Rationing Health Care - it's a lie!

NWO Sentryman said:
well, i retract my statements on healthcare and the beds. it is just i cannot bear to be wrong.
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Don't be so Grizzly about it......:o

Out of interest, do you have any links about beds and waiting lists in the US etc? *

There appears to be a massive shortage of stats out there about the US system, which I am surprised about, from both sides (Rep and Dems), to be honest.
The default position is the US has much shorter waiting times and much better bed availability - is that actually true?

*Something as comprehensive and detailed as the NHS one I linked earlier. Does this information actually exist? If not why not?

Mods feel free to split if this is too much of a derail.
 
This is all I have been able to find http://www.oecd.org/dataoecd/31/10/17256025.pdf an OECD report from 2003

My favorite part is this though

OECD said:
This report is devoted to the second objective. An interesting feature of OECD countries is that
while some countries report significant waiting, others do not. Waiting times are a serious health policy
issue in the 12 countries involved in this project (Australia, Canada, Denmark, Finland, Ireland, Italy,
Netherlands, New Zealand, Norway, Spain, Sweden, and the United Kingdom). Waiting times are not
recorded administratively in a second group of countries (Austria, Belgium, France, Germany, Japan,
Luxembourg, Switzerland, and the United States) but are anecdotally (informally) reported to be low.


4. This paper contains a comparative analysis of these two groups of countries and addresses what
factors may explain the absence of waiting times in the second group. It suggests that there is a clear
negative association between waiting times and capacity, either measured in terms of number of beds or
number of practising physicians. Analogously, a higher level of health spending is also systematically
associated with lower waiting times, all other things equal.
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So the countries that have a problem with wait times are the ones that record them and the countries that can only provide anecdotal data don't have a problem what so ever. To have continued the report on this basis make little sense to me - I hope I have misunderstood this!

There's an elephant in the room folks....
 
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thaiboxerken said:
The question to NWO is relevant because of the outrageous claims made with NO supporting evidence. Rolfe, however, is legitimately criticizing the USA based on facts, statistics and knowledge. One doesn't need to be a USA citizen to realize that the USA health care system is on the road to collapse and that the British health system is much, much better.
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Yeah OK. No he's hypocritical.

I don't think our system is on the road to collapse. The national reform of health care is based on the system in Massachusetts. Tell me how's that State's system doin' after 2 years?
 
Delscottio said:
This is all I have been able to find http://www.oecd.org/dataoecd/31/10/17256025.pdf an OECD report from 2003

My favorite part is this though



So the countries that have a problem with wait times are the ones that record them and the countries that can only provide anecdotal data don't have a problem what so ever. To have continued the report on this basis make little sense to me - I hope I have misunderstood this!

There's an elephant in the room folks....
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I don't know about the other non-recorded data countries, but in the U.S., it doesn't make sense to use it as a comparative statistic if data were available. Many people enter into the formal administrative record-keeping system at a much later point in the course of an chronic health problem. Here is why:

With many uninsured people, they can't go on a waiting list for elective surgery, even if it's surgery that would improve their lives immensely because they can't afford to pay for it. In fact, if they see a doctor about it at all, it becomes a pre-existing condition and if they manage to later get insurance coverage through an employer, the insurance company will often try to deny coverage on that basis.

So, what the uninsured do is don't go to see a doctor unless/until the problem becomes life threatening. Then they can go to the emergency room, where they can't be turned away and will receive treatment. Of course, at that point, it's often too late.
 
Beth said:
I don't know about the other non-recorded data countries, but in the U.S., it doesn't make sense to use it as a comparative statistic if data were available. Many people enter into the formal administrative record-keeping system at a much later point in the course of an chronic health problem. Here is why:

With many uninsured people, they can't go on a waiting list for elective surgery, even if it's surgery that would improve their lives immensely because they can't afford to pay for it. In fact, if they see a doctor about it at all, it becomes a pre-existing condition and if they manage to later get insurance coverage through an employer, the insurance company will often try to deny coverage on that basis.

So, what the uninsured do is don't go to see a doctor unless/until the problem becomes life threatening. Then they can go to the emergency room, where they can't be turned away and will receive treatment. Of course, at that point, it's often too late.
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I understand that, but I think Obama/ The Democrats have dropped a boll*ck here. The first thing you do when trying to convince people change is needed is to have as much information available as possible.

There is a massive argument here with absolutely no figures at hand. Even something simple about number of insured waiting for any sort of treatment would have been something. Christ, the stats I'd want for this sort of argument would be enormous.

I fear this is doomed to failure - a case of "fail to prepare, prepare to fail".
 
