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Originally posted by leadb:
In Spain, where everyone is covered, per capita health care spending is $2,000. In the US, where millions go without coverage (which means a -lot- of preventative health care is missed), the per capita spending is $6,000.

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Originally posted by Finn mac Cumhal:
Regardless of what you feel about the quality of nationalized healthcare, the Europeans are paying for it. They are getting nothing for free. Although European politicians probably rely heavily on the appearance of getting something for free.

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Originally posted by citizen:

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Originally posted by Finn mac Cumhal:
Regardless of what you feel about the quality of nationalized healthcare, the Europeans are paying for it. They are getting nothing for free. Although European politicians probably rely heavily on the appearance of getting something for free.

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You missed what Edward would have to pay for his health insurance. Europeans pay less for their healthcare than people in the states.

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Originally posted by Finn mac Cumhal:
Well, I didn’t actually miss it. I Just assumed that it would be understood.

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Regardless of what you feel about the quality of nationalized healthcare, the Europeans are paying for it. They are getting nothing for free. Although European politicians probably rely heavily on the appearance of getting something for free.

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Originally posted by citizen:
But this would seem to imply that Europeans pay more for healthcare than Americans.

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Originally posted by Finn mac Cumhal:
It doesn’t imply that at all. It only implies that many people don’t compare paying for government expenses through taxes as being the same as paying out of pocket, even though they are.

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Something politicians can and do exploit.

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In the 1990s, there was a paper I read that summed up the difference between US and Canadian healthcare system. It was debunking the assertion that because Canadians pay less in GDP for healthcare then the US, that this means that healthcare in Canada is more efficient, but as the author of this paper demonstrated, in that year Canada got their first MRI. In that year, New Jersey alone had 8 MRI machines. The US may pay a larger percentage of GDP in healthcare, but we also have a good healthcare.

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Nonetheless, as I said, I pay about $1000.00 a year for healthcare for my whole family, and I still don’t pay as high taxes as they do in Spain, yet I have access to as good or better healthcare as Spain. I agree that it is always going to be a challenge to compare healthcare between Spain and the US, but in the end, from my point of view as an American, I do seem to be paying much less for healthcare then the difference in taxation between Spain and the US, and I’m getting good healthcare for it. Now how this fits into the larger picture, I'm not completely sure, but these are, as they say, the facts on the ground.

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Originally posted by citizen:
I would have thought results would be a better indicator? What I mean is, how many MRI machines you have wouldn't seem to be a persuasive argument for which system is better.

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Originally posted by citizen:
But the Spanish pay less for healthcare.

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Originally posted by Finn mac Cumhal:
Well I would disagree with that. And so would just about anyone with a brain tumor they want to catch early. Having more and better healthcare equipment his typically translated into better results.

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And my guess is that there healthcare isn’t anyway near as good as the US healthcare on average, but either way, I'm still bringing home more money and getting good healthcare.

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Originally posted by citizen:
But that wasn't really my point. My point was that spending more money doesn't necessarily mean better. The number of MRI machines may imply that the care could be better, but its far from proving it or an argument towards it. I'd suggest that statistics for key factors would be a better indicator.

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Originally posted by citizen:
It's still an unfair, and irrelevant comparison. You might have more disposable cash, you may pay less taxes, but that doesn't say anything about healthcare or the cost of it. If the Spanish government is providing more services outside of healthcare, you can't compare all the taxes the Spanish pay as indicative of the price of public healthcare. It doesn't make sense.

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Originally posted by Finn mac Cumhal:
The number MRI is an indicator of the quality of care. I took my internship in Oncology and the number of and type of scanning devices is a huge indicator of quality.

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Yet, I can say that I pay less tax and still get good healthcare.

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Originally posted by rue:
And what does that have to do with per capita population figures ?

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Originally posted by citizen:
Lest we actually engage in an honest debate...

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Originally posted by Finn mac Cumhal:
In fact, in all honesty, I’m telling you want I understand to be true.

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You’re telling me it’s all wrong, but you’ve not given me any reason to believe that.

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The US pays a higher parentage of its GDP on healthcare evidently, but I don’t pay more taxes then Spain.

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Nationalized healthcare often limit the care that it can provide. The government then controls what is spent on healthcare by place restrictions on the care that Spanish citizens can receive.

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Far fewer restrictions exist in the US, where healthcare is much more subject to the market. People with lots of money in the US often have expensive procedures done, more expensive equipement and better facilities, and greater access to care including access to expensive treatements and drugs all of which could inflate the healthcare percent of GDP.

