments and new advances. Take Oregan for example, it will not pay for chemotherapy with it's medicare program, but will pay for physician assisted suicide. Why? Because chemo is a long expensive process that might not work. Killing the patient only requires the one visit and works every time. I fear that if the government takes over all healthcare, that is the direction we will be headed in.You can't seriously be suggesting that state-sponsored healthcase will lead to sanctioned mass murder? The doctors are the ones that make the decisions as to a persons care, then they bill the government. Not the other way around.
I'm sorry to hear about your family healthcare troubles. That sucks.
I was with you all the way until your last sentence. I think this is an argument for not only providing healthcare to all Americans, but to making sure the healthcare provided is good.
These are not incompatible goals.
I think it's a false dichotomy to say its one or the other. Much as its popular to bash government incompetency and hawk on corporate greed, there are well run government programs and responsible corporations. Its our duty as Americans to fight for both. IMHO anyway.
|
|
Agreed. The best way to fix the problem is to change the mindset of people, rather than turning the whole system over to the government. Our cultural perception is that doctors should live in big fancy houses, drive big fancy cars, and live extravegant lifestyles. In order to change the way health care works in this country, we should change the way people view the role of healers in our society, rather than just playing musical chairs with who runs the system.
Actually the best way to fix the problem is to change the malpractice and tort laws.
The biggest factor driving soaring healthcare costs and doctors becoming cosmetic surgeons instead of obstetricians is the cost of malpractice insurance, and the related costs of fees for litigation and settlement.Reform malpractice investigations so doctors are not set up to protect themselves. Reform tort laws so that compensation is not absurdly open-ended, and that simple complications are not treated the same as overt incompetence. Reform tort laws further so they compensate people rather than lawyers.
That, rather than any accusation of immoral greed on the part of physicians or patients, is what drives the health care problem. Of course telling even socialists, lawyer, lawmakers, or "patient victims", that they are at fault will elicit shrieks of outrage.
My uncle was a doctor in Alberta and we have discussed this subject at some length. He told me that the doctors already know what the government will pay for and that is the direction that they steer the patient. It's not a matter of the government deciding a course of treatment, it is a matter of the government deciding if they will pay for a course of treatment. In Oregan, for example, doctors can still recommend chemo for their medicare patients, the government just won't pay for it.
But that is simply not true in Canada. Doctors recommend treatment based on the advice of their professional associations, which are based on research.
Training is also a factor - not all doctors can do all procedures.
The government does not decide my treatment - my doctor does - the government just pays for it.
Even if this is accurate (not that you need me to tell you this, but I'm sure your Uncle is honest and believes it to be accurate), it's just an argument for doing a better job. Not an argument against providing healthcare for every citizen.
One way that socialized health care systems keep their costs down is to avoid using radical treatments and new advances. Take Oregan for example, it will not pay for chemotherapy with it's medicare program, but will pay for physician assisted suicide. Why? Because chemo is a long expensive process that might not work. Killing the patient only requires the one visit and works every time. I fear that if the government takes over all healthcare, that is the direction we will be headed in.I have no idea what is going on in Oregon.
But that is simply not true in Canada. Doctors recommend treatment based on the advice of their professional associations, which are based on research.
Training is also a factor - not all doctors can do all procedures.
The government does not decide my treatment - my doctor does - the government just pays for it.
Your fear is misdirected you should be terrified of your present system - american health care ranks 47th in performance while costing more than twice as much as the Canadian system.
So your claim is that in Canada, if a doctor believed that a treatment costing $1 million/day would be the most effective, the government would pay that with out batting an eye?
EDIT: Also the comments about private healthcare providers not being beholden to customers is a bit wrong. If me and my family are looking to purchase health insurance and we ask our family and friends about theirs and learn that company A has a reputation of dumping people, even though they are cheaper. Guess what. We wouldn't purchase insurance from them. With a government, if you recieve poor service then you can switch to ... what?