The Painter said:
Yeah OK. No he's hypocritical.

I don't think our system is on the road to collapse. The national reform of health care is based on the system in Massachusetts. Tell me how's that State's system doin' after 2 years?
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I take it this is referring to me?

Yes, I'm very interested in the US health "system" (I'm not sure it's really a system, it seems to be more of an ad hoc conglomeration of different ways of doing it). I'm also surprised to realise that after debating it on this forum and elsewhere, I'm often better informed than some of the US residents in the debate.

The thing is, I try to give sources for my statements, or at least say "as I understand it". I've been corrected on a number of occasions, and my main take-home message is that the system is so diverse, even fragmented, that what might be a criticism of one part is not necessarily a problem in another. Nevertheless, for a substantial number of people the original concern is very real, and getting into the part of the system where the problem doesn't exist is impossible for some people.

The post I was responding to was this bald statement:

Britain has huge waiting lists, contrary to whatever lies michael moore spouts. Sometimes people are taken off the list to deceive the public into thinking that waiting lists are getting shorter.
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Now the thing is, I've just recently watched Sicko, and that was a fair representation of the NHS from the point of view of someone who lives here and relies on it. Michael Moore was not lying. What he was doing, quite explicitly, was redressing the balance of right-wing propaganda, which shows a pattern of taking cock-ups from universal systems and presenting them as if this was the normal experience of patients in these systems, and then contrasting this with the best the USA has to offer to its more privileged citizens.

Moore's film showed that if you look for them, there are plenty patients in the USA who have has as bad or worse experiences than the worst of the universal healthcare horror stories, and that in contrast the normal patient experience in the NHS is happy people going home with a new baby or a new hip, and nothing to pay.

The other contrast which Moore didn't labour, and yet which I find very significant, is that the NHS reacts to its failings. We, collectively, own the system, and we have put it in place with the object of delivering healthcare. If healthcare is not delivered to people who need it, we get cross. We make a big fuss. This can all be read in the newspapers and the enquiries and the published statistics. Even Americans can read all about it. The net result, however, is that failings are addressed, waiting times get shorter, and more drugs are made available to patients.

Compare this to the US system. I've yet to hear of any US insurance company or HMO actively working to help the people it has turned down for insurance get healthcare, or to help the insured people it has decided to retroactively uninsure once they developed an expensive condition because of a small mistake on their application form, or to help the people only entitled to one surgical intervention in a year who actually need two.

NWO Sentryman's comment was so brief, so categorical, that it did sound as if he was speaking from personal experience. Which of course I was pretty sure he wasn't, because that isn't the experience of people actually using the NHS. Now I could have said, please present your evidence for that, and then got into a long debate about how his evidence was out of date or cherry-picked and so on.

Sometimes life's too short. So I asked him what his personal experience was of the NHS. So sue me.

Rolfe.
 
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Waiting lists. Worth some discussion.

First, the number of people on a waiting list is irrelevant. Yesterday I had to pre-purchase a ferry ticket, and the ferry was already starting boarding. There were so many people in front of me I thought I was screwed, and resigned myself to waiting for the next one. However, there were four kiosks open, the staff were handing out tickets at lightning speed, and I had my ticket in my hand in less than a minute.

Waiting times are the thing. How long might you have to wait?

This depends entirely on how urgent your condition is. If you fall over with acute appendicitis, you will get your operation immediately. There and then. If you are hit by a bus, you will get into hospital as fast as the ambulance can take you there. If on the other hand you have a joint problem that has been slowly progressing over a period of years, from the time your surgeon decides you need a joint replacement to your surgery can be several months. Sensible doctors see how a patient is progressing and get them into the system in good time. Even then, a patient who is deteriorating unusually fast will be bumped up the list.

So, sure, you'll find some maximum wait times for non-urgent elective surgery which may seem quite long. But these aren't typical, and are usually relating to people with chronic conditions with no particular urgency about them.

This experience cannot be described as "rationing". These people will all get their surgery, and they will get it in a reasonable time, where "reasonable" is defined by their clinical condition. And they will all get it, and it doesn't matter how much money they have or haven't got, they won't be left on the sidelines.

However, wait times can become too long. And in the past, they have been too long. Keeping patients with crippling joint pain waiting a year for surgery is not acceptable. This is understood, and recognised, and systems have been put in place to monitor and improve the situation. Current wait times for non-emergency surgery are much better than they were ten or fifteen years ago. One rather annoying side-effect of this is that government targets aimed at ensuring this have been subject to some "gaming" by health board administrators in order to make their statistics look better. And nobody's saying everything's perfect and nothing ever goes wrong.

