Health care - administrative incompetence

[xjx388]

Here are ten measures of healthcare in seven countries.

It doesn't include some of the best UHC systems in the world (France, Sweden), nor does it include some of the worst performing.

http://www.commonwealthfund.org/Con...rts/2010/Jun/Mirror-Mirror-Update.aspx?page=1

Your data for this comes from this survey. It asked 11910 people from seven different countries to rate the level of health care in the country, on a telephone call using only their opinion. The science behind such polling aside, how can you form any conclusions on the actual level of health care/outcomes in a country by asking 2000 of it's residents for their opinions? You can't, therefore, as a measure of health care in a country, this data is meaningless.

 

[varwoche]

Your continued insistence that the NHS covers everyone's needs perfectly is a utopian fantasy.

Oh the strawmanity.

the free market will drive healthcare costs down

Out of curiosity, does your whimsical universe also contain pink unicorns?

 

[Uncayimmy]

That's right, you can't save the ridiculous sums that healthcare costs under our current system. That's support of my argument, not a flaw. There have to be fundamental changes. Government out + Free Market in = lower cost.

It's like you can't hold more than one thought in your head at a time. It's like arguing with a blind man touching various parts of an elephant and insisting alternately that it's a rope, spear, wall and so forth.

You make the dubious claim that other states should follow the lead of Texas when it comes to malpractice insurance. Do you understand that Texas "accomplished" this via more government interference? They didn't expand the free market - they heavily restricted it. It's protectionism for medical practitioners.

 

[Darat]

xjx388 - no one here (from the UK side at least ) would claim that the NHS is perfect, or that it does not need to be improved.

 

[Emet]

How do you choose car insurance without knowing if you will crash into someone and kill them? How do you choose home insurance without knowing if your house will burn down or not? You're a smart person, Ducky, I think you'll figure it out.

Homeowners/renters insurance already covers catastrophic loss quite well, and is affordable.
Auto insurance has PIP: combined policies offer umbrella coverage. Very affordable.

Here is a current plan available to a family of four right now in this regulated climate: $7500 individual deductible/ $22,500 family deductible. $1000 prescription drugs deductible with a maximum $5000 out of pocket, no Lifetime Maximum, preventive covered at 100%. Cost per month ~$270.

So, a family of 4 would need to budget $3600/year, and have an extra $10-20 K saved up before the policy even kicks in? Is that correct?

I see no evidence that shows free markets don't work in healthcare. I see a lot of rhetoric, but no actual study or case where it has failed.

I see no evidence that it actually works-- or could.

 

[xjx388]

You have shown no evidence that an obese person will not receive treatment nor an alcoholic won't receive the medically appropriate treatment under the NHS.

This is nit-picking. You have shown no evidence that everyone in the UK gets all the treatment they need for their healthcare.

What if an alcoholic needs a liver transplant? They won't get one because of the drinking. So it's OK to let the alcoholic die.

What if an obese person needs a hip-replacement? They won't get it until they lose weight. They can't lose weight easily so they may never get it. So it's OK for the obese person to suffer with pain the rest of their life.

Rationing of healthcare is a fact, even in the NHS.

 

[Delscottio]

This is nit-picking. You have shown no evidence that everyone in the UK gets all the treatment they need for their healthcare.

What if an alcoholic needs a liver transplant? They won't get one because of the drinking. So it's OK to let the alcoholic die.

What if an obese person needs a hip-replacement? They won't get it until they lose weight. They can't lose weight easily so they may never get it. So it's OK for the obese person to suffer with pain the rest of their life.

Rationing of healthcare is a fact, even in the NHS.

Ah I see the proboem now, do you think the dr. just says no and thats it? What hapens is a treatment plan is put in place to get the patient to where they need to be for the best clnical outcome as per the evidence suggests. They aren't denied treatment. They may be denied ineffective treatment though.

 

[xjx388]

Oh the strawmanity.

This was in response to my pointing out that Rolfe's picture of the UK was a utopian vision that doesn't work in reality:

Er, it does here. I was describing actual reality, as she is right where I'm sitting.

<snip>

It's no utopian vision to point out that where I live, this isn't a consideration at all. Nobody needs to worry where the funding for any future healthcare needs is going to come from, because it's sorted. And nobody appears to bear any ill will towards the people who find themselves in the position of needing that healthcare.

[/quote]

"Nobody needs to worry about the funding for any future healthcare needs because it's sorted." = covering everyone's future needs perfectly

Out of curiosity, does your whimsical universe also contain pink unicorns?

No, but apparently, in some parts of the UK, there are leprechauns . . .

 

[xjx388]

It's like you can't hold more than one thought in your head at a time. It's like arguing with a blind man touching various parts of an elephant and insisting alternately that it's a rope, spear, wall and so forth.

You make the dubious claim that other states should follow the lead of Texas when it comes to malpractice insurance. Do you understand that Texas "accomplished" this via more government interference? They didn't expand the free market - they heavily restricted it. It's protectionism for medical practitioners.

