Universal Healthcare

[jasonxctf]

 

interesting looking map, for all to enjoy and fight over.

 

 

[jasonxctf]

Since it's hard to read, here is the table

 

ORANGE= Iraq and Afghanistan universal health coverage provided by US war funding

GRAY= Countries without universal healthcare

DARK GREEN= Countries with some form of universal healthcare

LIGHT GREEN= Countries trying to implement universal healthcare

[GoSox05]

Great, Siberia has Universal Healthcare before us. I'm moving to Siberia. Wait. Nevermind.

Edited January 4, 2008 by GoSox05

[southsideirish71]

Great, Siberia has Universal Healthcare before us. I'm moving to Siberia. Wait. Nevermind.

 

I find these cries for socialized medicine pretty interesting. I am a type II diabetic. I have been an athlete all my life, I eat healthy, never have smoked, and have run every night 5 or more miles. I am in great shape, and I am not the person you would look at and say thats a diabetic( 6'2 175). My doctor was probably just as shocked as I was. The family history is very strong, but to be diagnosed at 32 years old in the shape I was in was pretty odd. My children most likely carry the genetic cocktail that will turn them into diabetics later in life. So healthcare is a very important issue for me. I receive amazing care, I have a great medical team that helps me keep my glucose in control. I am not using Insulin, I am controlling it with drugs. The drug cocktail they give you takes time, and experimentation to get the right mix. And it always changes. One year one drug works, a few years later you need to adapt. So I can tell you honestly that the money I spend on my healthcare is money well spent in my opinion. I only have to look at my young children for a reason to stay issue free. As I have relatives around the world, some in socialized medicine countries. Their experience with dealing with diabetes and the care is not the same. They get put on a drug, and it takes a minor miracle before it gets changed if its not working. They take longer to get minor issues taken care off. For a diabetic, a minor issue one day is a major one in a few years. Do you know why a diabetic gets their eyes checked. Its not just because of the blindness issue. The arteries in the eyes and your kidneys are similar in structure. They use the eye test to gage what is going on with your renal arteries, another area that can fail over time with glucose poisoning. When you have too much glucose in your system over time, it damages these arteries. This damage can be reversed if caught in time, but if it isn't caught in time it can cause renal failure. So a simple issue can become a major one if left untreated. The idea that the care will be the same because the government will take over and it will be free is naive as well. People with chronic diseases will suffer with the level of care they will receive if we move to socialized medicine.

 

 

[Jenksismyhero]

What? A large-scale government project that wouldn't be as efficient or effective as one run by a free market? Seriously though, it's too bad morons like Edwards just can't seem to get this through his head.

 

Also, what does this map prove? That more people do it? Who cares? The majority of the world hates gays and can't find food. Should we follow?

[Steve9347]

I find these cries for socialized medicine pretty interesting. I am a type II diabetic. I have been an athlete all my life, I eat healthy, never have smoked, and have run every night 5 or more miles. I am in great shape, and I am not the person you would look at and say thats a diabetic( 6'2 175). My doctor was probably just as shocked as I was. The family history is very strong, but to be diagnosed at 32 years old in the shape I was in was pretty odd. My children most likely carry the genetic cocktail that will turn them into diabetics later in life. So healthcare is a very important issue for me. I receive amazing care, I have a great medical team that helps me keep my glucose in control. I am not using Insulin, I am controlling it with drugs. The drug cocktail they give you takes time, and experimentation to get the right mix. And it always changes. One year one drug works, a few years later you need to adapt. So I can tell you honestly that the money I spend on my healthcare is money well spent in my opinion. I only have to look at my young children for a reason to stay issue free. As I have relatives around the world, some in socialized medicine countries. Their experience with dealing with diabetes and the care is not the same. They get put on a drug, and it takes a minor miracle before it gets changed if its not working. They take longer to get minor issues taken care off. For a diabetic, a minor issue one day is a major one in a few years. Do you know why a diabetic gets their eyes checked. Its not just because of the blindness issue. The arteries in the eyes and your kidneys are similar in structure. They use the eye test to gage what is going on with your renal arteries, another area that can fail over time with glucose poisoning. When you have too much glucose in your system over time, it damages these arteries. This damage can be reversed if caught in time, but if it isn't caught in time it can cause renal failure. So a simple issue can become a major one if left untreated. The idea that the care will be the same because the government will take over and it will be free is naive as well. People with chronic diseases will suffer with the level of care they will receive if we move to socialized medicine.

