Stossel Solves the Health Crisis with Capitalism

[Rolfe]

Uhhhh, huh, huh........

And was that a shout out to Star Trek thrown in there?

Probably.

I'm getting the feeling you didn't entirely follow my explanation of the "brain tumour" woman. (Just so happens that the condition she had, while rare in humans, is common in dogs, so vets know a lot more about it than your average doctor. I may have been over-technical.)

She had a hormone imbalance, caused by a very small growth (an adenoma) in her pituitary gland, which is situated at the base of the brain. Her actual problems were caused by the hormone imbalance - if it wasn't for that, nobody would notice these tiny growths.

This is a very slowly progressive condition which can drag on for years. Sometimes does, before it's diagnosed for sure. In fact, in cases which are less obvious, often the best thing to do is leave them for a bit and repeat the testing in six months, when hopefully it will be that much clearer.

Here is an explanation of that.

In most cases the symptoms develop gradually. The diagnosis is often not clear for quite some time, sometimes years, after symptoms first begin. This is because most of the symptoms can also be caused by other common problems. For example, although most people with Cushing's syndrome have obesity, most people with obesity do not have Cushing's syndrome. Likewise, high blood pressure is common, but Cushing's syndrome is a rare cause of it.

Also, the symptoms can be fairly 'non-specific' at first. For example, you may put on some weight, and have mood swings, and just not 'feel right', but it is difficult to say why. You may even be treated for 'depression' or 'obesity' before the cause of your symptoms becomes clear.

In animals, we treat the patients medically, with tablets to correct the hormone imbalance. Even these aren't especially safe, and you certainly don't want to give them to a patient until you're sure they're needed. Treatment of choice in man is indeed surgical, but it's not a case of cracking the skull open and scooping out brain tissue. Harvey Cushing invented a nifty operation where the base of the brain is accessed by a small incision under the nose, and the little growth taken out that way. Again, you really do want to be sure there's something there that needs scooping before you go down that road.

In my experience with dogs, it's not uncommon for an owner to become frustrated by the slow pace of the investigations, especially if it's not explained to them properly. They may then switch practices, and the new practice is often presented with a Cushing's case at just the right stage to be easily diagnosed. Thus the new vet is the hero and the old practice are a bunch of knuckleheads. This is what would appear to have happened with the Canadian woman.

The really shocking thing is when she declared that the US doctors had told her that she'd die if she wasn't operated on immediately. This is a flat-out lie. Untreated Cushing's drags on for years and years and years. Obviously I don't know who was lying there, but somebody was.

I'm sure the woman was entirely sincere. But she had the wrong end of the stick big time. The honesty of someone (who should know better) who will present this video as evidence of poor care by a universal healthcare provider has to be seriously questioned.

Rolfe.

 

[DaN K. StAnLeY]

I noticed the "Opinionated Nurse Lady" mentioned something about high rates of infection in NHS hospitals. Didn't someone post a link addressing that one already?

 

[Darat]

Not one of the best examples of what is wrong with the NHS to pick on Dan.... For some reason these rates started to increase after the cleaning services of hospitals were put out to tender to private companies and awarded to the lowest costed.

 

[DaN K. StAnLeY]

Not one of the best examples of what is wrong with the NHS to pick on Dan.... For some reason these rates started to increase after the cleaning services of hospitals were put out to tender to private companies and awarded to the lowest costed.

Is the infection rate of NHS hospitals significantly higher than the US, or other Euro-HC systems??

 

[Darat]

Don't know.

 

[Rolfe]

The country with the best record as regards hospital-acquired infections is Sweden. That's the example of best practice everyone is looking to emulate.

Sweden has an excellent universal healthcare system. So I really don't think you can use the NHS's difficulties with hospital-acquired infections as an argument against universal healthcare per se. It is an argument that the NHS needs to get its act together on that one.

Darat's point is the most relevant. Problems in the NHS with poor cleanliness and hospital-acquired infections were essentially unknown until someone had the bright idea of letting "the free market" in. So instead of cleanliness being the responsibility of the head nurses, ward cleaning became a service which was simply contracted out to the lowest bidder.

The lowest bidders turned out to be very reluctant to spend money on good disinfectants, and cleaning staff with actual brains between their ears, for some reason. OK we know the reason. Less spent on providing the service is more dividends for the shareholders. And look where that got us.

Rolfe.

 

[Rolfe]

Don't know.

I don't know about the US. I do know that we're among the worst in Europe, if not the worst. And that Sweden is the shining example of How To Do It Right.

