Results 1 to 24 of 24

Thread: Health Care - Where does the U.S. REALLY rank ?

  1. #1
    Banned Eric Stoner's Avatar
    Joined
    Oct 2006
    Location
    NYC
    Posts
    5,150
    Thanks
    1,261
    Thanked 1,430 Times in 888 Posts

    Default Health Care - Where does the U.S. REALLY rank ?

    It is commonly and casually thrown around that the U.S.has lousy health care. A favorite statistic for those who want our health care system to be more like Canada's (or CUBA's ???? ) is our infant mortality rate. Depending on which survey one uses ( the UN- WHO survey; our own CIA survey ) we rank either 42nd or 47th in our infant mortality rate. Number "1" in both surveys is MONACO ! Also ranked ahead of us are other CITIES, and very wealthy ones at that, like Hong Kong , Singapore and Macau. Two of which are supposed to be part of China. Four others ranked ahead of us are tax havens : Isle of Man , Jersey, Luxembourg and Lichtenstein. We are a diverse nation of over 300 million people. Cuba supposedly outranks us. But they are a dictatorship that lies about everything. Who would like to have their next child delivered in Havana or Santiago ?

    We are of course outranked by France, Spain, Italy,Germany, the UK, Canada, Australia and Japan. We lose a LOT of ranking by the way in which our doctors treat premature birth, the leading cause of infant mortality. Our rate of premature birth is higher than almost every country ranked ahead of us e.g. 65% higher than in the U.K. The National Center for Health Statistics calls this the "primary reason" Western Europe has better numbers. In it's infant mortality survey the WHO notes that it is "common practice" in Western Europe NOT to count a delivery as a "live birth" until the child has survived for a set period of time outside the womb. Doctors in other countries often consider premature fetuses as "medical waste" and avoid heroic life saving measures. Not in the U.S. One breath ourside the womb in the U.S. means a "live birth" and since a lot of them don't make it, that drives up our mortality numbers.

    Does anyone seriously contend that Ob-gyn's are better in countries ranked ahead of us ? That they have better delivery rooms ? Better neo-natal intensive care ?
    Better pre-natal care ? Hmmm. One would think that many of the countries ranked ahead of us have better pre-natal care , better nutrition for expectant mothers etc. Not really. Expectant mothers do not see the doctor more often on average than American mothers .The difference is that high risk pregnancies are not favored in most of those countries and abortion in such cases is often encouraged. Like it or not , medical rationing is an essential component of many health care systems whose stats are supposedly better than ours. Choices are made to avoid using resources on things like high risk pregnancies. I haven't even mentioned the effects of legal systems that do NOT favor medical malpractice suits. What recourse do injured mothers and babies have in Cuba or Macau ?

    Almost every country ranked ahead of us has a lower birth rate than we do. Quality over quantity ? To some extent, yes !

    What I have looked for and haven't found is a survey or study that allows for or corrects for some of these important differences in how various medical systems handle things like high risk pregnancies and premature births. If anyone knows of any, I'd like to see them . My guess is that our system would stack up very well.
    I'm sure we could beat out Cuba lol.

    Our overall life expectancy is rather good IF we correct for our high death rate from violence , drugs, suicide and car accidents i.e. morbidity and mortality factors completely outside the health care system.
    Last edited by Eric Stoner; 06-25-2012 at 11:25 AM.

  2. #2
    Banned Melonie's Avatar
    Joined
    Jul 2002
    Location
    way south of the border
    Posts
    25,932
    Thanks
    612
    Thanked 10,563 Times in 4,646 Posts
    Blog Entries
    3
    My Mood
    Cynical

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    an interesting blurb on the relevance of comparing Infant Mortality Rates ... from


    (snip)"Virtually every national and international agency involved in statistical assessments of health status, health care, and economic development uses the infant-mortality rate — the number of infants per 1,000 live births who die before reaching the age of one — as a fundamental indicator. America’s high infant-mortality rate has been repeatedly put forth as evidence “proving” the substandard performance of the U.S. health-care system. And now a new report focusing specifically on neonatal mortality (mortality rates in the first four weeks of life) from Mikkel Oestergaard and the World Health Organization (WHO) is being cited as an indictment of U.S. health care, with headlines proclaiming that the U.S. ranks 41st in the world on this measure.

