REAL WORLD EVENT DISCUSSIONS

VA Health care, good enough for vets?

POSTED BY: LEADB
UPDATED: Monday, December 17, 2007 11:40
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Saturday, December 8, 2007 3:50 AM

LEADB


Is it good enough for other folks?

http://www.peoplespharmacy.com/archives/radio_shows/659_health_care_in
_america.php

"Many pundits look to other countries for good models of health care, but one author believes we have an excellent model right in front of our noses. Philip Longman set out to find an innovative health care system in America and discovered the surprising strengths of the system run by the Veterans Administration."

I heard the last half of the radio show; unfortunately, they don't have the entire show on the net either in print nor audio, except by charge.

Net: They reviewed the services by VA Health care, and why it works. One reason is that VA 'owns' the patient's health; if they fail to treat/prevent diabetes, then they have to deal with the costs of renal failure, etc.

They also hit on Spain's Health care system. If you have appendicitis, you will have it removed, with 'good care' stated (and I have no reason to suspect otherwise), and no bill. Even if you are a tourist. In the US, you will get it removed, but if you are one of the millions with no health care, you are liable to face charges of $30,000. 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.

Thoughts?

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Saturday, December 8, 2007 3:52 AM

LEADB


Not in the radio show, I think Fletch, reported the system in England works pretty well as well. In England, they permit the purchase of 'higher coverage', which I'd like to see in anything the US might consider.

I consider Hillary's plan to force folks to buy private insurance a cruel joke.

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Saturday, December 8, 2007 5:22 AM

FINN MAC CUMHAL


Quote:

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.

I crunched some numbers that I got off the internet. Now some of these numbers may be debatable, but they look good right now.

Consider two people - Edward in Alabama and Eduardo in Spain.

Eduardo makes 60,000EUR a year.

Edward makes the same adjusted by the exchange rate[1], 87600USD.

Calculating the income tax on Eduardo using the scale in [2], Eduardo pays 35% of his income back to the state.

Doing the same for Edward using [3] and [4], Edward pays only 26% of his income back to the state.

This is not including property taxes, gasoline taxes, etc, almost all of which are much higher in Spain.

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.

[1] http://www.x-rates.com/
[2] http://www.spainexpat.com/spain/information/taxes_for_expatriates_in_s
pain
/
[3] http://www.irs.gov/formspubs/article/0,,id=150856,00.html
[4] http://swz.salary.com/salarywizard/layouthtmls/swzl_statetaxrate_AL.ht
ml





Nihil est incertius vulgo, nihil obscurius voluntate hominum, nihil fallacius ratione tota comitiorum.

Nothing is more unpredictable than the mob, nothing more obscure than public opinion, nothing more deceptive than the whole political system.

-- Cicero

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Saturday, December 8, 2007 5:25 AM

CITIZEN


Quote:

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.

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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Saturday, December 8, 2007 5:31 AM

FINN MAC CUMHAL


Quote:

Originally posted by citizen:
Quote:

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.

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

Well, I didn’t actually miss it. I Just assumed that it would be understood.

If you take the difference between income tax rates, Edward has ~$8760 to spend on healthcare, which would more then adequately provide for good healthcare for Edward and his whole family, plus some. And that's assuming that Edward purchases insurance himself, since it's very likely that he is part of a group plan and actually pays only about ~$1000 a year, which is basically what I pay.



Nihil est incertius vulgo, nihil obscurius voluntate hominum, nihil fallacius ratione tota comitiorum.

Nothing is more unpredictable than the mob, nothing more obscure than public opinion, nothing more deceptive than the whole political system.

-- Cicero

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Saturday, December 8, 2007 5:47 AM

CITIZEN


Quote:

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

Huh? It would seem the only fair comparison if you're going to base it on taxes, is to add healthcare spending in with that.

But taxes would seem a bad way of making the distinction, since they pay for more than just healthcare.

I would have thought the best way to see who pays more for healthcare, would be to look at who has the highest GDP spending.