Sweden, as I said, has an excellent universal healthcare system.

Rolfe.

 

[DaN K. StAnLeY]

Sweden has an excellent universal healthcare system. So I really don't think you can use the NHS's difficulties with hospital-acquired infections as an argument against universal healthcare per se. It is an argument that the NHS needs to get its act together on that one.

Darat's point is the most relevant. Problems in the NHS with poor cleanliness and hospital-acquired infections were essentially unknown until someone had the bright idea of letting "the free market" in. So instead of cleanliness being the responsibility of the head nurses, ward cleaning became a service which was simply contracted out to the lowest bidder.

The lowest bidders turned out to be very reluctant to spend money on good disinfectants, and cleaning staff with actual brains between their ears, for some reason. OK we know the reason. Less spent on providing the service is more dividends for the shareholders. And look where that got us.

I was just trying to get an idea of this womans honesty/credibility and I thought someone posted a link to some information about infection rates on this post, or the other UHC post we were on. I thought I'd ask and see if any of you remembered.

 

[Rolfe]

It's possible someone did post such a link, though I don't recall exactly. It is true that the rate of hospital-acquired infections in the NHS has not been anything to boast about in recent years. It is a failure of management, at many levels.

I merely point out that the country in the world with the best record in that respect also has a universal healthcare system, so as an argument against universal healthcare systems in general it's not going to get you very far.

Rolfe.

 

[Rolfe]

Opinionated Nurse Lady lost all claim to honesty or credibility in my eyes when she posted a video of a woman with a very very slowly-progressing and difficult to diagnose condition who had jumped ship due to poor communication, declaring that she had a Brain Tumour, and that she would have Died if she hadn't had Immediate Surgery.

Maybe the Canadian woman didn't know what Cushing's disease is, or how exceedingly non-urgent it is, but Opinionated Nurse Lady should bloody well know, or if she doesn't know, find out.

She's entitled to her opinions, but while she may not be a minority of one, she's close to that. Forgive me for touching on the Truther analogy as well, but this is like ignoring Architect and all the mainstream evidence-based opinions on the matter, and trying to find out how much honesty and credibility Pilots for Truth has.

Did you ever check out the links I gave to a couple of satisfied, indeed grateful, recipients of NHS care?

The Prime Minister

Mr Brown's spokesman said: "Thousands of other parents are in the same position.

"They are confident that the advice and treatments available, including proper exercise and, later, sporting activity will keep him fit and healthy.
"The NHS is doing a great job, and Gordon and Sarah are very optimistic that the advances being made in medicine will help him and many others, and they hope to be able to play their part in doing what they can to help others."

And the Leader of the Opposition.

That meant late-night visits to the hospital, sometimes sleeping on the floor by their son's bedside.

It meant meeting other parents with seriously ill children, from all social backgrounds and walks of life.

But perhaps most importantly in terms of David Cameron the politician, it meant a profound respect and admiration for the NHS.

From the outset, David Cameron has made clear the important part he believes it plays in the life of the nation - based on the significant part it plays in his own life.

He told the Tory Party conference in 2006: "For me, it's not a question of saying the NHS is safe in my hands.

"My family is so often in the hands of the NHS. And I want them to be safe there. Tony Blair once explained his priority in three words: education, education, education. I can do it in three letters - NHS."

These guys are all about politics. The second guy is as about as right-wing as politics gets in Britain. But he knows very well that the way to get votes is to support the NHS and promise to make it perform even better - not to undermine it.

Rolfe.

 

[DaN K. StAnLeY]

Forgive me for touching on the Truther analogy as well, but this is like ignoring Architect and all the mainstream evidence-based opinions on the matter, and trying to find out how much honesty and credibility Pilots for Truth has.

Really? Her group is considered THAT crazy in the UK?? She seems to have a genuine difference of opinion and outlines reasons for her disagreements. Saying everyone that disagrees with you is truther-like is counter-productive and not really a fair comparison. I mean, she isn't saying space beams are going to administer HC or anything (Although, I'm sure you will equate the two somehow).

 

[Rolfe]

Well, more like nobody in the UK has ever heard of her. Like I suspect almost nobody in the USA has ever heard of "Pilots for Truth".

Your links are the first and only time I've ever come across her. She has no profile at all. When I read what she's written, it comes across as unrealistic, ideology-driven rightwing claptrap. Spiced with enough flat-out lying to make me distrust her a lot.

