US Health Care - First in Spending, Last in Everything Else

[Supermarioman]

I'd like to point out that even though everyone is huffing and puffing about this, the study isn't from a impartial group.
http://www.commonwealthfund.org/

The Commonwealth Fund, among the first private foundations started by a woman philanthropist—Anna M. Harkness—was established in 1918 with the broad charge to enhance the common good.


The mission of The Commonwealth Fund is to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.


The Fund carries out this mandate by supporting independent research on health care issues and making grants to improve health care practice and policy. An international program in health policy is designed to stimulate innovative policies and practices in the United States and other industrialized countries.

It's little more then a liberal activist group, and this study should hardly be considered anything more then amusing.

[Khendraja'aro]

What exactly makes this group "liberal"? What exactly makes it "activist"?

[']['ear]

Ditto. Sounds like a typical do-gooder nonprofit.

[']['ear]

hey man take it easy social anxiety disorder doesn't have to equal mild shyness. a little empathy please.

Sure, there are some people who have severe versions. They are advertising for the ones who don't, but hate stammering when talking to a cute woman. It's part of the pathologizing of normal behavioral range that has been going on here over the last 20 years. It's driven mostly by big pharma, who makes tons of money from long-term Rx of lifestyle drugs.

[EyeKhan]

What exactly makes this group "liberal"? What exactly makes it "activist"?

Come on Kenny, did you read this?

The mission of The Commonwealth Fund is to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults

That's fuckin' liberal, bull shit socialism, man.

[Supermarioman]

What exactly makes this group "liberal"? What exactly makes it "activist"?

The historic action by the House of Representatives in passing comprehensive health reform legislation will usher in a new era in American health care—one in which all Americans will be able get the care they need without incurring financial hardship, and no American will be denied health insurance coverage simply because they have a preexisting medical condition.

Health reform will provide new security for working-age Americans across the income spectrum, increasing access to needed care for millions who are currently uninsured and underinsured. It will cover an additional 32 million people by 2019, or 95 percent of legal residents, by expanding eligibility for Medicaid and by bringing sweeping change to the individual and small group health insurance markets with new premium subsidies. New regulations will prohibit insurers from excluding or charging higher premiums to individuals and small businesses on the basis of health status or preexisting medical conditions, charging excessive premiums to older adults, revoking coverage when people get sick, or setting lifetime and annual limits on what plans will pay. Young adults will be able to remain on their parents' health plans up to age 26 beginning in 2010.

From their blog:http://www.commonwealthfund.org/Cont...alth-Care.aspx

It reads like a press release from the White House.

That's fuckin' liberal, bull shit socialism, man.

I never said I disagree with their mission, In fact I share similar views.
But it most certainly is not an impartial study group like it's being portrayed in the news reports.

[Khendraja'aro]

I still don't see neither "liberalism" nor "activism".

[GGT]

What we can say is that there is no good evidence favouring one kind over another, because there have been few studies, mostly small and summat flawed ones.

Tear's doing his "my disease is more important than yours" bit. Are you doing your "the old ways are best" bit??

Nah. Like you said--not much study. But I wasn't aware that millions of paraplegics or those with neuropathy were having rampant UTIs from their catheters. (?)

GGT, I doubt that "at home" techniques of sterilization can reliably yield as good results as professional ones. Because you either need an aggressive chemical like Formaldehyde, some kind of ray generator (UV, X-Ray, Microwaves) or an Autoclave to properly sterilize stuff.

It's not like they're really using a true sterile field, though. More like clean technique. Boiling tubing, using vinegar solutions for storage (or whatever), having clean hands....some folks have to cath several times a day and in public restrooms. Sterile one-use caths can still be fucked up by dirty fingers.


Anyway, it's the ads that bother me. Millions of dollars toward marketing firms and air-time just make the things more expensive and harder to afford, so they need insurers to help pay for them. Same for pharmaceuticals.

[EyeKhan]

I never said I disagree with their mission, In fact I share similar views.
But it most certainly is not an impartial study group like it's being portrayed in the news reports.