Thanks for the recap, this is a very educated view on healthcare. However, I think Universal Healthcare is for the better. People shouldn't be avoiding the doctor just to save a few hundred bucks (or more.)

[Soxy]

Are there any stats on this? Controlling for income and education is there any difference in life expectancy, cancer rates, cancer success rates, or any of that stuff available? I've never looked, so I've seen seen a controlled study.

 

People's opinions on this seem to rely almost exclusively on anecdotal evidence, and I'd like some facts (anything published in a reputable journal would be even better). . .

[southsider2k5]

Since it's hard to read, here is the table

 

ORANGE= Iraq and Afghanistan universal health coverage provided by US war funding

GRAY= Countries without universal healthcare

DARK GREEN= Countries with some form of universal healthcare

LIGHT GREEN= Countries trying to implement universal healthcare

 

So I guess in excess of being Mexico's unemployment and social security plans, we are their health care plan too?

[Texsox]

So I guess in excess of being Mexico's unemployment and social security plans, we are their health care plan too?

 

Actually major employers in Mexico provide Doctors in the workplace. When I worked in Mexico, the quality of routine health care the employees and families received was very good. Of course, I never saw the rest of the story. We also were required by law to provide a meal. People forget that when they ask what our employees were paid.

 

What is a shame with our system is the very poor and those with greater resources have coverage. The working poor, the small business owner, the people who work for the small business, are squeezed. My ex father-in-law worked his ass off for 40 years. At 58 years old he was released from his job. Both he and my ex mother in law had medical issues. Facing over $1000 a month for insurance, plus co-pays, plus out of pocket, ruined them quickly.

 

There is room for improvements. Workers earning $30,000 per year shouldn't be faced with 20% or more of their net being taken up with routine health care.

[Balta1701]

I haven't had time to read the full study yet, but this appears new and the conclusions are interesting.

In a Commonwealth Fund-supported study comparing preventable deaths in 19 industrialized countries, researchers found that the United States placed last. While the other nations improved dramatically between the two study periods—1997–98 and 2002–03—the U.S. improved only slightly on the measure.

 

In "Measuring the Health of Nations: Updating an Earlier Analysis" (Health Affairs, Jan./Feb. 2008), Ellen Nolte, Ph.D., and C. Martin McKee, M.D., D.Sc., both of the London School of Hygiene and Tropical Medicine, compared international rates of "amenable mortality"—that is, deaths from certain causes before age 75 that are potentially preventable with timely and effective health care. In addition to the U.S., the study included 14 Western European countries, Canada, Australia, New Zealand, and Japan. According to the authors, if the U.S. had been able reduce amenable mortality to the average rate achieved by the three top-performing countries, there would have been 101,000 fewer deaths annually by the end of the study period.

 

The concept of amenable mortality was developed in the 1970s to assess the quality and performance of health systems and to track changes over time. For this study, the researchers used data from the World Health Organization on deaths from conditions considered amenable to health care, such as treatable cancers, diabetes, and cardiovascular disease.

U.S. Ranks Last

 

Between 1997–98 and 2002–03, amenable mortality fell by an average of 16 percent in all countries except the U.S., where the decline was only 4 percent. In 1997–98, the U.S. ranked 15th out of the 19 countries on this measure—ahead of only Finland, Portugal, the United Kingdom, and Ireland—with a rate of 114.7 deaths per 100,000 people. By 2002–03, the U.S. fell to last place, with 109.7 per 100,000. In the leading countries, mortality rates per 100,000 people were 64.8 in France, 71.2 in Japan, and 71.3 in Australia.

 

The largest reductions in amenable mortality were seen in countries with the highest initial levels, including Portugal, Finland, Ireland, and the U.K, but also in some higher-performing countries, like Australia and Italy. In contrast, the U.S. started from a relatively high level of amenable mortality but experienced smaller reductions.