    Yet it’s not that simple. Infant and neonatal mortality rates are complex, multifactorial end-points that oversimplify heterogeneous inputs, many of which have no relation to health care at all. Moreover, these statistics gleaned from the widely varied countries of the world are plagued by inconsistencies, problematic definitions, and gross inaccuracies, all of which disadvantage the ranking of the U.S., where accuracy is paramount. Even though Oestergaard’s WHO report lists several “challenges and limitations” in comparing neonatal mortality rates, sensationalized headlines continue to rage about the supposedly poor showing of the United States. The following are a few of the difficulties:

    Underreporting and unreliability of infant-mortality data from other countries undermine any comparisons with the United States. In a 2008 study, Joy Lawn estimated that a full three-fourths of the world’s neonatal deaths are counted only through highly unreliable five-yearly retrospective household surveys, instead of being reported at the time by hospitals and health-care professionals, as in the United States. Moreover, the most premature babies — those with the highest likelihood of dying — are the least likely to be recorded in infant and neonatal mortality statistics in other countries. Compounding that difficulty, in other countries the underreporting is greatest for deaths that occur very soon after birth. Since the earliest deaths make up 75 percent of all neonatal deaths, underreporting by other countries — often misclassifying what were really live births as fetal demise (stillbirths) — would falsely exclude most neonatal deaths. Any assumption that the practice of underreporting is confined to less-developed nations is incorrect. In fact, a number of published peer-reviewed studies show that underreporting of early neonatal deaths has varied between 10 percent and 30 percent in highly developed Western European and Asian countries.

    Gross differences in the fundamental definition of “live birth” invalidate comparisons of early neonatal death rates. The United States strictly adheres to the WHO definition of live birth (any infant “irrespective of the duration of the pregnancy, which . . . breathes or shows any other evidence of life . . . whether or not the umbilical cord has been cut or the placenta is attached”) and uses a strictly implemented linked birth and infant-death data set. On the contrary, many other nations, including highly developed countries in Western Europe, use far less strict definitions, all of which underreport the live births of more fragile infants who soon die. As a consequence, they falsely report more favorable neonatal- and infant-mortality rates.

    A 2006 report from WHO stated that “among developed countries, mortality rates may reflect differences in the definitions used for reporting births, such as cut-offs for registering live births and birth weight.” The Bulletin of WHO noted that “it has also been common practice in several countries (e.g. Belgium, France, Spain) to register as live births only those infants who survived for a specified period beyond birth”; those who did not survive were “completely ignored for registration purposes.” Since the U.S. counts as live births all babies who show “any evidence of life,” even the most premature and the smallest — the very babies who account for the majority of neonatal deaths — it necessarily has a higher neonatal-mortality rate than countries that do not."

    A separate WHO Bulletin in 2008 noted that registration of stillbirths, live births, and neonatal deaths is done differently in countries where abortion is legal compared with countries where abortion is uncommon or illegal, and these discrepancies generate substantial differences in infant-mortality rates. Jan Richardus showed that the perinatal mortality rate “can vary by 50% depending on which definition is used,” and Wilco Graafmans reported that terminology differences alone among Belgium, Denmark, Finland, France, Germany, Greece, the Netherlands, Norway, Portugal, Spain, Sweden, and the U.K. — highly developed countries with substantially different infant-mortality rates — caused rates to vary by 14 to 40 percent, and generated a false reduction in reported infant-mortality rates of up to 17 percent. These differences, coupled with the fact that the U.S. medical system is far more aggressive about resuscitating very premature infants, mean that very premature infants are even more likely to be categorized as live births in the U.S., even though they have only a small chance of surviving. Considering that, even in the U.S., roughly half of all infant mortality occurs in the first 24 hours, the single factor of omitting very early deaths in many European nations generates their falsely superior neonatal-mortality rates.

    An additional major reason for the high infant-mortality rate of the United States is its high percentage of preterm births, relative to the other developed countries. Neonatal deaths are mainly associated with prematurity and low birth weight. Therefore the fact that the percentage of preterm births in the U.S. is far higher than that in all other OECD countries — 65 percent higher than in Britain, and more than double the rate in Ireland, Finland, and Greece — further undermines the validity of neonatal-mortality comparisons. Whether this high percentage arises from more aggressive in vitro fertilization, creating multiple-gestation pregnancies, from risky behaviors among pregnant women, or from other factors unrelated to the quality of medical care, the U.S. National Center for Health Statistics has concluded that “the primary reason for the United States’ higher infant mortality rate when compared with Europe is the United States’ much higher percentage of preterm births.” (M. F. MacDorman and T. J. Matthews, 2007)"(snip)

    (snip)"The fact is that for decades, the U.S. has shown superior infant-mortality rates using official National Center for Health Statistics and European Perinatal Health Report data — in fact, the best in the world outside of Sweden and Norway, even without correcting for any of the population and risk-factor differences deleterious to the U.S. — for premature and low-birth-weight babies, the newborns who actually need medical care and who are at highest risk of dying.