According to NationMaster GDP healthcare spending for the US and Spain:
#1 United States: 13.9 % of GDP
#20 Spain: 7.5 % of GDP
http://www.nationmaster.com/graph/hea_tot_exp_as_of_gdp-health-total-e
xpenditure-gdp

Or per capita spending:
#1 United States: $4,631.00 per capita
#19 Spain: $1,556.00 per capita
http://www.nationmaster.com/graph/hea_hea_car_fun_tot_per_cap-care-fun
ding-total-per-capita


Which would seem to run counter to your assertion that Europeans are paying for their healthcare, as they are paying less than people in the States.

EDIT:
I'm not disputing that Europeans pay for healthcare, in fact I know we do, and politicians, at least here and from what I see of other countries, don't suggest Public healthcare is free.

But this would seem to imply that Europeans pay more for healthcare than Americans:
Quote:

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.
Which is incorrect.



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Saturday, December 8, 2007 6:34 AM

FINN MAC CUMHAL


Quote:

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

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. Something politicians can and do exploit.

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.

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.



Nihil est incertius vulgo, nihil obscurius voluntate hominum, nihil fallacius ratione tota comitiorum.

Nothing is more unpredictable than the mob, nothing more obscure than public opinion, nothing more deceptive than the whole political system.

-- Cicero

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Saturday, December 8, 2007 6:50 AM

CITIZEN


Quote:

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.

That's why I said seems. But nonetheless it still seems an unfair comparison for numerous reasons.
Quote:

Something politicians can and do exploit.
All I'm saying is I've never heard a politician say "we don't pay for healthcare". I've heard them say "we don't pay enough"...
Quote:

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.
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.
Quote:

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.
But the Spanish pay less for healthcare. The higher taxes are evidently not due to spending more for their healthcare, they likely get more social programs that they have to pay for. Its an entirely unfair comparison to make, since most of those extra taxes likely go on something extraneous too and have nothing to do with healthcare.



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Saturday, December 8, 2007 7:41 AM

FINN MAC CUMHAL


Quote:

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.

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.
Quote:

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

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.



Nihil est incertius vulgo, nihil obscurius voluntate hominum, nihil fallacius ratione tota comitiorum.

Nothing is more unpredictable than the mob, nothing more obscure than public opinion, nothing more deceptive than the whole political system.

-- Cicero

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Saturday, December 8, 2007 8:06 AM

CITIZEN


Quote:

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.

More MRI machines, doesn't == better results. It's more important how the equipment is used, than how much there is of it.

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.
Quote:

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.
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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Saturday, December 8, 2007 8:21 AM

RUE

I have a vote and I'm not afraid to use it!


Finn

Not ALL of Eduardo's taxes go to health insurance. To come up with the figures they include all spending on health (portion of the government's budget that goes to health care, individual spending on items not covered) and divide that by the number of people.

I hope that clears up any confusion you may have, or tried to sow. Finn.

***************************************************************
"Global warming - it's not just a fact, it's a choice."

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Saturday, December 8, 2007 8:23 AM

FINN MAC CUMHAL


Quote:

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.

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.
Quote:

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.

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



Nihil est incertius vulgo, nihil obscurius voluntate hominum, nihil fallacius ratione tota comitiorum.

Nothing is more unpredictable than the mob, nothing more obscure than public opinion, nothing more deceptive than the whole political system.

-- Cicero

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Saturday, December 8, 2007 8:40 AM

RUE

I have a vote and I'm not afraid to use it!


"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."

Ahem. Actually life span, immunization rates and infant mortatlity are indicators used by all reputable agencies.

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

And what does that have to do with per capita population figures ?

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"Global warming - it's not just a fact, it's a choice."

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Saturday, December 8, 2007 8:43 AM

CITIZEN


Quote:

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.