But the fact remains that the system is set up with the goal of delivering all necessary healthcare to everyone, and when it fails in that goal, corrective action is taken.

The corrective action is usually of course to throw more money at it. One of the main drawbacks of a tax-funded health system is that nobody likes paying taxes, nothing gets a blank cheque, and politicians like to promise tax cuts. You can take efficiency savings too far. Britain went through a period of spending far too small a proportion of GDP on healthcare, and that was the cause of the bad headlines and discontent. However, this was recognised, and we now spend about even with the pack on this area. As a result the service has got a lot better.

America is spending twice what we spend (as a proportion of GDP) on healthcare. For that money, you really ought to be able to deliver state-of-the-art healthcare to the entire population with enough slack in the system to keep waiting times to a minimum. Dammit, there isn't a French word for "waiting list", and they spend less than the US does (and not that much more than Britian does as far as I know).

And you know what? If you're in Britain, and the NHS gives you a wait time you don't like, there's another solution. Just ask your surgeon what it would cost to have the procedure done privately. If you can afford it, and you think the beneft is worth the price, then you can be done next week.

Isn't this solution acceptable to capitalist Americans? Works well here. The thing is though, that the poor people who can't afford a few thousand pounds to get it done immediately, will get their surgery in the end. Can you say the same?

Rolfe.
 
Not necessarily, but it does seem to require registration.

This information is all over the net. USA pays about 15 to 16% of GDP on healthcare. Countries with universal healthcare are around the 8% mark.

And by any standard marker of population healthcare outcomes, the USA is doing no better than and possibly slightly worse than these other countries. The other countries cover everyone for about half of what the USA spends to cover only some of its population. Or to put it another way, the USA is flushing about 7% of its GDP (conservative) down the toilet.

Nobody in any other country understands why Americans put up with it.

Rolfe.
 
Michael moore was the guy who trumpeted the ultimate of leftist potemkin villages: cuba.

His works are basically agitprop.
 
Attack his arguments, not his political views. If you've a problem with specific points of fact (or otherwise) in his work, then start a thread and raise it there. What Rolfe has done is point out that his assessment of the NHS was fairly on the nail, she didn't mention Cuba.
 
NWO Sentryman said:
Michael moore was the guy who trumpeted the ultimate of leftist potemkin villages: cuba.

His works are basically agitprop.
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Did you actually watch the film?

Moore was making a point, and he did it very cleverly. Unfortunately he was too clever for the idealism-blinded right-wingers who can't stand any suggestion that Cuba isn't Hell on Earth.

He began from the observation that many US citizens who suffered adverse health events following volunteer duties at the Twin Towers in 2001 are finding it very difficult to access healthcare. He then observed that the USA is boasting about the excellent living conditions in Camp Delta (in but not of Cuba), including boasting about the good healthcare that is provided for them.

Moore ran a stunt, a completely above-board stunt, where he pretended to take a boatload of these people to Guantanamo Bay to access the healthcare being provided for the terrorist suspects incarcerated there. There was no possibility that he was going to get in. He knew that, and they knew that, and everybody watching the film knew that.

So why did all these people volunteer to go on the trip with Moore? Because Moore wanted to contrast the exclusivity and expense of the US system with the sort of universal healthcare system even an impoverished and disadvantaged country can manage. He had therefore arranged in advance with the Cuban health professionals to treat these American visitors, just as a Cuban national would be treated. No doubt the Cuban health professionals agreed for propaganda reasons, to let Americans see that they were not actually in the Dark Ages. Nevertheless they received the visitors kindly and treated them well.

Moore at no point "trumpeted" the Cuban healthcare system as being wonderful. He pointed out that even a very poor country with very limited resources was managing to do a fairly respectable job, and that they did have some high-tech equipment and the ability to do more than hand out an aspirin. And that the population as a whole could access this, not just those who could afford to pay.

I read an awful lot of adverse comment about this part of the film long before I actually saw it, and most of it was just like the above, lambasting Moore for praising the Cuban health system. I was curious myself to know why he highlighted Cuba, but I understood perfectly when I watched the film.

Moore "trumpeted" Britain and France (especially, as far as I remember) as examples of what rich, developed countries with a lot of resources can do when they choose to provide healthcare to all their people. He also showed that a small, poor, disadvantaged country can turn in a passable job within its limited resources, if it puts its mind to it.

Watch the film, and quit with the ad hominem.

Rolfe.
 
Cuba is what is known as a potemkin village. Basically a Facade.

Cuba uses it for "useful idiots", or leftists such as Oliver Stone and Michael Moore who are easily seduced into beliving whatever lies comes out of castro's propganda machine.