    In summary, the analysis and subsequent comparison of neonatal- and infant-mortality rates have been filled with inconsistencies and pitfalls, problematic definitions, and inaccuracies. Even the use of the most fundamental term, “live births,” greatly distorts infant-mortality rates, because often the infants who die the soonest after birth are not counted as live births outside the United States. In the end, these comparisons reflect deviations in fundamental terminology, reporting accuracy, data sources, populations, and cultural-medical practices — all of which specifically disadvantage the U.S. in international rankings. And unbeknownst to organizations bent on painting a picture of inferior health care in the U.S., the peer-reviewed literature and even the WHO’s own statements agree."(snip)


    The USA ranking #3 in the world by uniform medical criteria, and ranking #41 in the world by 'official gov't statistics', MUST be due to something other than 'rounding errors' !!! One would almost think that, like official US statistics for inflation, for unemployment etc. that the official gov't statistics for Infant Mortality Rate were being deliberately 'massaged' to provide a higher than actual number to further some particular gov't agenda !!!
    Last edited by Melonie; 06-25-2012 at 01:22 PM.

  3. #3
    Banned Eric Stoner's Avatar
    Joined
    Oct 2006
    Location
    NYC
    Posts
    5,150
    Thanks
    1,261
    Thanked 1,430 Times in 888 Posts

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    Your post echoed mine in most respects but I thank you all the same for finding material that further explained and fleshed out the flawed reportage of such things as "live births " and the varying treatment that premature infants get outside the womb. In the U.S. it tends to be heroic ( and VERY expensive btw ) while in many so-called "advanced" countries nature is often permitted to take its course.

    Part of this is cultural. We tend to frown on things like "the right to a perfect child " and abortion is of course a hot button issue. Just as big a reason is the " rationing" that many advanced countries and their nationalized health care systems use. I am NOT saying that they are right and we are wrong. Nor the converse. I am saying that it is an issue that requires careful thought and policy formulation. The Christers and other extremists apparently have no problem with excessive spending for premature births in the usually vain hope that there will be some sort of "miracle". Imho, if somebody else is paying, then practicality and probability ought to trump faith and feelings. And I am generally "pro-life" !
    Last edited by Eric Stoner; 06-26-2012 at 11:09 AM.

  4. #4
    God/dess Zofia's Avatar
    Joined
    Apr 2002
    Location
    Durham, North Carolina
    Posts
    2,417
    Thanks
    2,964
    Thanked 2,370 Times in 934 Posts

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    The biggest problem with US health care is not outcomes. When you norm away differences in reporting, we look very good. When you norm away differences in poverty rates, we look very good. The problem is cost. Costs are running wild in US health care. That is what is unsustainable. Obama refused to include any cost containment in his affordable care act, what we all deride as Obama care. The fact is, Obama care does little to improve outcomes other than for insurance companies bottom lines and greatly increases our costs.

    Z

  5. The Following 2 Users Say Thank You to Zofia For This Useful Post:


  6. #5
    Banned All Good Things's Avatar
    Joined
    Sep 2004
    Posts
    2,451
    Thanks
    33
    Thanked 601 Times in 233 Posts
    My Mood
    Daring

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    Eric, you know in the aggregate, this is not an actual contest, right? I mean where a country falls in such a comparison is just an arbitrary ranking that depends on many factors and variables, including how the data are sliced.

    And that nobody ranked one actually wins a trophy or gets to go to Disneyland.

    The question to ask is not "Where does the U.S. really rank," it's "Where does the U.S. really rank at things that actually matter to people?"

    If you spend a great deal of time traveling and living abroad, you'll soon enough appreciate that people around the world value different things. Their health care choices tend to reflect that value structure.

    In the vast majority of the advanced industrialized nations, "health care" is treated as a minimally invasive, preventative care process with protection against extremes -- like being bankrupted by a terrible illness, which can and still does happen in the U.S.

    If you are largely healthy, exercise and watch what you eat, you actually may find yourself better off with the health care cultures in countries like Canada, the U.K and Japan.

    The reason you are so indignant -- or perhaps just insistently demanding -- about the U.S.'s ranking is that you've been exposed -- like everybody in the U.S. -- to the constant drumbeat of heroic life-saving, leading-edge-technology miracle hype blasting out over every media channel every day all over the U.S. How could the country that deploys all this magic, 23rd-century bioengineered genetically-mapped triply-tested, screened, examined, surgery-focused, God-damn-it-fix-it-right-now technology not have the "best" health care?

    Because the U.S. has a heroic, hail-Mary pass, go for the miracle system. In terms of actual health, it's non-preventative, bordering on non-supportive.

    But damn, if you are 450 lbs, with high blood pressure, diabetes, have lost a foot to gout, burst your gastric-bypass stitches because you couldn't stop eating 6,000 calories a day and can barely lift your head off the gurney -- no problem! Our expert physicians and hospital staff who have spent their entire lives in training will jump right on your (nightmarishly self-indulgent, selfish and self-destructive lunatic) case and fix you right up!