Not impartial, they are of the school of thinking that the health care system ought to be FIRST a machine for maintaining the health of all Americans and SECOND a machine for generating profits. The American Right thinks the opposite is the proper priority. After all, if you're not making money, you're worthless (and probably socialist (and we all know that's fundamentally evil)).

I still don't see neither "liberalism" nor "activism".

It's the helping society's most vulnerable, those who can't pay their own way, that makes it Liberal. Conservatives like to help the poor with their version of "tough love" - in other words by not helping them or even punishing them for being lazy and or stupid.

[Supermarioman]

Not impartial, they are of the school of thinking that the health care system ought to be FIRST a machine for maintaining the health of all Americans and SECOND a machine for generating profits. The American Right thinks the opposite is the proper priority. After all, if you're not making money, you're worthless (and probably socialist (and we all know that's fundamentally evil)).

You're overly simplifying the issues because your "study" is a load of quack.

[EyeKhan]

You're overly simplifying the issues because your "study" is a load of quack.

#1. Well duh. (Did you really think we were having a serious conversation???)

#2. My study?

[Supermarioman]

#2. My study?

You started the thread. What else did you think I meant?

[GGT]

Has anyone offered up any other study that disproves the OP? Anyone who claims the US "has the best health care system in the Wooorrrld", even when comparing the costs to other countries that have better outcomes?

[EyeKhan]

You started the thread. What else did you think I meant?

#1. I thought you were talking about the current nonsense.

#2. It isn't MY study, I've merely offered it for discussion.

#3. You can't just say its quack, you need to lay out some kind of argument or something. All you've said is the organization's blog is in agreement with current Administration Policy. To me, that's not much of an argument that the study is not legitimate.

Has anyone offered up any other study that disproves the OP? Anyone who claims the US "has the best health care system in the Wooorrrld", even when comparing the costs to other countries that have better outcomes?

Of course not.

[Supermarioman]

Has anyone offered up any other study that disproves the OP? Anyone who claims the US "has the best health care system in the Wooorrrld", even when comparing the costs to other countries that have better outcomes?

Keep in mind that the United States does the most pharmaceutical research of any nation, which the rest of the world feeds on to lower their costs.
It's not possible for the US to lower costs to the level of other, smaller countries because it's making the drugs and treatments that keep them healthy.

[EyeKhan]

Keep in mind that the United States does the most pharmaceutical research of any nation, which the rest of the world feeds on to lower their costs.
It's not possible for the US to lower costs to the level of other, smaller countries because it's making the drugs and treatments that keep them healthy.

<checks for Loki's hand in Mario's back>

[Supermarioman]

<checks for Loki's hand in Mario's back>

Since you clearly can't do anything but make jokes, I'll take that as proof that you don't have anything to refute that.

Subtract 10% from the current amount of the GDP spent on healthcare in the U.S, since nations in Europe don't develop many medications, and the U.S spends 10 cents of every dollar of healthcare funds on drug research.
You'll find that the U.S is only ahead of France by 3 percent, which is reasonable considering the size difference.

There are problems aplenty in the U.S healthcare system, though the new bill does help address some major flaws, but it's hardly terrible in comparison to the EU's systems.
That's why I believe the study is a load of quack. Satisfied?

[EyeKhan]

Burden of proof's on you dude. And that will require links, so no, I'm not satisfied.

[Khendraja'aro]

Keep in mind that the United States does the most pharmaceutical research of any nation, which the rest of the world feeds on to lower their costs.
It's not possible for the US to lower costs to the level of other, smaller countries because it's making the drugs and treatments that keep them healthy.

Isn't the amount spent on advertising higher than the actual costs of research?

http://www.sciencedaily.com/releases...0105140107.htm

Whoops, there goes your argument.

[Supermarioman]

Burden of proof's on you dude. And that will require links, so no, I'm not satisfied.