Many Lives in U.S. Could Be Saved

 

The researchers estimated the number of lives that could have been saved in 2002 if the U.S. had achieved either the average of all countries analyzed (except the U.S.) or the average of the three top-performing countries. Using this formula, the authors estimated that approximately 75,000 to 101,00 preventable deaths could be averted in the U.S. "[E]ven the more conservative estimate of 75,000 deaths is almost twice the Institute of Medicine's (lower) estimate of the number of deaths attributable to medical errors in the United States each year," the authors say.

Future Implications

 

The rate of amenable mortality is a valuable indicator of health care performance, say the authors—one that can point to potential weaknesses in a nation's health system that require attention. "[T]he findings presented here are consistent with other cross-national analyses, demonstrating the relative underperformance of the U.S. health care system in several key indicators compared with other industrialized countries," they say.

[Jenksismyhero]

I don't want to piss on the study right off the bat, but really, there has to be SO many other factors in play here that simply comparing otherwise preventable deaths from country to country is just worthless. Are their major differences in the types of patients treated in each health system? What are the rates of preventable diseases? What are income levels? Do other countries serve as big of a group? Are the systems themselves comparable, in terms of advancement of care?

 

 

[Balta1701]

I don't want to piss on the study right off the bat, but really, there has to be SO many other factors in play here that simply comparing otherwise preventable deaths from country to country is just worthless. Are their major differences in the types of patients treated in each health system? What are the rates of preventable diseases? What are income levels? Do other countries serve as big of a group? Are the systems themselves comparable, in terms of advancement of care?

All true. There are a ton of variables. Looking solely at industrialized countries certianly helps with it, and they've taken the further step in not just looking at mortality but looking at specific types of mortality that could be prevented with adequate care. However, that's not going to be my comeback. The key point and the question I put to you then is...if the U.S. spends 1.5 to 3 times as much per person on Health care as any other country surveyed there, can you explain to me why the U.S. should still finish last?

[EvilMonkey]

All true. There are a ton of variables. Looking solely at industrialized countries certianly helps with it, and they've taken the further step in not just looking at mortality but looking at specific types of mortality that could be prevented with adequate care. However, that's not going to be my comeback. The key point and the question I put to you then is...if the U.S. spends 1.5 to 3 times as much per person on Health care as any other country surveyed there, can you explain to me why the U.S. should still finish last?

Because the researchers want the US to look bad? I don't know. I cannot believe that diabetics get better care anywhere else but here. Or cancer patients. I just don't see it. The article didn't say any specific kind of death, so what do they consider 'preventable'? And I question your cost estimates as well. While others may not shell out much out of pocket DIRECTLY for medical care, they sure as hell pay enough in taxes.

[StrangeSox]

Because the researchers want the US to look bad? I don't know. I cannot believe that diabetics get better care anywhere else but here. Or cancer patients. I just don't see it. The article didn't say any specific kind of death, so what do they consider 'preventable'? And I question your cost estimates as well. While others may not shell out much out of pocket DIRECTLY for medical care, they sure as hell pay enough in taxes.

 

I'm just wondering what evidence/ data you base this on.

[CanOfCorn]

I think Universal health care is a bad name. There's got to be a way to mix the capitalism with socialism. I mean, instaed of having the poor go to the ER for a bad cold and sit and wait for 12 hours. Everyone SHOULD have healthcare, no matter if your income is zero or a gazillionaire. I am not a politician nor am I a policy maker, but there's got to be a way. Maybe all hospitals should have free clinics attached to it? I don't know.

[Balta1701]

I think Universal health care is a bad name. There's got to be a way to mix the capitalism with socialism. I mean, instaed of having the poor go to the ER for a bad cold and sit and wait for 12 hours. Everyone SHOULD have healthcare, no matter if your income is zero or a gazillionaire. I am not a politician nor am I a policy maker, but there's got to be a way. Maybe all hospitals should have free clinics attached to it? I don't know.

Germany has a system that works something like what you're asking for, for example. They have a health insurance plan that sets an entry level of coverage for everyone in the system. Beyond that, you are then able to purchase additional insurance to allow for more luxurious accommodations if you get sick or something like that.

[EvilMonkey]

I'm just wondering what evidence/ data you base this on.

There is no evidence, I said that I just can't believe it. Kinda like saying "in my opinion..." Look at SouthsideIrish's example with his diabetes.

