Dr Adequate
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Michael Moore's "Sicko"
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Read the Wikipedia article I linked to, you are not comparing apples with apples with that £20,741 figure. I compared a UK qualified GP practitioner with their USA equivalent.
Lonewulf
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Obesity and diet have a lot to do with (adult) life expectancies, I would think. Obesity is a large problem in America. I wouldn't say that the statistics demonstrates *only* medical ability of the country, but also factors in personal lifestyles in the country.
Segnosaur
Penultimate Amazing
Well, has anyone here who has argued against your statistics actually had an argument that was WRONG?
You pointed to WHO rankings (which place the U.S. rather low on the list...) it was pointed out that the rankings include financial factors so its not a measure of how good the system is, its a measure of how well money is spent (something that's important, but not THE most important thing)
You pointed to statsitics on life expectancy, and it was pointed out that there are other factors that determine life expectancy.
So where are our arguments wrong?
http://www.payscale.com/research/UK/Job=Physician_/_Doctor,_General_Practice/Salary
http://www.payscale.com/research/US/Job=Physician_/_Doctor,_General_Practice/Salary
Is this a little better? It shows saleries for GP's in Great Britain to be slightly less than in the US. Granted it does not show some major cities from GB but would appear that the wikipedia article is a little misleading.
I also found this article from the UK.
http://news.scotsman.com/index.cfm?id=995812007
Maybe MM can do a sequel.
http://news.scotsman.com/index.cfm?id=995812007
Maybe MM can do a sequel.
Dr Adequate
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No, of course not. None of them has offered a quantitative argument of the sort that could be proven wrong. I have offered statistics of which the interpretation is, I agree, questionable, whereas none of the people arguing with me have submitted any statistics whatsoever. They are not wrong because they are not even wrong: they have offered no testable claims, no figures, no statistics, no analysis, nothing whatsoever.
Agreed. This is why I switched to direct measurements of health.
Sure. For example, the French smoke more than Americans, and the statistics don't compensate for that. The French have a lower average per capita income, and the statistics don't compensate for that. On the other hand, Americans are more likely to be killed by gunfire or excess of cheeseburgers, and the statistics don't compensate for that.
So, I'll ask one more time. What statistics would be relevant?
Apparently we in western europe have a health system which is much cheaper, and which works at least as well, if not better, in terms of life expectancy, child mortality, and the WHO rankings. I do not claim that all these statistical measures are perfect. Nonetheless ...
If someone wishes to dismiss all these statistics as irrelevant, I should still like to hear an answer to my question. Which facts ARE relevant? If we want to figure out which system of health provision is working best, what figures should we be looking at?
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Lonewulf
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What statistics would be relevant? Something that directly targets medical success or lack of success.
In short, measure those who "get better" and those who do not, measure the people that die and the people that do not in hospitals. The main arguments involve doctors and how good they are, right? How many people "get better"? So isolate that, and look at actual hospital records.
It's harder than looking at something more general and extrapolating data, but it's also more relevant.
Is that the main argument? American doctors are some of the best in the world, but if you have no access to them due to financial reasons, they might as well not exist. This seems to be the main point of argument between the two side in the US healthcare debate. One says the American healthcare is the best in the world, and the other says that millions of Americans have no access to that wonderful healthcare.
Lonewulf
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Then demonstrate the statistics that show that "millions of americans" have no access to healthcare.
That's a lot of people with no access... some evidence would be nice.
EDIT: Also, I currently live in Germany, near Heidelberg (though so close, I write that I live in Heidelberg on my profile).
Here in Germany, they also have privatized healthcare (as far as I can tell, I honestly do not understand the ins and outs of the healthcare system here). To be a student, I'm required to have health insurance.
So, a question: Is the German system just as bad as the American? If not, why not?
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Segnosaur
Penultimate Amazing
Not quite right... when I pointed out the fault of relying on the WHO organizational rankings, I pointed out that the U.S. system was ranked #1 in responsiveness. That's a fact that can be checked just by looking at the links you yourself provided.