This EDIT is slightly inaccurate, as health insurance is not a commodity like peaches. Meaning, you can't always get the other healthcare companies. For example, in NY, many of the private health care insurance companies don't service rural areas. Selection is much sparser. And the company's that do offer insurance in rural areas tend to be (a) much more expensive and (b) have reputations for poor service.
The basic problem is that preventative care is unavailable to many Americans. They go untreated and small diseases here and there and lack of doctor to patient education leads to more VERY sick people taxing the system.
By giving everyone access to basic preventative care, you give everyone lower medical costs.
I am a case in point. I have genetically based high-cholesterol. Even with changing my diet, I would not be able to lower it to a point where it is safe. So I have to be on cholesterol medication.
If I didn't have health insurance, this would go untreated and I'd likely have heart disease sooner rather than (hopefully) never. Because I am going to the doctor and am able to get a prescription for cholesterol reducing medication, I am saving the insurance company money. If it were government paid healthcare, I'd be saving the taxpayers money.
You are absolutely correct.
The problem for a corporation is that they are responsible for their shareholders on a quarter by quarter basis - so they do not see it that way - why should the CEO today care if the CEO in 10 years saves money?
Also you are faced with the fear that if you lose your health care or you will be denied health care because of preexisting conditions... this is an insanity of the private system - in Canada if I am sick the medical system *wants* to treat me.
The propaganda out there tells you that the minute you don't have health insurance and you get sick, you're kicked to the curve. Not true. I have health problems and I have no insurance and I'm getting very good treatment.
I'm very glad for you. But since we're still playing the anecdote game, let me counter you with a friend of mine. His wife got breast cancer after their insurance lapsed and before he could find new insurance. She now has a pre-existing condition on record, and they've been rejected by multiple insurnace carriers. He has to work 3 jobs now and is selling their house and still fears his ability to help her through the cancer.
I think this is, by far, the more common experience.
Another friend has a similar problem only his wife is dying. His problem was that he started a new small business and didn't get insurance in time.
Wow -- typing this I'm starting to get very angry. While I'm very happy for your good fortune, please don't try to tell me there is no problem. People are suffering and dying. It's that serious.
EDIT: I regret having to say "friend" and not name names, but I have to respect their privacy. Sorry.
|
|
How about the New York Times?
The NY Times is highly biased.
Of course every now and then they manage to slip up and actually report something like that.And then of course it is denied by everyone that support socialized medicine as actually being an issue.
So indeed, with a cost managed system, paying for palliatives, including euthanasia, will inevitably become a significant element because resources are limited.
While the debate on health care is interesting I'd like to offer this new debate point -
Since we can identify potions of each system that are broken why can't we seem to fix them?
For example,
Congressman A introduces a simple bill that deals with a specific problem.
Congresswoman B, sensing the overwhelming popularity of the bill, tacks on a tiny provision addressing her particular district.
C adds his little piece.
It goes to the Senate where the process is rinsed, refined, and repeated.
Senator D says 'I don't agree with these add-ons', cut them and add these others. Compromises are made to get support.
If they manage to get both the House and the Senate to agree, the bill barely resembles the original form, contains a portion of dubious language/pork barrel, and costs a whole lot more.
A - President/Governor vetoes a good Bill because of the add-ons.
Bad President.
B - President/Governor signs the Bill and taxpayers pay for a lot of extra crap to get a simple fix made.
Bad President.Problem fixed? Maybe, maybe not. I'm not even sure if anyone remembers the original goal. Beyond the sound bits about this new law being 'good' for you.
Now there's a finger on the pulse of the workability problem!
There are only two ways to maximize profit. Charge more or decrease services.Hmm that statement is so silly it kinda made it hard to listen to anything else you have to say.
Well you can reduce the cost of delivering the same service, but other than those three ways, why is it silly? And even if it was silly, shouldn't every other statement be weighed on its merits?
I won't stop listening to you just because I thought the objection you just made was silly. Promise.