I wasn't aware that the MRI machine cured all ills. Success rates are still a better indicator.
Quote:

Yet, I can say that I pay less tax and still get good healthcare.
Still irrelivent, and you're making no case whatsoever. Someone who can't afford insurance because it's more expensive than Spanish healthcare, and there are less government programs, has little money and no healthcare. But lets just look at the really good side of one and exaggerate the bad in the other for rhetorical gain .

Lest we actually engage in an honest debate...

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Saturday, December 8, 2007 8:44 AM

CITIZEN


Quote:

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

It doesn't, but 'Finn's got his' seems to be a relevant point when talking about which system produces the best overall results.



More insane ramblings by the people who brought you beeeer milkshakes!
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Saturday, December 8, 2007 8:54 AM

RUE

I have a vote and I'm not afraid to use it!


I wonder what else he'll come up with ?

Anyway, here I am at work on a Saturday with things too do, so I'll cruise on by later on. Have a good one !

***************************************************************
Oh yeah, and they had a major pipe problem so the cold water is shut off and drained. I guess I can forget about using the loo while I'm here.

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Saturday, December 8, 2007 9:05 AM

FINN MAC CUMHAL


Quote:

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

There’s nothing dishonest about the debate as it is. In fact, in all honesty, I’m telling you want I understand to be true. You’re telling me it’s all wrong, but you’ve not given me any reason to believe that. The US pays a higher parentage of its GDP on healthcare evidently, but I don’t pay more taxes then Spain. 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. 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. 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.



Nihil est incertius vulgo, nihil obscurius voluntate hominum, nihil fallacius ratione tota comitiorum.

Nothing is more unpredictable than the mob, nothing more obscure than public opinion, nothing more deceptive than the whole political system.

-- Cicero

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Saturday, December 8, 2007 9:26 AM

RALLEM


I have no real opinion about the American Health Care System compared to those others around the world, because I am a disabled Veteran of the United States of America. I have several friends and who live around the world and they all marvel at our System of Care for our Veterans. My friends are from Germany, England, Canada, and Australia. I met them all through online sources and have discussed the available sources to us, and they were all impressed.


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Saturday, December 8, 2007 10:02 AM

CITIZEN


Quote:

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

And I could tell you the sky is blue, it doesn't mean it has anything to do with what we're talking about. Taxes spent on things other than healthcare can't be submitted to prove that Spanish healthcare is more expensive, because they're not being spent on healthcare. 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.
Quote:

You’re telling me it’s all wrong, but you’ve not given me any reason to believe that.
Hardly, maybe if you read my posts you'd understand where I'm coming from?
Quote:

The US pays a higher parentage of its GDP on healthcare evidently, but I don’t pay more taxes then Spain.
Edward has ten children, Eduardo has none. Eduardo has more money left over after his taxes are paid and his basics bought than Edward, and he gets good healthcare.
Quote:

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.
So does private healthcare. Private Health insurance often says it won't pay for this or that, and if you get a long term disease they'll often drop your cover, where as a public system will still cover you.
Quote:

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.
People can still get private healthcare for things not covered by the public system. Given that the same factors that would inflate the US healthcare expenditure, are there for Spain, so we're still back to where we started.
Quote:

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.
No it doesn't. I'd bet that any expensive procedure you can get in the US, you can get in Spain. So 'rich' people can still inflate the GDP expenditure through expensive private procedures as much in Spain, as they can in the US. Leaving us with the fact that US healthcare is more expensive than Spanish.



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Saturday, December 8, 2007 1:35 PM

FINN MAC CUMHAL


Quote:

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.

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. 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. So how do you account for that? 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. Or the 1500 patients who were on the weighting list for Bypass surgery, some of who had already died, between April 1996 and March 1997 in Canada? 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. Even group plans don’t come close. Socialized medicine is often touted but facts on the ground, I think, are almost always very, very different.

http://www.heritage.org/Press/NewsReleases/NR092900.cfm


Nihil est incertius vulgo, nihil obscurius voluntate hominum, nihil fallacius ratione tota comitiorum.