The "Pilots for Truth" probably isn't an exact analogy. But you seem to be intent on finding anyone at all who supports your pre-conceived ideas and presenting them in support, even if they are a tiny minority fringe.

Rolfe.

 

[DaN K. StAnLeY]

But you seem to be intent on finding anyone at all who supports your pre-conceived ideas and presenting them in support, even if they are a tiny minority fringe.

Look, I'm no quitter! I'm not intent on basing my argument on "fringe minorities" either. I'm not going to sit here and say she represents the majority opinion on HC in the UK, but I'm interested to see just how in the minority she is. I trust your opinion that she is in the minority, but it did only take me a quick googling to find that site.

 

[DaN K. StAnLeY]

This video reminded me of ya'll:
http://www.ireport.com/docs/DOC-228759

 

[Professor Yaffle]

Look, I'm no quitter! I'm not intent on basing my argument on "fringe minorities" either. I'm not going to sit here and say she represents the majority opinion on HC in the UK, but I'm interested to see just how in the minority she is. I trust your opinion that she is in the minority, but it did only take me a quick googling to find that site.

Well lets just say that among the people I know including some pretty conservative/right wing ones, I have never heard a single one express the opinion that would would be better off with a free market/private type system. I have heard plently of people grumble about the NHS, but they always make comparisons to other countries with UHC when talking about how things might be done better.

 

[DaN K. StAnLeY]

Well lets just say that among the people I know including some pretty conservative/right wing ones, I have never heard a single one express the opinion that would would be better off with a free market/private type system. I have heard plently of people grumble about the NHS, but they always make comparisons to other countries with UHC when talking about how things might be done better.

Sure, I take your word for it. I'm definitely not expecting her to just go un-vetted here at JREF.

 

[Rolfe]

Well lets just say that among the people I know including some pretty conservative/right wing ones, I have never heard a single one express the opinion that would would be better off with a free market/private type system. I have heard plently of people grumble about the NHS, but they always make comparisons to other countries with UHC when talking about how things might be done better.

That's my experience too. Like I said, bitching about the NHS is practically a national sport. However, this always takes the form of wanting/demanding that the NHS should do better. If you were to ask, OK, would you rather abolish the NHS and be responsible for paying for your own medical treatment, then entire population would run screaming.

Of course, they would then quite rightly point out the false dichotomy. We should be able to demand that the NHS does better without this being interpreted as a desire not to have the NHS. The trouble is that every time anyone points out a problem and suggests that it's not beyond the wit of man to get this sorted, some [Americans] take one look at this and shout "told you so, universal healthcare sucks!"

This is why I've continually said to Dan that he'll be able to find references to problems quite easily if he looks. Nobody is saying that the NHS is perfect. Nobody is even trying to claim that the NHS is the best universal system. The evidence is that it is not. However, the more any of us looks at the US system, the more certain we are that we'd rather have our fingernails pulled out without anaesthetic than opt for that instead.

The most right-wing friend I have is a consultant surgeon, who seems to spend his every waking moment either bellyaching about the NHS or bellyaching about how Gordon Brown hates the middle classes. He would probably secretly prefer to be able to ignore the entirety of the unwashed hoi polloi and spend all his time operating on the well-heeled and the BUPA-funded. But even he comes to a screeching halt in his tirades if you suggest just abolishing the NHS.

That's why I think that Opinionated Nurse Lady isn't really all that bright. She's found herself a sociology niche argument, which is a distillation of every complaint there has been about the NHS over the past 20 years, and she's essentially dining out on it. But everything she says is negative. It's don't do this and don't do that. What she doesn't have as far as I can see is is a positive proposal. It's right back to "the free market will sort it out".

But the evidence from the USA is that the free market isn't sorting it out. If it was, we wouldn't be having this conversation.

Rolfe.

 

[DaN K. StAnLeY]

bitching about the NHS

That's my experience too. Like I said, bitching about the NHS is practically a national sport. However, this always takes the form of wanting/demanding that the NHS should do better. If you were to ask, OK, would you rather abolish the NHS and be responsible for paying for your own medical treatment, then entire population would run screaming.

Of course, they would then quite rightly point out the false dichotomy. We should be able to demand that the NHS does better without this being interpreted as a desire not to have the NHS. The trouble is that every time anyone points out a problem and suggests that it's not beyond the wit of man to get this sorted, some [Americans] take one look at this and shout "told you so, universal healthcare sucks!"