As I have relatives around the world, some in socialized medicine countries. Their experience with dealing with diabetes and the care is not the same. They get put on a drug, and it takes a minor miracle before it gets changed if its not working. They take longer to get minor issues taken care off. For a diabetic, a minor issue one day is a major one in a few years

 

And what is Amenable mortality? It is mortality that can theoretically be averted by good health care. How many people do you know who have insurance, but smoke? Or are fat? Or drink alot? And don't listen to medical advise to stop? The choices people make effect these stats greatly. How many guys do you know over 40 who don't get prostate exams because they don't want a finger up their ass? If something is going on in there, and they put it off until it is too late and die, does that count towards the stat? All the available healthcare in the world wouldn't have saved that person, unless you force them to do it. You want to force a finger in someone's ass? I sure don't. I thnk it is fairly common knowledge that there is an obesity problem here in the states. How many people die from fat-relatyed health issues, that COULD have been prevented had they lost weight?

 

What kind of deaths go into amenable mortality? Here is a list:

Intestinal infections

 

Tuberculosis

 

Other infections (diphtheria, tetanus, poliomyelitis)

 

Whooping cough

 

Septicaemia

 

Measles

 

 

Malignant neoplasm of colon and rectum

 

Malignant neoplasm of skin

 

Malignant neoplasm of breast

 

Malignant neoplasm of cervix uteri

 

Malignant neoplasm of cervix uteri and body of uterus

 

Malignant neoplasm of testis

 

Hodgkin's disease

 

Leukaemia

 

Diseases of the thyroid

 

Diabetes mellitus

 

Epilepsy

 

Chronic rheumatic heart disease

 

Hypertensive disease

 

Cerebrovascular disease

 

All respiratory diseases (excluding pneumonia and influenza)

 

Influenza

 

Pneumonia

 

Peptic ulcer

 

Appendicitis

 

Abdominal hernia

 

Cholelithiasis and cholecystitis

 

Nephritis and nephrosis

 

Benign prostatic hyperplasia

 

Maternal death

 

Congenital cardiovascular anomalies

 

Perinatal deaths, all causes, excluding stillbirths

 

Misadventures to patients during surgical and medical care (this one sounds interesting)

 

Ischaemic heart disease*

http://www.bmj.com/cgi/content/full/327/7424/1129/TBL1

 

Did you know that in many countries a newborn isn't registered as 'born' for up to 24 hours?

In the US, if the baby makes it out, but dies at any time, it gets a birth and death certificate. While the United States reports every case of infant mortality, many other countries do not. For example, a 2006 artilce in U.S. News & World Report states, "First, it's shaky ground to compare U.S. infant mortality with reports from other countries. The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates

http://en.wikipedia.org/wiki/Infant_mortality

 

It seems like most of the things that figure into the rate are cancers or things that can be caused or aided by obesity & other related 'vices' (hypertension, peptic ulcers, Cholelithiasis ) You may have to change the behavioral patters of the nation as a whole before you can fix any of the numbers cited. Until Big Brother or socialized medice arrive, you can't force someone to go to the doctor or to listen to medical advice.

Edited January 10, 2008 by Alpha Dog

[southsideirish71]

I'm just wondering what evidence/ data you base this on.

 

Well I can simply base it on the 18 diabetics in my extended family outside the united states, and the 11 that are here in the US. The treatment plans and the medicine we get here is above and beyond what they get there.

Edited January 10, 2008 by southsideirish71

[southsider2k5]

I think Universal health care is a bad name. There's got to be a way to mix the capitalism with socialism. I mean, instaed of having the poor go to the ER for a bad cold and sit and wait for 12 hours. Everyone SHOULD have healthcare, no matter if your income is zero or a gazillionaire. I am not a politician nor am I a policy maker, but there's got to be a way. Maybe all hospitals should have free clinics attached to it? I don't know.

 

As an economist this line of thinking really bothers me. Why would people hold the belief that we are going to get more and better healthcare by taking the incentive to conserve health care out of the system? Think about it. Our system is this overburdened and out of whack with it being very expensive to partake in health care today. Say we take the costs of the system for patients, it actually gives them MORE reason to go to a doctor everytime something is wrong, not less. Unless someone comes up with a way to produce way more doctors, hospitals, nurses, clinics, etc, wait and quality of service are not going to improve if you add WAY more people and visits to the system. In fact, I would bet the system collapses if they take the patient costs out of the system. Economically the cost of health care tells you exactly the demands being put on the system, even at the higher prices. Plus it is an economic fact that if the government goes in and forces a reduction in prices, it will result in a reduction, not an increase, in services being offered in the medical sector. If you remove the profit incentive, you remove people who are willing to offer their products and services.