U.S spends 15.3% of it's GDP on healthcare. http://en.wikipedia.org/wiki/List_of...ta#cite_note-1
10% of every dollar the U.S spends on healthcare is spent on Pharmaceuticals. http://en.wikipedia.org/wiki/Health_..._note-PHRMA-34
10% of 15.3% is 1.3%. Subtract 1.3% percent for a figure that ignores drug research, which France does little to none of.
Corrected for drug research, the U.S spends 14% of it's GDP on healthcare, compared to France spending 11% of it's GDP.

It's just math.

EDIT:

Isn't the amount spent on advertising higher than the actual costs of research?

http://www.sciencedaily.com/releases...0105140107.htm

Whoops, there goes your argument.

The U.S still develops more of the best selling drugs worldwide then any other country.
http://en.wikipedia.org/wiki/Medicat...easonable_23-6

Whoops, there goes your argument.

[Khendraja'aro]

[...]It's not possible for the US to lower costs to the level of other, smaller countries because it's making the drugs and treatments that keep them healthy.

The U.S still develops more of the best selling drugs worldwide then any other country.
http://en.wikipedia.org/wiki/Medicat...easonable_23-6

Whoops, there goes your argument.

M'dear, trying to change your argument afterwards is a pretty laughable move. You argued that you can't reduce costs. Well, how about reducing advertisement?

Besides, you're getting your cause and effect mixed up. Shoddy work from your side. Companies are going where they can make the most profit - not the other way around, my dear. To say that the high prizes of the US save the rest of the world is a pretty moronic idea.

It's simply that US citizens are morons for letting themselves bled dry so that they can continue to live. Furthermore, the idea of "free market" does not work with health care since you cannot affix a price to your health.

I can do a cost/benefit analysis of owning a car vs. car sharing vs. public transport vs. bike and choose the option which suits me best and is affordable. Additonally, it's not a big catastrophe if I cannot afford a car.
If I can't afford the cancer treatment with the best chance of success, then that is a catastrophe. The market is skewed heavily towards the providers in that regard. I cannot pick and choose which approach fits me best and is affordable.

[GGT]

Mario, it's not just math. The monies in / monies out might be math, but quality care and outcomes include subjective things. (Satisfaction with staff, ease of maneuvering the system, preventing complications or adverse reactions. Even pain relief has a subjective component.)

We spend a ton. Some is on durable medical, pharma, R & D, marketing, advertising, lobbyists, administration red tape, insurance bureaucracies....that doesn't mean direct care, let alone excellent care. Much of the expensive research never comes to market as a patient product, and good care doesn't have to revolve solely around meds, new meds or more meds.

We also end up with physicians in deep debt, which affects their business model and fee-for-service, unless they join a huge network with a sign-on bonus to pay their med school debts, and covers their malpractice insurance. It all adds up, and fast.

[EyeKhan]

U.S spends 15.3% of it's GDP on healthcare. http://en.wikipedia.org/wiki/List_of...ta#cite_note-1
10% of every dollar the U.S spends on healthcare is spent on Pharmaceuticals. http://en.wikipedia.org/wiki/Health_..._note-PHRMA-34
10% of 15.3% is 1.3%. Subtract 1.3% percent for a figure that ignores drug research, which France does little to none of.
Corrected for drug research, the U.S spends 14% of it's GDP on healthcare, compared to France spending 11% of it's GDP.

It's just math.

Mario, you gotta start over. You quote % of GDP but the OP is talking spending per capita. (You know, apples/oranges) Considering the US and France have VASTLY different GDPs and VASTLY different populations, it is fair to say your numbers at best are meaningless and at worst are misleading. Since it's just math, I would assume you know this, so are you trying to mislead here or what?

[Aimless]

It's not possible for the US to lower costs to the level of other, smaller countries because it's making the drugs and treatments that keep them healthy.

Once again, this isn't entirely true. Please stop propagating this myth ffs. Please keep in mind that a third of your healthcare expenditure was waste, not long ago. Please keep in mind that most of your drug-companies tend to spend far more on marketing than on research. Please keep in mind that that research isn't always particularly good (because, let's face it, the people conducting it are pretty biased) so that the drugs can end up being pretty useless anyway (after they've been sold all over the US of course ). Please keep in mind that much--if not most?--of that research is also on substances that are minor variations of already existing drugs.