This is why I've continually said to Dan that he'll be able to find references to problems quite easily if he looks. Nobody is saying that the NHS is perfect. Nobody is even trying to claim that the NHS is the best universal system. The evidence is that it is not. However, the more any of us looks at the US system, the more certain we are that we'd rather have our fingernails pulled out without anaesthetic than opt for that instead.

The most right-wing friend I have is a consultant surgeon, who seems to spend his every waking moment either bellyaching about the NHS or bellyaching about how Gordon Brown hates the middle classes. He would probably secretly prefer to be able to ignore the entirety of the unwashed hoi polloi and spend all his time operating on the well-heeled and the BUPA-funded. But even he comes to a screeching halt in his tirades if you suggest just abolishing the NHS.

That's why I think that Opinionated Nurse Lady isn't really all that bright. She's found herself a sociology niche argument, which is a distillation of every complaint there has been about the NHS over the past 20 years, and she's essentially dining out on it. But everything she says is negative. It's don't do this and don't do that. What she doesn't have as far as I can see is is a positive proposal. It's right back to "the free market will sort it out".

But the evidence from the USA is that the free market isn't sorting it out. If it was, we wouldn't be having this conversation.

I'm still finding the internal dialog I have with myself about this (because nobody else I know gives two craps about this kind of thing) leading to the assumption that if soc-HC was better, our doctors would have insisted on a system like this by now. Why haven't they? If they do want this system, who has been stopping it from happening for this long and why? The Clintons prolly coulda got it passed, why didn't it happen then? People in America don't just draw conclusions out of thin air (for the most part), so why have we been made to believe these things that are lies? It's a lot to take in for me.

 

[Rolfe]

.... why have we been made to believe these things that are lies?

Actually, that's the fascination for me about this discussion. Why?

I note that certain posters (Balrog and Beerina spring to mind) aren't in this thread. They absolutely refuse to believe that these things are lies. To the point that they'll take any fact that's presented to them and twist it round so that in their mind, it supports their original point of view.

Recently one of them was dementing on about how doctors in Britain were slaves, forced to charge set prices and unable to work if they didn't work for the government. I posted a long explanation of why this was in fact complete BS. Doctors don't charge any prices at all, they are paid in a different way. They are also entirely free to set up in private practice outside the NHS, and many do. They are also free to go and work abroad, just as doctors from other countries (with no previous NHS connection) are free to apply for and get jobs in Britain. I did, however, mention that as a matter of practicality, new medical graduates need to secure an NHS training post in order to advance their careers towards full professional membership status.

This was jumped on as "all that was needed to prove that your system treats doctors as slaves", and the poster then left the thread never to return. I don't know why he needs to believe that. But he does.

You've seen the web pages I've linked to showing how the system actually works. Remember the booklet for patients explaining the choices for heart surgery within the NHS? The pages about the swanky private practices run by the top maxillofacial surgeons? Lots more stuff like that.

You've noted how satisfied the Brits on the forum are in general with the NHS, even those of us who've also had private treatment. Several of us have told you that while we could afford private insurance if we wanted it, we're confident enough with the NHS just to keep our money thank you.

Why do you think the lies are being told?

Rolfe.

 

[kellyb]

I'm still finding the internal dialog I have with myself about this (because nobody else I know gives two craps about this kind of thing) leading to the assumption that if soc-HC was better, our doctors would have insisted on a system like this by now. Why haven't they? If they do want this system, who has been stopping it from happening for this long and why? The Clintons prolly coulda got it passed, why didn't it happen then? People in America don't just draw conclusions out of thin air (for the most part), so why have we been made to believe these things that are lies? It's a lot to take in for me.

Doctors don't know any more about the feasibility of UHC than other professions.

Americans have not demanded UHC before now because it has historically been seen as "socialist" and contrary to free market economics, and so it has been considered "unpatriotic" to the point of blasphemy to even seriously consider.

The cold war hasn't been over for that long, if you think about it. And the ideology that got us through that was our belief in our inherent "rightness" and the inherent "wrongness" of communism. Of course, totalitarian communism is morally repugnant, but there's a world of difference between that, and democratically elected officials creating programs funded by taxes, that meet the needs of the people. We've always had quite a bit of the latter, but you'll notice, they were largely instituted before the war against communism. (and anything "socialist" is considered soft-core-communism).
So in a nutshell, I think we're just biased because of our history. All of us, liberal and conservative alike. It's difficult for us to evaluate all of our potential solutions objectively, because for so long, our national identity has been based on NOT doing things like Europe, and being ethnocentric humans, we operate on the assumption that whatever our own culture does, is the best way.