Nothing is more unpredictable than the mob, nothing more obscure than public opinion, nothing more deceptive than the whole political system.

-- Cicero

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Saturday, December 8, 2007 3:48 PM

CITIZEN


Quote:

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.

Which still has nothing to do with the cost or effectiveness of healthcare. Believe it or not, but those taxes in Spain get spent on a lot of things other than Healthcare, you might want to make out that healthcare is responcible for all that extra tax, but it simply isn't.
Quote:

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.
I don't accept that it's the case that all socialised healthcare 'seriously' restricts available care at all. All you've provide to support that is an article from a conservative think tank from seven years ago, that focuses on just two examples, and seems to base a lot of it's conclusions on anecdotal evidence. I could easily ask what about the kid who died from toothache?
http://www.washingtonpost.com/wp-dyn/content/article/2007/02/27/AR2007
022702116.html


I mean really, it's hardly surprising that an American Right wing think tank would find something bad about public healthcare.
Quote:

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.
According to the American Cancer Society, 37,000 people will die of cancer without health insurance, is that a factor that influences the quality of the healthcare?
http://www.buzzle.com/articles/37000-cancer-patients-will-die-without-
health-insurance.html

Quote:

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.
Really? Seems the restrictions for the kid that died from toothache rather outstripped the ones you see in any socialised healthcare system.

But really, I'm not going to defend the NHS to much, it's been well and truly shafted by a Thatcherite government that wanted to privatise it, and an incompetent Labour government that couldn't fix it (beyond chucking more and more useless management staff at the problem). However, it's always a source of constant amazement to me (actually it isn't) that no one wants to look at the majority of success for public healthcare.
Quote:

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

If the private only healthcare system is so superior, how do you explain the fact (on the ground so to speak) that the US spends the most money on it's healthcare, but doesn't provide the best healthcare. According to the World Health Organisation the top five providers are:
Sweden
Norway
Australia
Canada
France
All public healthcare systems, all spending considerably less than the US.

(2003 rankings of developed countries only)



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Sunday, December 9, 2007 9:49 AM

LEADB


Finn,
Sounds like you are pretty lucky. I work for a major corporatation (top 100), and my 'small family of two' pays
$1,700 toward the cost of health care insurance. Amazingly, my company claims they spend millions on employee health care. Sounds like I'm getting ripped off... or is your company paying part of the premium? Can you share this group plan name? I'd love to get it over to my employer... then they'd be able to cut out their contribution AND my cost would go down. I also am not clear, how do you avoid paying the FICA-Med? If this is optional, I'd like to skip paying it too. This runs about
$1,000 per year for someone making 86K. This past year has been pretty good to me, I've probably only had
$1000 in out of pocket expenses for co-pays, drugs, etc. Some years have not been so kind, and I've had bills for my family run upward of 3-4k out of pocket.

Bottom line, assuming that Cit'z numbers of about 4,500 per year in the US and 1,500 per year in Spain, once all is said and done, and you figure out who all is paying for the health care you are receiveing, I suspect you might find your health care is more expensive than you think. I never claimed nor thought we would get a free lunch, I just have no idea how much my company is shelling out for medical insurance, so I only 'see' the portion I'm directly paying.

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Sunday, December 9, 2007 9:59 AM

CHRISISALL


...I'd like to only pay $1000 a year for my family coverage...

Co-pay-Chrisisall

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Sunday, December 9, 2007 11:19 AM

LEADB


http://www.kff.org/insurance/ehbs092606nr.cfm
Quote:

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.



(spaces added to URL to minimize 'scrolling problems)
http://www.towersperrin.com/tp/jsp/ hrservices_webcache_html.jsp?webc=HR_Services/United_States/ Press_Releases/2007/20070924/2007_09_24.htm
Quote:

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.

Note this one is just the employer's portion./\


This one is a little old but...

http://www.usatoday.com/money/industries/health/2005-09-14-family-heal
th-policy_x.htm

Quote:

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.