As for some of the other statistics you provided (e.g. life expectancy), given the complexity and number of factors involved, I don't feel there IS a need to come up with direct statistics to refute your claim. (Its like doing a study but not providing a proper control group.)
It depends... what exactly are you trying to measure?
The WHO rankings do an OK job at determining cost effectiveness of health care spending (although I'm sure someone could come up with a better system.)
If you are trying to measure the actual quality of the health care itself (regardless of how much it costs or how wasteful the spending is), you could look at things like:
- Average wait times (time to get treatment for diseases, etc.)
- Survival rates for various illnesses (what percentage of people who come up with a disease either get cured, or die while either under treatment, or die because they cannot afford treatment)
At least those types of measurements minimize the impact of outside factors (since you aren't measuring the number of people who get a disease, only how they are treated in the health care system.)
Admittedly, I don't have any specific statistics on hand (although I've seen some in the past, mostly related to waiting times). However, I'm also not really trying to champion the U.S. system. I recognize it has flaws, but blaming it for problems it DOESN'T have seems counter-productive.
Damien Evans
Up The Irons
Hey, when did you move out of Texas?
Also, as i understand it, our Australian system is a mix of both public and private healthcare, is it similar in Britain and France, or are they 100% public?
Rolfe
Adult human female
Britain is certainly a mix, but I'd say most people go the NHS route.
I had a sinus operation privately because I had BUPA coverage through my job (my business partner had decided to take it out because he didn't want me lauguishing on a waiting list). My mother had her glaucoma operations on the NHS almost as soon as they were deemed necessary, because glaucoma of that stage was deemed to be a priority, but when soon after she needed cataract operations the waiting time was 13 months because cataract was not deemed to be a priority (even in elderly ladies living alone whose sight was already poor due to glaucoma), so she decided to pay for these privately out of her savings. She was admitted very quickly for surgery and in fact it didn't cost her an arm and a leg, she comfortably paid for it out of savings. And as soon as the surgery was done, she's back in the NHS system for her routine ophthalmology appointments, free sight assessments and visual aids as required.
My cousin has recently had a hip replacement on the NHS. She couldn't have afforded that herself, and in fact her GP get her bumped up the waiting list because of the pain she was in. A friend was getting a bit of the runaround regarding hip pain and chose to pay for a private consultation. This brought her condition to the attention of the surgeon, who bounced her straight back into the NHS system at the top of the queue, because of clinical priority.
You can mix and match to good effect, and I think not everybody realises this. There's a bit of a feeling that one shouldn't pay to "jump the queue", which I had to browbeat my mother out of regarding the cataract operations.
What there is very little of (none outside of the rich quarters of the very biggest cities) is private General Practice. Everybody can get to see their GP pretty quickly, and the GPs are a pretty effective triage (usually, not saying there aren't some dodos). Where private care comes in is usually someone with a non-urgent condition deciding to pay rather than wait for ages. Like my mother and the cataracts.
Even that Scotsman article linked to was mainly saying that the NHS can't necessarily provide everything everyone wants. How badly do you need varicose vein surgery? If it's cosmetic, should you be having that done privately? The call is for openness and equity as regards rationing, rather than denying it happens.
At least nobody has to file for bankruptcy because they were injured or fell ill, and apart from a few controversial and expensive treatments that people are bickering over, by and large you'll get what you need.
Rolfe.
PS. Writing this has just jogged my memory that both myself and my mother registered with a new practice last week, as we've just moved house. When I handed in the paperwork, the receptionist said the doctor would like to see Mum in person, due to her age and eye condition and so on. So I just phoned the surgery. That's fine, 2.20 next Wednesday, yes we'll organise a car to pick her up to get to the appointment (this is through the Red Cross I think). The doctor now has all Mum's health records sent from her previous doctor. Oh yes, and they want me to make an appointment to see the practice nurse just for a quick health check as a new patient too.
How much is all this going to cost? How much is Mum's medication going to cost?
Zilch. Nada.