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It actually makes sense then that healthcare could be a larger percentage of GDP in the US then in Spain, while healthcare in the US is still generally cheaper.

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Originally posted by citizen:
I'm giving reasoning and in response you just say "well I've got more money, and pay less taxes". Fantastic for you, go buy yourself a HD DVD player to congratulate yourself, but it doesn't say a damn thing about comparative healthcare systems.

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Originally posted by Finn Mac Cumhal:
I already have one. But the tax rate that applies to me doesn’t just apply to me only. It applies to everyone in Alabama, likewise the tax rate, presumably, applies to everyone in Spain. Therefore, this is not about me only. Almost Everyone in Alabama gets a better deal on their taxes then almost everyone in Spain.

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There is a small percentage of people, ~15% who don’t have health insurance, but they still get healthcare just not as much as they probably need. Socialized medicine would probably be able to provide those 15% with better care, but at a cost of seriously restricting healthcare across the board, compared to most people in the US.

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Aren’t the 25,000 British cancer patients who have died unnecessarily, according to the WHO, due to a lack of modern technologies and cancer treatments in Britain a factor that influences the quality of the healthcare.

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We can be sure that both the US and Spain probably have deficiencies in healthcare somewhere, but private healthcare insurance in the US does not come even remotely close to the kinds of restrictions that we see in socialized medicine.

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Socialized medicine is often touted but facts on the ground, I think, are almost always very, very different.

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HEALTH INSURANCE PREMIUM GROWTH MODERATES SLIGHTLY IN 2006, BUT STILL INCREASES TWICE AS FAST AS WAGES AND INFLATION

Enrollment in Consumer-Directed Health Plans Remains Modest At 2.7 Million; Relatively Few Employers Expect To Adopt Such Plans Next Year

Washington, D.C. – Premiums for employer-sponsored health coverage rose an average 7.7 percent in 2006, less than the 9.2 percent increase recorded in 2005 and the recent peak of 13.9 percent in 2003, according to the 2006 Employer Health Benefits Survey released today by the Kaiser Family Foundation and the Health Research and Educational Trust (HRET). Key findings from the survey were also published today as a Health Affairs Web Exclusive.

This year’s survey recorded the slowest rate of premium growth since 2000, though premiums still increased more than twice as fast as workers’ wages (3.8 percent) and overall inflation (3.5 percent). Premiums have increased 87 percent over the past six years. Family health coverage now costs an average $11,480 annually, with workers paying an average of $2,973 toward those premiums, about $1,354 more than in 2000.

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STAMFORD, CT, SEPTEMBER 24, 2007 -- As employers across the United States get ready to unveil next year's health plan changes -- and the costs associated with them to America’s workers and retirees, new data from Towers Perrin indicate that the average corporate health benefit expenditure in 2008 will be $9,312 per employee -- an increase of 7% over 2007.

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Average family health policy nears $11,000
By Julie Appleby, USA TODAY
The average cost for a family health insurance policy topped $10,000 for the first time this year, although premium costs rose at their slowest rate since 2000, a closely watched survey of employers released Wednesday shows.

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Originally posted by leadb:
So, if these quotes bear any resemblence to reality, Spanish folks are making out like bandits.

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Originally posted by Finn mac Cumhal:
Well, it certainly seems entirely possible that there is a lot more hidden cost in healthcare then I originally realized, but I’m not sure that the Spanish are necessarily making out like bandits. Socialized medicine is still pretty pathetic across the board. Basically they are paying through the nose for healthcare that is probably not unlike what you get from a free clinic.

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Originally posted by citizen:

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Originally posted by Finn mac Cumhal:
Well, it certainly seems entirely possible that there is a lot more hidden cost in healthcare then I originally realized, but I’m not sure that the Spanish are necessarily making out like bandits. Socialized medicine is still pretty pathetic across the board. Basically they are paying through the nose for healthcare that is probably not unlike what you get from a free clinic.

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Yet it's cheaper and out performing the US system by a huge degree in most systems. Facts on the ground dispute your claim.

Private only medicine is failing and pathetic, and grossly over priced across the board...

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More insane ramblings by the people who brought you beeeer milkshakes!
No one can see their reflection in running water. It is only in still water that we can see.

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Originally posted by Kirkules:

In my opinion there is no question that socialised medicine systems are less expensive and result in a healthier society. My problem with them is that they do so by devaluing the individual. I understand that from a ethical standpoint the goal should be to do the most good with the resources available, but sometimes it seem like these systems make choices that go against the American ideal of individual value. Of course from a financial and ethical standpoint it makes sense to allow a 89 year old to man die in line waiting for an expensive surgery because the same money that would be spent on the old man could do so much more good for society if spent on preventive medicine. Letting the old man die will save many more lives in the long run. I just don't want government bureaucrats deciding that the old man isn't worth the money. The US can afford a health system that maintains our values of individual worth and also provides preventive medicine for all Americans. The problem is that so many politicians want this as an issue to beat up the other side with, a compromise that maintains our values and fills in the gaps in the current system is unlikely.