So, if these quotes bear any resemblence to reality, Spanish folks are making out like bandits.

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Sunday, December 9, 2007 11:26 AM

CHRISISALL


Si hable Espanoil...

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Monday, December 10, 2007 5:17 AM

FINN MAC CUMHAL


Quote:

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

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.



Nihil est incertius vulgo, nihil obscurius voluntate hominum, nihil fallacius ratione tota comitiorum.

Nothing is more unpredictable than the mob, nothing more obscure than public opinion, nothing more deceptive than the whole political system.

-- Cicero

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Monday, December 10, 2007 6:15 AM

CITIZEN


Quote:

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.

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...



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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Monday, December 10, 2007 8:25 AM

FLETCH2


My (not so great) health insurance has over $2000 per patient in copays. That's potentially $4000 bucks on top of the premium that I would have to spend in a bad year before I saw much benefit. Add to that the hastles of paying individual providers when the insurance doesnt cover treatment and you can see that it's a mess.

You guy's need to get into the 20th century and get a reasonable healthcare solution.

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Monday, December 10, 2007 1:59 PM

KIRKULES


Quote:

Originally posted by citizen:
Quote:

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.

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...



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.





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 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. 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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Monday, December 10, 2007 2:15 PM

FLETCH2


Quote:

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.




Unfortunately those choices still get made in the US system. I had a friend, let's call her Cindy, she lived in Colorado was 40 something recently divorced. Spring of 2001 she was "head hunted" into a management role in a local company. She was on full healthcare, plus dental. Late summer of 2001 she has a pulminary embolism that put her in the hospital, it proved to be the first of many. In the spring of 2002 after not working for 6 months her medical insurance lapsed without the doctors finding the root cause of her ailments. From that moment until she died in 2005 Cindy only saw a doctor on the occasions that she was hospitalised and a few pro bono days that some doctors offered to a hospice where she was an outpatient.

Private medicine and her insurance company decided that she was no longer covered, she went from good job/benefits/personal savings to charity case in less than 3 years of cronic illness.

The month Cindy died my father had a heart attack, he was 60 years old. The NHS took him in and did a quadruple heart bypass operation and saved his life. So the British social medicine system thinks a 60 year old man is worth the price of one of the most complex surgical procedures in modern medicine, while the US private system wouldn't even pay for test on a woman in her early 40's that might have diagnosed what was wrong with her.

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Monday, December 10, 2007 3:01 PM

RUE

I have a vote and I'm not afraid to use it!


"sometimes it seem like these systems make choices that go against the American ideal of individual value"

And the US DOES value the individual - depending on how much $$ you have, that's how much you're valued.

***************************************************************
"Global warming - it's not just a fact, it's a choice."

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Monday, December 10, 2007 3:01 PM

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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Monday, December 10, 2007 5:02 PM

FINN MAC CUMHAL


Quote:

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.

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.



Nihil est incertius vulgo, nihil obscurius voluntate hominum, nihil fallacius ratione tota comitiorum.

Nothing is more unpredictable than the mob, nothing more obscure than public opinion, nothing more deceptive than the whole political system.

-- Cicero

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Monday, December 10, 2007 5:13 PM

RUE

I have a vote and I'm not afraid to use it!


I believe you're either military or a federal. If so, you're leaving out a big piece of your personal picture, which is that the government is already taking care of your health ...

***************************************************************
"Global warming - it's not just a fact, it's a choice."

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Monday, December 10, 2007 6:48 PM

LEADB


Quote:

Originally posted by Finn mac Cumhal:
Quote:

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

Frankly, I consider I've done quite well. I did mention there were a few rough years where I might have had a few thousand dollars out of pocket, but frankly you do -not- want to know how much the insurance companies came up with. It was a bundle. I admit it; all my life I've been a 'have', and in the past few years, I've come to appreciate just how dang lucky I've been. I see folks putting tin cans out on convenience store counter tops to get get life saving medical services... services that I would get for a few hundred dollars of co-pays or deductibles.