I had a sinus operation privately because I had BUPA coverage through my job (my business partner had decided to take it out because he didn't want me lauguishing on a waiting list). My mother had her glaucoma operations on the NHS almost as soon as they were deemed necessary, because glaucoma of that stage was deemed to be a priority, but when soon after she needed cataract operations the waiting time was 13 months because cataract was not deemed to be a priority (even in elderly ladies living alone whose sight was already poor due to glaucoma), so she decided to pay for these privately out of her savings. She was admitted very quickly for surgery and in fact it didn't cost her an arm and a leg, she comfortably paid for it out of savings. And as soon as the surgery was done, she's back in the NHS system for her routine ophthalmology appointments, free sight assessments and visual aids as required.
My cousin has recently had a hip replacement on the NHS. She couldn't have afforded that herself, and in fact her GP get her bumped up the waiting list because of the pain she was in. A friend was getting a bit of the runaround regarding hip pain and chose to pay for a private consultation. This brought her condition to the attention of the surgeon, who bounced her straight back into the NHS system at the top of the queue, because of clinical priority.
You can mix and match to good effect, and I think not everybody realises this. There's a bit of a feeling that one shouldn't pay to "jump the queue", which I had to browbeat my mother out of regarding the cataract operations.
What there is very little of (none outside of the rich quarters of the very biggest cities) is private General Practice. Everybody can get to see their GP pretty quickly, and the GPs are a pretty effective triage (usually, not saying there aren't some dodos). Where private care comes in is usually someone with a non-urgent condition deciding to pay rather than wait for ages. Like my mother and the cataracts.
Even that Scotsman article linked to was mainly saying that the NHS can't necessarily provide everything everyone wants. How badly do you need varicose vein surgery? If it's cosmetic, should you be having that done privately? The call is for openness and equity as regards rationing, rather than denying it happens.
At least nobody has to file for bankruptcy because they were injured or fell ill, and apart from a few controversial and expensive treatments that people are bickering over, by and large you'll get what you need.
Rolfe.
PS. Writing this has just jogged my memory that both myself and my mother registered with a new practice last week, as we've just moved house. When I handed in the paperwork, the receptionist said the doctor would like to see Mum in person, due to her age and eye condition and so on. So I just phoned the surgery. That's fine, 2.20 next Wednesday, yes we'll organise a car to pick her up to get to the appointment (this is through the Red Cross I think). The doctor now has all Mum's health records sent from her previous doctor. Oh yes, and they want me to make an appointment to see the practice nurse just for a quick health check as a new patient too.
How much is all this going to cost? How much is Mum's medication going to cost?
Zilch. Nada.
boooeee
Dart Fener
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From the snippets I've seen, Moore's main contention is that the US healthcare system is screwed up because it is run as a for-profit business.
However, it is my understanding that many countries in Europe have for-profit health insurance. The main difference being that the insurance is mandatory, ensuring that healthy members pay into the pool. Can anybody here verify this?
However, it is my understanding that many countries in Europe have for-profit health insurance. The main difference being that the insurance is mandatory, ensuring that healthy members pay into the pool. Can anybody here verify this?
Earthborn
Terrestrial Intelligence
Basically correct, though not all private insurance companies are for profit. Some are non-profit organisations. It is generally illegal for private insurers to refuse clients with pre-existing conditions, or increase their premiums based on medical grounds, or to throw them out if they become too high a risk.
Lonewulf
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boooeee
Dart Fener
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Thanks. We also have non-profit health insurance organizations here in the U.S. (I'm currently employed by one).
In most U.S. states, health insurance companies can refuse to cover people applying on their own on the basis of pre-existing conditions. People call it "cherry-picking", but it's the only way an individual health insurance market can function when people are allowed to opt out of coverage. I think Moore touches on this in his documentary, and generally tries to portray it in a bad light (I've only seen the Oprah summary so far, so I may be wrong on this).
E.J.Armstrong
Illuminator
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What all good folk want around the world. Dead Peasant Insurance. Way to go the WalMart way. You know it makes sense.
Lonewulf
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This post is so professional and mature.
I would be interested to see a graph made by state. I am thinking theres a big difference between the states here, maybe not though.