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Originally posted by leadb:
Folks in the US, consider this:

If you have health insurance, you are one misfortune from being on the wrong side of the health care system.

Get laid off at the wrong time.
Get sick and run through your benefits or lose your job and then your benefits.
Retire, then have your company either slash health care or simply go belly up.

If you don't have health care, you are simply screwed already and you don't need this explained.

For this wonderful 'system', we pay through the nose. If you have health insurance, I wish you the best of luck in keeping it.

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Originally posted by Finn mac Cumhal:

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For this wonderful 'system', we pay through the nose. If you have health insurance, I wish you the best of luck in keeping it.

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I don’t pay through the nose, and I never have, so I don’t know what you guys are doing different. But when I didn’t have health insurance, the emergency room still accepted me for emergencies and there was always a clinic somewhere where I could get free healthcare. It wasn’t great, and I certainly wouldn’t trade it for what I have now, but it worked. Frankly, I don’t think Americans would ever accept socialized medicine, because I doubt it would be a giant difference from free clinics and emergency rooms, and we obviously don’t appreciate that too much. I’m not saying that the current system in the US is perfect, but I think we glamorize socialized medicine a little too much and that makes me very suspicious of it. I think a huge piece of this issue is the grass is always greener syndrome.

But maybe I’m the exception, somehow.

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Originally posted by leadb:
One of the problems of our medical systems is that all too often the 'have nots' of insurance do exactly what you say; they get sick enough they go to the emergency room, where life threatening illness -must- be treated. Guess who pays for that when the patient can't? And guess how much less it would have been if they had a seen the doctor before it became life threatening? We are often penny wise and pound foolish in how we handle the medical system.

I'm sure you have done just fine. Many folks do. Nestle in your 'I've got mine', you will likely continue to do just fine.

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Originally posted by Kirkules:
I understand that from a ethical standpoint the goal should be to do the most good with the resources available, but sometimes it seem like these systems make choices that go against the American ideal of individual value. Of course from a financial and ethical standpoint it makes sense to allow a 89 year old man to die in line waiting for an expensive surgery because the same money that would be spent on the old man could do so much more good for society if spent on preventive medicine.

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Originally posted by rue:
What time is it there now ?

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Originally posted by rue:
Thanks. I was wondering. Conversations over multiple time zones. I wonder how you do that.

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Originally posted by chrisisall:
...I'd like to only pay $1000 a year for my family coverage...

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If you don't have health care, you are simply screwed already and you don't need this explained.

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Originally posted by SignyM:
Even back in "the good old days".... yanno, BEFORE doctors.... people got sick!

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http://en.wikipedia.org/wiki/Iatrogenic

Iatrogenesis is a major phenomenon, and a severe risk to patients. A study carried out in 1981 "found that 36% of 815 consecutive patients on a general medical service of a university hospital had an iatrogenic illness. In 9% of all persons admitted, the incident was considered major in that it threatened life or produced considerable disability. In 2% of the 815 patients, the iatrogenic illness was believed to contribute to the death of the patient. Exposure to drugs was a particularly important factor in determining which patients had complications." (Steel et al., 1981). In another study, done in 101 adverse iatrogenic events in 84 patients, "the most commonly reported process of care problems were inadequate evaluation of the patient (16.4%), failure to monitor or follow up (12.7%), and failure of the laboratory to perform a test (12.7%)." (Weingart et al., 2000).

In the United State alone, recorded deaths per year (2000):

12,000 -- unnecessary surgery
7,000 -- medication errors in hospitals
20,000 -- other errors in hospitals
80,000 -- infections in hospitals
106,000 -- non-error, negative effects of drugs
Based on these figures, 225,000 deaths per year constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer. Also, there is a wide margin between these numbers of deaths and the next leading cause of death (cerebrovascular disease).

This totals 225,000 deaths per year from iatrogenic causes. In interpreting these numbers, note the following:

most data were derived from studies in hospitalized patients.
the estimates are for deaths only and do not include negative effects that are associated with disability or discomfort.
the estimates of death due to error are lower than those in the IOM report. If higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000.
(Dr. Barbara Starfield of Johns Hopkins School of Hygiene and Public Health, Journal of the American Medical Association, July 2000)

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