It is a propaganda technique which has been used time and again. Lenin, Pol Pot, Mao, they have all used it.

How do you know it applies to all of Cuba? we are only shown what the cuban government wants them to show. A facade. Hence, the Potemkin village. Scratch the surface, and you will see a lot more.

Heck the guy who made The Power of Nightmares described Michael moore as a "political agit-prop film maker"

Many cuban dissidents have described it as a hell on earth.

Socialism does bring that hell. Castro killed 70000 people. Stalin killed 50 million. Mao killed 80 million.
 
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Investors Business Daily editorials have been spreading the rationing story.

Rationing: In the recesses of the House health care "reform" bill is a provision for end-of-life counseling for seniors. Don't worry, granny, they're from the government and they're here to help.
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A bit later is this little gem of misinformation:

People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.
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Don't they know Stephen HawkingWP has lived in the UK for his entire life?
 
NWO Sentryman said:
Cuba is what is known as a potemkin village. Basically a Facade.

Cuba uses it for "useful idiots", or leftists such as Oliver Stone and Michael Moore who are easily seduced into beliving whatever lies comes out of castro's propganda machine.

It is a propaganda technique which has been used time and again. Lenin, Pol Pot, Mao, they have all used it.

How do you know it applies to all of Cuba? we are only shown what the cuban government wants them to show. A facade. Hence, the Potemkin village. Scratch the surface, and you will see a lot more.

Heck the guy who made The Power of Nightmares described Michael moore as a "political agit-prop film maker"

Many cuban dissidents have described it as a hell on earth.

Socialism does bring that hell. Castro killed 70000 people. Stalin killed 50 million. Mao killed 80 million.
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Isn't that terrible. I've lived in a country with universal healthcare all my life. So have virtually all the posters on JREF who aren't American. And nobody's been killed (heck, our police force isn't even armed), and if this is hell, all I can say is, it's really comfortable.

Quit with the ad hominem nonsense, and address Moore's actual arguments.

Rolfe.
 
Rolfe said:
Isn't that terrible. I've lived in a country with universal healthcare all my life. So have virtually all the posters on JREF who aren't American. And nobody's been killed (heck, our police force isn't even armed), and if this is hell, all I can say is, it's really comfortable.
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You're all just saying that because, to say anything negative about the gov online in Europe will result in a midnight abduction by the SS for committing Crimes of Thought and Speech against the State!
 
Dymanic said:
Allow me:
http://www.mckinsey.com/mgi/reports/pdfs/healthcare/US_healthcare_report.pdf

Whether calculated on a per capita basis or as a percentage of the GDP, the U.S. spends nearly twice as much on healthcare as the next biggest spender (Canada), yet lags well behind other OECD contries on measures of broad outcomes including life expectancy and infant mortality.
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Here's a site that analyses and discusses the McKinsey report, which doesn't require registration.

What is the cause of excess costs in US healthcare?



It would be one thing if everyone in the USA recieved gold-plated state-of-the-art healthcare. If it was coming out top in all or most of the global indicators of population health, it might arguably be worth it. But it isn't. Things like life expectancy and infant mortality are actually worse than several of the other countries in that chart, and the individual horror story anecdotes coming out of the USA are an order of magnitude worse than those from countries with universal healthcare.

Do you wonder that the rest of us can't understand why you put up with it?

Rolfe.
 
NWO Sentryman said:
Cuba is what is known as a potemkin village. Basically a Facade.

Cuba uses it for "useful idiots", or leftists such as Oliver Stone and Michael Moore who are easily seduced into beliving whatever lies comes out of castro's propganda machine.

It is a propaganda technique which has been used time and again. Lenin, Pol Pot, Mao, they have all used it.

How do you know it applies to all of Cuba? we are only shown what the cuban government wants them to show. A facade. Hence, the Potemkin village. Scratch the surface, and you will see a lot more.

Heck the guy who made The Power of Nightmares described Michael moore as a "political agit-prop film maker"

Many cuban dissidents have described it as a hell on earth.

Socialism does bring that hell. Castro killed 70000 people. Stalin killed 50 million. Mao killed 80 million.
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Firstly, how do you know that it's just a facade? It might well be, but you'll have to cite sources and more detailed information. Let's see links to your dissidents in order that we can assess bona fides, etc. But most of all, why don't you DO IT IN A NEW THREAD!

Likewise, I'm not sure that your figures about deaths are particularly relevant here. Western Europe is predominantly socialist in outlook - even our right wing mainstream parties are somewhat the left of the US Democrats - and since we all seem to be rather well off and in good health, you'll excuse us for not quite buying into your position.

Now, do you have a detailed point to make?
 
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