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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Monday, December 10, 2007 9:10 PM

FINN MAC CUMHAL


Quote:

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.

Well, unlike you, I have not been a “have” for most of my life. Much of my life, particularly my early years, was spent on the “have not” side of the economic equation. I grew up very poor to a single uneducated mother. I kind of resent this implication that I’m nestled in my wealth. I know what it’s like to rely on free clinics, and I don’t see how socialized medicine can be that far from that. I went to my share of free clinics to deal with medical issues before they became life threatening. It got the job done, but it couldn‘t replace what I have now. I realize that 15% of the US must rely on free clinics, but I don’t think the solution is to essentially force the other 85% to do that too.



Nihil est incertius vulgo, nihil obscurius voluntate hominum, nihil fallacius ratione tota comitiorum.

Nothing is more unpredictable than the mob, nothing more obscure than public opinion, nothing more deceptive than the whole political system.

-- Cicero

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Monday, December 10, 2007 11:00 PM

RUE

I have a vote and I'm not afraid to use it!


"I don’t see how socialized medicine can be that far from that (free clinics)"

I've spent a lot of time in Canada and it is very far from that.

***************************************************************
"Global warming - it's not just a fact, it's a choice."

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Tuesday, December 11, 2007 12:11 AM

CITIZEN


Quote:

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.

I'm not sure I agree with your emotive, beyond Fletch's example I've not seen any decisions of "they're to old to help", beyond considerations that they probably wouldn't survive a given procedure. It's an exception I hear a lot, and seems most often based on a conceptual assumption, that doesn't seem to bear out in reality. On the other hand I can't see how a socialised scheme that aims to treat all individuals, can be said to be less supportive of the inherent value of the individual than a system that places a dollar value on each individuals healthcare, if you can't pay, you have no worth.

There are numerous examples of people paying into private healthcare schemes, then the moment they actually require treatment the provider drops them at the first excuse. A system that requires you to pay, but will drop you when they're end of the contract comes up, would seem more indicative of a scam to me.

To drop to anecdotal evidence (which I find to be a particularly bad indicator of overall performance, but seems to be the way the thread is leading): My girlfriend lives in Missouri, she pays more per month on healthcare than I do for both national insurance contributions and my own limited private cover combined; she has to pay a certain percentage of her care even with that insurance. She's recently had some health problems that the doctors have still not been able to diagnose, yet she’s had to stop going for tests because she can no longer afford them. If I were to have health problems, I could go to an NHS hospital, and they'd carry on testing me until they found the problem and it wouldn't cost me a thing. To be particularly blunt, I find the fact that my Girlfriend, despite paying into the system, despite paying for procedures being unable to receive tests, let alone treatment is disgusting; especially in the richest country in the world.



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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Tuesday, December 11, 2007 1:34 AM

RUE

I have a vote and I'm not afraid to use it!


What time is it there now ?

***************************************************************
"Global warming - it's not just a fact, it's a choice."

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Tuesday, December 11, 2007 1:43 AM

CITIZEN


Quote:

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

Here now? 11:45 am



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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Tuesday, December 11, 2007 2:57 AM

RUE

I have a vote and I'm not afraid to use it!


Thanks. I was wondering. Conversations over multiple time zones. I wonder how you do that.

***************************************************************
"Global warming - it's not just a fact, it's a choice."

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Tuesday, December 11, 2007 3:00 AM

CITIZEN


Quote:

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

With great difficulty. She's also a night worker.



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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Tuesday, December 11, 2007 3:06 AM

RUE

I have a vote and I'm not afraid to use it!


Which means she's awake when you're awake (with an offset) but at work. Too much for an old brain to puzzle out right now.

That's why it's you youngsters who are managing the whole schedule.


***************************************************************

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Tuesday, December 11, 2007 6:49 AM

CITIZEN


Missouri is only 5 or 6 hours behind me, I can ussually catch her in the evenings around 8, there's always email and stuff.