RPG Superstar 2009 Top 32, 2010 Top 8
|
I'm very glad for you. But since we're still playing the anecdote game, let me counter you with a friend of mine. His wife got breast cancer after their insurance lapsed and before he could find new insurance. She now has a pre-existing condition on record, and they've been rejected by multiple insurnace carriers. He has to work 3 jobs now and is selling their house and still fears his ability to help her through the cancer.
I think this is, by far, the more common experience.
Another friend has a similar problem only his wife is dying. His problem was that he started a new small business and didn't get insurance in time.
Wow -- typing this I'm starting to get very angry. While I'm very happy for your good fortune, please don't try to tell me there is no problem. People are suffering and dying. It's that serious.
EDIT: I regret having to say "friend" and not name names, but I have to respect their privacy. Sorry.
Lou, pre-existing conditions suck. In the states, we have HIPPA and COBRA acts, some of their aspects are a pain, but even I see the benefits they have.
I assume you're not in the US or your friends went more than 60 days W/o coverage?
Stats don't always show the real picture. You need to look into some of the reasons behind the stats instead of the raw numbers themselves.Because your system isn't as good as you make it out to be.I am not inventing the data.
What your asking, really, is whether the OECD (sic) study is well designed or not. A fair enough question. In return, it is a fair question to ask whehter or not any opposing study is well designed or not.
Now that we've established none of us can say whether any study has led to reliable results, we've kind of shut down the argument, haven't we?
Now I doubt that was your intention, but I think it may show we're a bit off track. The question is not "Does the Canadian system work better than the US system?" Not really. Though, personally I think it does.
The question is "Should we try to give all US citizens good medical coverage, regardless of individual incomes?" I say yes. WE should try to do that. Do you agree?
Even if you prove that Canada's system isn't so hot (which I don't accept), so what, really? The fact that they can't do it right wouldn't me that we can't or shouldn't, does it?
Hey - if you actually go and read the methodology section of the OECD (or whatever they're called study), get back to me and we can have a debate over its validity. Until then, I'll accept the statistical work as valid and professional -- meaning it accounts as best one can for variability issues like those your raise -- just like I'll accept the studies that show higher heart disease. Otherwise we can't even talk.
If however you have a specific reason for doubting the validity and design of a specific study, I'd love to hear it.
Would you mind providing some unbiased sources for this assertion?Why is it that Canadians are not flocking to move to America for healthcare if their system is so bad? However, I have seen busloads of Americans flock to Canada for cheaper medications.Actually, Jim Carry, a Canadian, once said that if America went to Canadian style health care, rich Canadians would have nowhere to go to see the doctor. The reality is that many places in the world are now establishing American style health care systems for people who can afford it, du mostly to popular demand in those countries.How about the New York Times?
And here?
I don't think these say what you think they do. On my read they argue that the UK, for example, is starting to supplment care delivery with non-government owned, non-government run facilities. The government is still paying the bill, which makes it a sort of hybrid system emerging between the US and Canadian. However, there is still universal coverage paid by the government, so I'm not sure it really supports your point.
I'm very glad for you. But since we're still playing the anecdote game, let me counter you with a friend of mine. His wife got breast cancer after their insurance lapsed and before he could find new insurance. She now has a pre-existing condition on record, and they've been rejected by multiple insurnace carriers. He has to work 3 jobs now and is...The basic problem is that preventative care is unavailable to many Americans. They go untreated and small diseases here and there and lack of doctor to patient education leads to more VERY sick people taxing the system.
By giving everyone access to basic preventative care, you give everyone lower medical costs.
I am a case in point. I have genetically based high-cholesterol. Even with changing my diet, I would not be able to lower it to a point where it is safe. So I have to be on cholesterol medication.
If I didn't have health insurance, this would go untreated and I'd likely have heart disease sooner rather than (hopefully) never. Because I am going to the doctor and am able to get a prescription for cholesterol reducing medication, I am saving the insurance company money. If it were government paid healthcare, I'd be saving the taxpayers money.
You are absolutely correct.
The problem for a corporation is that they are responsible for their shareholders on a quarter by quarter basis - so they do not see it that way - why should the CEO today care if the CEO in 10 years saves money?