And how have you managed to miss the examples of companies marking up the prices of their drugs by several hundred percent simply because they decided one day that they can get away with it??

I'm not trying to say that the US doesn't drive pharmaceutical research in our modern world, I'm saying that the excuses you're making don't hold up. The US wastes a lot of money on healthcare. The encouraging thing is that there is lots of room for improvement

[GGT]

@ minx

Speaking of waste---in just a couple of hours of watching teevee last night I saw commercials for Cialis, Viagra, Lipitor, some new fish oil derivative Rx, Zegrid (sp? prescription stomach acid blocker), Lyrica, Abilify, and the Scooter Store. In between ads for fast food, pizza, Red Lobster, designer vodka, beer, vacations to Sandals and Atlantis (Bahamas), Aflac and Blue Cross health insurance.

[Aimless]

I think the greatest obstacle in understanding what's been going on with your healthcare industry is the assumption that it's efficient. Not an argument for socialised healthcare, or an argument against competition in healthcare, just a reminder that our assumptions can get in the way.

[GGT]

I think the greatest obstacle in understanding what's been going on with your healthcare industry is the assumption that it's efficient. Not an argument for socialised healthcare, or an argument against competition in healthcare, just a reminder that our assumptions can get in the way.

Yes, because the mantra says Freee Market Capitalism is always more efficient. And we have millions of people who believe, believe that health is just another for-profit commodity, not a social service good. Some even believe the same for education.

The only way to make people value something is to make them pay for it they say. Well, that only works to a point. Not sure anyone else wants to talk about what paying really means, when it doesn't mean just money.

[EyeKhan]

I think the greatest obstacle in understanding what's been going on with your healthcare industry is the assumption that it's efficient. Not an argument for socialised healthcare, or an argument against competition in healthcare, just a reminder that our assumptions can get in the way.

Does anyone on this forum claim the US health care system is efficient??? Seriously???

[GGT]

Does anyone on this forum claim the US health care system is efficient??? Seriously???

I recall some right-of-center folks that did. Mostly Loki, Dread, and Lewk. Should we count Cain even though he's absent now? Cain used to rail about the US being the last bastion for freeeedom, and he even emigrated from Canada and joined the US military to confirm that. He routinely bashed the Canadian health system and said his parents got better care here than there (but he had to help them pay for it).

Cracky, Veldan and aggamemnus seem to be free market guys for all things, even health care. They probably have a subsidy from their parents, state, or employers. *And who the hell knows where Fuzzy lands. Lately he just comes around to analyze posts but never gives his own opinion*

[EyeKhan]

I recall some right-of-center folks that did. Mostly Loki, Dread, and Lewk. Should we count Cain even though he's absent now? Cain used to rail about the US being the last bastion for freeeedom, and he even emigrated from Canada and joined the US military to confirm that. He routinely bashed the Canadian health system and said his parents got better care here than there (but he had to help them pay for it).

Cracky, Veldan and aggamemnus seem to be free market guys for all things, even health care. They probably have a subsidy from their parents, state, or employers. *And who the hell knows where Fuzzy lands. Lately he just comes around to analyze posts but never gives his own opinion*

Even numbers from Conservative entities state plainly the US Health Care system as a whole is grossly inefficient. That's where everyone starts, then Conservatives go on and say this is caused by frivolous law suits and want 'tort reform' so no doctor or hospital or pharma company need ever again worry about paying significant court damages for their own negligence. But the duplication of effort between all the variety of insurance companies, the extreme variety of billing methods all these companies have, the variety of reimbersement requirements the various state Medicaid and Medicare agencies have, creates a paperwork nightmare for office managers of every stripe. Then the fee for service method of paying doctors actively encourages them to schedule every conceivable test for whatever ailment anyone walks in the door with - then they turn around and cry that all this extra testing, that they get paid for by individual procedure, is because they're afraid of being sued. Anyone who really thinks the US system is anything but inefficient is completely clueless.