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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Tuesday, December 11, 2007 8:05 AM

SIGNYM

I believe in solving problems, not sharing them.


FINN: workplace family coverage $11,000 per year for an HMO, $16,400 per year for a PPO. (This is right off our union notice.) Family coverage not through workplace $14,000 per year. But if you have a pre-existing condition, you might not even get insurance. I remember trying to get insurance for my MIL who had pre-existing migraines, and she was turned down by five companies before I sweet-talked one into covering her for a mere $1400 per month.

In other words, we pay well more than that $8700 in tax differential. And in addition, our system covers far fewer people.

Pay more, get less! That's our plan!
---------------------------------
Always look upstream.

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Tuesday, December 11, 2007 8:19 AM

RUE

I have a vote and I'm not afraid to use it!


I think most people won't realize just how broken the system is until they need to live in an assisted care facility, nursing home, or skilled nursing facility. Or until they get a major illness, whichever comes first.

***************************************************************
"Global warming - it's not just a fact, it's a choice."

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Tuesday, December 11, 2007 8:42 AM

CANTTAKESKY


Quote:

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

No kidding. Our health care costs $1000 per month for family coverage. And then the insurance only pays 80% of costs.

Quote:

If you don't have health care, you are simply screwed already and you don't need this explained.
How much you're screwed depends on how much you rely on conventional health care systems. We decided to discontinue family coverage and only keep coverage for my husband, cutting our monthly premiums from $1000 to $200. Why? Because we never use conventional health care. What little we do use from time to time can be paid from the $800 a month we are saving in premiums.

We rely on homeopathy for all our health care problems, from severe illness and trauma to the flu. It is cheaper, safer, and for us, more effective.

In case someone says I only say this because I've never had catastrophic illness, I was recently hospitalized for nearly 3 weeks for severe joint/back pain that rendered me completely immobile. I was pregnant and had to have a C-section.

Looking back, it could have all been prevented if I hadn't gone to a doctor in the first place. I started off with moderate back pain, not unusual for my stage of pregnancy. I made an exception given that I was pregnant, went to get health care, got injured, and it cascaded from there to a point of no return. Had I stuck with homeopathy, like I usually do, it wouldn't have happened.

In my view, a lot of the desperate need for health care is iatrogenic.

Can't Take My Gorram Sky
Aude sapere (Dare to know). -- Samuel Hahnemann, M.D., founder of homeopathy

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Tuesday, December 11, 2007 10:01 AM

RUE

I have a vote and I'm not afraid to use it!


"In my view, a lot of the desperate need for health care is iatrogenic."

Until you fall and break your hip, have a large pulmonary embolism or have some other catastrophic illness or injury. Or until you simply get too old, too frail or too demented to look after yourself.


***************************************************************
"Global warming - it's not just a fact, it's a choice."

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Tuesday, December 11, 2007 10:52 AM

SIGNYM

I believe in solving problems, not sharing them.


CTS- As my SO likes to say Mother Nature is a bitch. She created all germs, syndromes, frailties.... Even back in "the good old days".... yanno, BEFORE doctors.... people got sick!
---------------------------------
Always look upstream.

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Tuesday, December 11, 2007 12:05 PM

CANTTAKESKY


Quote:

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

Indeed they did. Obviously, I don't believe ALL need for health care is iatrogenic.

We've had doctors for a long, long time. And before that, witch doctors and medicine men. So our recorded history without physicians is relatively brief. It seems reasonable to assume that in Hippocrates' time, iatrogenesis existed enough to prompt his motto, "First do no harm." The question is, in each medical paradigm, how much of the need was/is iatrogenic?

Of course, I don't know the answer. But in our current paradigm, the following (from Wikipedia) gives us a general idea.

Quote:

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)


So I stand by my original statement: a lot (not all) of our need for health care is iatrogenic.

Can't Take My Gorram Sky
Aude sapere (Dare to know). -- Samuel Hahnemann, M.D., founder of homeopathy

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