And you don't understand the basics of what you are talking about. Tell me, UY, what was the government interference that led to restriction of the free market?

 

[xjx388]

Ah I see the proboem now, do you think the dr. just says no and thats it? What hapens is a treatment plan is put in place to get the patient to where they need to be for the best clnical outcome as per the evidence suggests. They aren't denied treatment. They may be denied ineffective treatment though.

Right. The care is rationed. Too fat? No treatment. You drink? No treatment. First let's cure those other problems. Can't cure those other problems? Too bad, we can't do your surgery. Suffer/die.

 

[ServiceSoon]

...

Isn't it crazy that we could get a similar type of health care by emulating the NHS without even raising taxes? Without even raising taxes, we could get similar health care in the US. All we need to do is cut off the gravy train of extreme profits in some industries.
...

I disagree because it is not true. You can not account for the difference in healthcare spending per capita between the US and (pick a country) due to the mere existence of the health insurance industry. The US spent $2.47 trillion on healthcare in 2009. The top 14 health insurance companies posted $8,500 million in profits. That's .0034% of the US's healthcare expenditures in 2009.

 

[Tatyana]

Your data for this comes from this survey. It asked 11910 people from seven different countries to rate the level of health care in the country, on a telephone call using only their opinion. The science behind such polling aside, how can you form any conclusions on the actual level of health care/outcomes in a country by asking 2000 of it's residents for their opinions? You can't, therefore, as a measure of health care in a country, this data is meaningless.

It isn't meaningless, it does indicate that people in the USA are not satisfied with the current situation.

There is also the WHO ranking of countries for various health outcomes.

http://www.photius.com/rankings/healthranks.html

1 France
2 Italy
3 San Marino
4 Andorra
5 Malta
6 Singapore
7 Spain
8 Oman
9 Austria
10 Japan
11 Norway
12 Portugal
13 Monaco
14 Greece
15 Iceland
16 Luxembourg
17 Netherlands
18 United Kingdom
19 Ireland
20 Switzerland
21 Belgium
22 Colombia
23 Sweden
24 Cyprus
25 Germany
26 Saudi Arabia
27 United Arab Emirates
28 Israel
29 Morocco
30 Canada
31 Finland
32 Australia
33 Chile
34 Denmark
35 Dominica
36 Costa Rica
37 United States of America

38 Slovenia
39 Cuba
40 Brunei
41 New Zealand
42 Bahrain
43 Croatia
44 Qatar
45 Kuwait
46 Barbados
47 Thailand
48 Czech Republic
49 Malaysia
50 Poland
51 Dominican Republic

 

[xjx388]

Homeowners/renters insurance already covers catastrophic loss quite well, and is affordable.
Auto insurance has PIP: combined policies offer umbrella coverage. Very affordable.

And healthcare insurance can be affordable too.

So, a family of 4 would need to budget $3600/year, and have an extra $10-20 K saved up before the policy even kicks in? Is that correct?

In that particular example, maybe. Are you suggesting that families should not save for their own future needs?

I see no evidence that it actually works-- or could.

You only have to look at the other free markets for basic human rights that currently exist: Food and Shelter.

 

[Uncayimmy]

It's not a fantasy. The average person spends about $2100 on entertainment, alcohol and tobacco and about $2010 on healthcare.

Do you understand that employer paid health insurance premiums were not included? If you have five people paying insurance out of pocket (about $6,000/year for me) and five whose employers pay it, and none of us actually need any health care, the average is going to be $3,000. Likewise, these two groups spend on entertainment, alcohol and tobacco at complete opposites (none for the self-insured, $6,000 for the employer insured), it looks like that on average people spend just as much on entertainment as they do health care, when in reality that's not the case at all.

 

[Agatha]

This is nit-picking. You have shown no evidence that everyone in the UK gets all the treatment they need for their healthcare.

What if an alcoholic needs a liver transplant? They won't get one because of the drinking. So it's OK to let the alcoholic die.

What if an obese person needs a hip-replacement? They won't get it until they lose weight. They can't lose weight easily so they may never get it. So it's OK for the obese person to suffer with pain the rest of their life.

Rationing of healthcare is a fact, even in the NHS.

Why do you keep saying this when you have been repeatedly shown it to be wrong?

Alcoholics do get treatment - if they will benefit from a transplant they will get one (assuming there is an organ available). They do have to give up the alcohol though this requirement can be overridden by their doctors but they will be helped to abstain, even if that means months of inpatient treatment.

Obese people - I assume you are referring to yet another Daily Fail sensational article such as this one from 2005? http://www.dailymail.co.uk/health/article-369464/Obese-patients-denied-hip-replacements.html

The one which goes on to say

Even those who have a BMI lower than 30 may have to exhaust other options first, including painkillers and physiotherapy.

According to the new guidelines, the surgery will only then be performed if the pain and disability interfers [sic] with the patient's daily life and ability to sleep.