Also you are faced with the fear that if you lose your health care or you will be denied health care because of preexisting conditions... this is an insanity of the private system - in Canada if I am sick the medical system *wants* to treat me.
The propaganda out there tells you that the minute you don't have health insurance and you get sick, you're kicked to the curve. Not true. I have health problems and I have no insurance and I'm getting very good treatment.
I'm sorry to hear that. I realize the system fails at times. We need to make changes to the system so things like this don't happen. However, socialized medicine isn't the answer. It fails too often as well.
|
|
The question is "Should we try to give all US citizens good medical coverage, regardless of individual incomes?" I say yes. WE should try to do that. Do you agree?
See, here is where you and I disagree. I think that the best solution is to get the government completely out and let people make their own choices. As I pointed out earlier, there is a movement in places where the government does control the health care system to put those decisions back in the hands of the people who they affect most.
I'm very glad for you. But since we're still playing the anecdote game, let me counter you with a friend of mine. His wife got breast cancer after their insurance lapsed and before he could find new insurance. She now has a pre-existing condition on record, and they've been rejected by multiple insurnace carriers. He has to work 3 jobs now and is selling their house and still fears his ability to help her through the cancer.
I think this is, by far, the more common experience.
Another friend has a similar problem only his wife is dying. His problem was that he started a new small business and didn't get insurance in time.
Wow -- typing this I'm starting to get very angry. While I'm very happy for your good fortune, please don't try to tell me there is no problem. People are suffering and dying. It's that serious.
EDIT: I regret having to say "friend" and not name names, but I have to respect their privacy. Sorry.
Lou, pre-existing conditions suck. In the states, we have HIPPA and COBRA acts, some of their aspects are a pain, but even I see the benefits they have.
I assume you're not in the US or your friends went more than 60 days W/o coverage?
I live in NY. They both went more than 60 days and both own their own businesses.
I'm sorry to hear that. I realize the system fails at times. We need to make changes to the system so things like this don't happen. However, socialized medicine isn't the answer. It fails too often as well.
I'm sorry to do this to you, but I think 'socialized' is still a boogeyman word, best avoided. It has a lot of noise but different content for too many people.
How about this: making sure all Americans recieve free or dirt cheap, decent health insurance is a solution.
Just like all Americans receive free or dirt cheap clean water.
It would clearly be a solution for my friends and millions of others like them; say, the 40+million women without prenatal care.
See, here is where you and I disagree. I think that the best solution is to get the government completely out and let people make their own choices. As I pointed out earlier, there is a movement in places where the government does control the health care system to put those decisions back in the hands of the people who they affect most.
The question is "Should we try to give all US citizens good medical coverage, regardless of individual incomes?" I say yes. WE should try to do that. Do you agree?
How about this. What about paying for the health insurance regardless of who delivers the medical care? Because I don't know how much choice a broke person has or the people I've mentioned or the millions like them.
|
|
Okay I've forgotten now, how is the health care debate tied to Palin other than that she's against socialized medicine?
Speaking of Palin polling shows that she actually is turning out to have been the best possible choice for VP she's energized the party base and is pulling in those wascawy uncommiteds.
Another factor to be considered in the 'Canadian versus US' (since this has taken center stage of the larger discussion) Health Care debate is the differences between the 2 countries. These differences skew the statistical analysis and results.
While Canada is a very large country it has a much smaller population to care for. Fewer 'customers' spread out over a large area.
Comparisons also need to include all variables - Medicare does provide a basic level of 'coverage', COBRA is available to workers in transition, General Hospitals do provide emergency/urgent care to patients (even if they are illegal aliens - and the US has a lot of them), and people can buy different levels of coverage. If people choose not to maintain coverage that's taking on a risk, and limits you to the bottom tier of coverage.
The healthcare system in the US does provide competition and innovation. And once those innovations are proven ALL countries/healthcare systems can take advantage of them. (Benefits with minimal cost outlay.) YES, this could be replaced by government sponsored research but at significant cost.