 

The law of unintended consequences is worth exploring in depth here.

[iamshack]

As an economist this line of thinking really bothers me. Why would people hold the belief that we are going to get more and better healthcare by taking the incentive to conserve health care out of the system? Think about it. Our system is this overburdened and out of whack with it being very expensive to partake in health care today. Say we take the costs of the system for patients, it actually gives them MORE reason to go to a doctor everytime something is wrong, not less. Unless someone comes up with a way to produce way more doctors, hospitals, nurses, clinics, etc, wait and quality of service are not going to improve if you add WAY more people and visits to the system. In fact, I would bet the system collapses if they take the patient costs out of the system. Economically the cost of health care tells you exactly the demands being put on the system, even at the higher prices. Plus it is an economic fact that if the government goes in and forces a reduction in prices, it will result in a reduction, not an increase, in services being offered in the medical sector. If you remove the profit incentive, you remove people who are willing to offer their products and services.

 

The law of unintended consequences is worth exploring in depth here.

 

What about something that is currently happening in the private sector...a lot of corporations are now starting employee health care plans whereby the corporation's insurance will allow a cash incentive or return up to a certain amount of coverage on an employee- say $1,500. Any amount the employee does not use, he receives a certain percentage back in cash. The early returns on this system are showing that employees are less likely to abuse the health care system "because they have insurance," and also have become much more frugal shoppers of health care. No longer do they just go to any physician or hospital, but they look for value, much as we do when shopping for other goods or services.

 

Perhaps a universal health care system could have a similar rebate or incentive program not to abuse the system built in. The threshold number could vary depending on age and gender, perhaps even other demographic factors, and even location. And any amount you do not use up to this threshold number could be applied to your tax return or something...

[ptatc]

I base most of what I know on Universal Healthcare on friends and relatives from other countries. They all say the same thing. Everyone wants a job where once you are high enough in the company you can get private insurance for healthcare and don't have to deal with the universal healcare system. They don't care what the job is as long as that is an option. They all hate the universal system.

[EvilMonkey]

There are always the small clinics available at some Wal-marts and Walgreens that offer services for the things like colds, sinus infections, etc that many people without insurance clog emergency rooms for. Faster, and cheaper, than using an emergency room for a bad cold.

[southsideirish71]

I will play devils advocate here for a second. If we do go to Universal Health care, and we are paying for insurance through taxes. Then should smoking and other choice vices be outlawed. Everyone knows the medical issues with certain choice vices, so why should the community as a whole have to pay for a choice that someone made on their own. In fact, lets take it further. Should you be forced to keep in some sort of shape. I mean why should the community pay for you because you decide that the hearattack menu at McDonalds and sitting on your couch is the best way to go then come in at Age 45 needing a quad bypass. How about when you are born, we do a genetic map of you to pre-determine what your diseases and tendancies will be so we can dictate a program. See where this is going.

 

 

[NorthSideSox72]

I will play devils advocate here for a second. If we do go to Universal Health care, and we are paying for insurance through taxes. Then should smoking and other choice vices be outlawed. Everyone knows the medical issues with certain choice vices, so why should the community as a whole have to pay for a choice that someone made on their own. In fact, lets take it further. Should you be forced to keep in some sort of shape. I mean why should the community pay for you because you decide that the hearattack menu at McDonalds and sitting on your couch is the best way to go then come in at Age 45 needing a quad bypass. How about when you are born, we do a genetic map of you to pre-determine what your diseases and tendancies will be so we can dictate a program. See where this is going.

Of course, the scenario you mention here, and that slippery slope, could just as easily happen in private insurance as public.

 

[Balta1701]

Of course, the scenario you mention here, and that slippery slope, could just as easily happen in private insurance as public.

In fact it is already happening, as with a partially employer based system, employers have begun firing or refusing to hire people for smoking even during hours when they aren't working. Some 20 states have banned the practice, but in others, it is a logical decision for an employer to make if it cuts their health care costs.