So patients are not denied surgery, nor are they left to suffer in pain. What happens is that all patients, thin or fat, are treated with painkillers and physio first, and if that doesn't help, then they get the surgery. It is an outright lie to claim that an obese person is left to suffer in pain for the rest of their life.

In any case, the decision is NEVER taken on cost grounds, but only ever on the basis of clinical need.

A friendly piece of advice - don't take everything you read in the Daily Mail as being true. DOC came a bit unstuck with that on his "more baby boys being called Mohammed" thread; the news report he quoted and relied on was shown to be absolutely false. The paper has an agenda and it's not a particularly pleasant one IMO.

 

[Emet]

And healthcare insurance can be affordable too.

How, exactly?

In that particular example, maybe. Are you suggesting that families should not save for their own future needs?

Please do not presume what I am suggesting. Why not look at median household incomes for a family of four, and explain to me how they can budget for the example you presented (n.b.: this data is from 2004-- the only source I could find readily that specified a family of 4--feel free to find a more current reference or increase median income for 2010):

http://www.hhsc.state.tx.us/research/dssi/ESI/StateMedianFamilyIncome.html

You only have to look at the other free markets for basic human rights that currently exist: Food and Shelter.

Have you read this article yet? Care to dispute Paul Krugman?

(Please disregard political philosophy and dispute on the merits only-- if you can)

 

[Ampulla of Vater]

Okay y'all, I am very interested in this thread but have been extraordinarily busy with family commitments. I am off today so I am wandering back over to catch up on the debate. I have a couple of questions for you guys in the UK.

How much (percentage-wise) do you pay in taxes? I pay upwards of 45% in taxes and I fear that implementing a UHC system will raise taxes.

Several posters have referenced enormous bonuses and salaries paid to certain executives. What constitutes a ridiculously large bonus/salary? Who should determine what is considered a colossal salary/bonus?

 

[Uncayimmy]

And you don't understand the basics of what you are talking about. Tell me, UY, what was the government interference that led to restriction of the free market?

They put a cap of $250,000 on non-economic damages. They told the citizens of Texas that they can't decide that damages are more than that. As far as I can tell they didn't tie that number to inflation, so every year that number gets lower and lower in real dollars. That means 30 years from now that cap will be about $75,000 in today's money.

They changed the burden for emergency room practice to require willful and wanton negligence. They carved out a special exemption for them.

So, in Texas if an ordinary citizen crashes his car into somebody, he doesn't have to be willfully and wantonly negligent to be liable. And there's no cap on the non-economic damages. If an ER doc screws up, the victim has a much higher burden to get damages, and he's restricted on how much he can get.

How is that in any way, shape or form a free market? The market was much more free before the changes, and the rates were higher. By restricting free market, the rates got lower. This is the opposite of what you claim should happen.

 

[xjx388]

It isn't meaningless, it does indicate that people in the USA are not satisfied with the current situation.

There is also the WHO ranking of countries for various health outcomes.

http://www.photius.com/rankings/healthranks.html
<snip>

C'mon, now. This was a ranking based on attainment of the WHO's goals for each country. One of the criteria is "Fairness in Financial Contribution." What the heck is that and how do you measure it? Interestingly, that same spreadsheet ranks the US #1 in "Health Expenditure per capita in International Dollars." Switzerland is #2 and France is #3. So according to that report, we spend less per capita in international terms of reference than any other country . . . interesting, huh?

I want to see data on morbidity and mortality for the major killers: cancer, heart disease, etc. Those are real health outcomes. For example, the WHO has a pretty cool database on cancer mortality for many countries. If you fiddle around a bit, you can get a table for the US and the UK. If you select for: all cancers, Male, you will find that in the UK, the death rate from cancer (all 2005 numbers) is 272.09 per 100,000 and in the US 195.23. Pretty significant difference in outcomes don't you think? Breast cancer? UK = 36.68, US =26.77. So in cancer, the US system has the UK's NHS beat. Those are the kind of numbers we need to see to compare outcomes.

 

[xjx388]

They put a cap of $250,000 on non-economic damages. They told the citizens of Texas that they can't decide that damages are more than that. As far as I can tell they didn't tie that number to inflation, so every year that number gets lower and lower in real dollars. That means 30 years from now that cap will be about $75,000 in today's money.

They changed the burden for emergency room practice to require willful and wanton negligence. They carved out a special exemption for them.

So, in Texas if an ordinary citizen crashes his car into somebody, he doesn't have to be willfully and wantonly negligent to be liable. And there's no cap on the non-economic damages. If an ER doc screws up, the victim has a much higher burden to get damages, and he's restricted on how much he can get.

How is that in any way, shape or form a free market? The market was much more free before the changes, and the rates were higher. By restricting free market, the rates got lower. This is the opposite of what you claim should happen.

What you described is not a restriction of any market. You are deluded or willfully twisting terminology to phrase it that way. Show me an economist who thinks that tort reform=restricting markets. Ludicrous.