    This also is why the whole system is just mind-blowingly expensive. There is nothing in the system to encourage personal responsibility at all, and everything in the system to encourage people to do anything they feel like doing and waiting for others to pay the bill.

  7. #6
    Veteran Member
    Joined
    Oct 2009
    Posts
    493
    Thanks
    32
    Thanked 211 Times in 137 Posts

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    As someone who has a lot of experience with the U.S. medical/insurance system and that of 3 other countries, IMHO, the US system ranks somewhere between "incredibly stupid" and "completely unsustainable". If you are going to ask a question like the one you pose, the answer should include a consensus of the entire society. I think the US probably has by far the smallest group of people who are getting "very good" medical care of almost any industrialized nation. I also think the US pays a lot more money than most other industrialized countries and has A LOT less to show for it.

    I could be wrong, but I think the US has by far the most waste, corruption and price gouging factored into the system. I think lobbyists and unregulated greed are at the heart of this problem. I will tell you that whenever I have to spend over 6 months in the US and need to get a US policy, I absolutely DREAD it!. It's very frustrating to see relatively simple fixes that work very well in other countries that continually get blocked here in the US because of politics and/or ideology.

  8. #7
    Banned
    Joined
    Jul 2005
    Posts
    11,037
    Thanks
    1,891
    Thanked 5,124 Times in 3,086 Posts

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    Quote Originally Posted by All Good Things View Post
    Eric, you know in the aggregate, this is not an actual contest, right? I mean where a country falls in such a comparison is just an arbitrary ranking that depends on many factors and variables, including how the data are sliced.

    And that nobody ranked one actually wins a trophy or gets to go to Disneyland.

    The question to ask is not "Where does the U.S. really rank," it's "Where does the U.S. really rank at things that actually matter to people?"

    If you spend a great deal of time traveling and living abroad, you'll soon enough appreciate that people around the world value different things. Their health care choices tend to reflect that value structure.

    In the vast majority of the advanced industrialized nations, "health care" is treated as a minimally invasive, preventative care process with protection against extremes -- like being bankrupted by a terrible illness, which can and still does happen in the U.S.

    If you are largely healthy, exercise and watch what you eat, you actually may find yourself better off with the health care cultures in countries like Canada, the U.K and Japan.

    The reason you are so indignant -- or perhaps just insistently demanding -- about the U.S.'s ranking is that you've been exposed -- like everybody in the U.S. -- to the constant drumbeat of heroic life-saving, leading-edge-technology miracle hype blasting out over every media channel every day all over the U.S. How could the country that deploys all this magic, 23rd-century bioengineered genetically-mapped triply-tested, screened, examined, surgery-focused, God-damn-it-fix-it-right-now technology not have the "best" health care?

    Because the U.S. has a heroic, hail-Mary pass, go for the miracle system. In terms of actual health, it's non-preventative, bordering on non-supportive.

    But damn, if you are 450 lbs, with high blood pressure, diabetes, have lost a foot to gout, burst your gastric-bypass stitches because you couldn't stop eating 6,000 calories a day and can barely lift your head off the gurney -- no problem! Our expert physicians and hospital staff who have spent their entire lives in training will jump right on your (nightmarishly self-indulgent, selfish and self-destructive lunatic) case and fix you right up!

    This also is why the whole system is just mind-blowingly expensive. There is nothing in the system to encourage personal responsibility at all, and everything in the system to encourage people to do anything they feel like doing and waiting for others to pay the bill.
    I am a big believer in preventative care more than anything else. The problem I see is that doctors in general don't want to fix something before it happens. Most people don't realize most diseases (not all) are caused by poor habits to begin with. When I was diagnosed with arthritis many years ago I could have gone on medications like my doctor preferred. Instead I started working out more, doing yoga, eating healthier and other things and guess what? my arthritis went into remission. Many drugs are actually used to make a condition worse and make the patient dependent on them. I rarely even take aspirins for headaches and I am generally opposed to drugs unless it's proven to be a need.

    One thing also not mentioned often in this is that the reason we have high rates is because we have high rates of obesity. Many years ago it was pretty uncommon to see obese people now they are everywhere. When I was growing up it was rare for me to know an obses kids and the few I knew had gland problems. Now there are more than ever and it's because of the poor eating habits combined with not being active.

    While discussing birth rates and all of that one needs to look at all the aspects going on. For example Monaco has a low birthrate because they are very much a resort country. They also have a lot of wealthy foreign residents, including a high percentage of Americans. They are also a tiny country. Another issue with the birth rates in the USA is that least in this country many of the most educated are not having as many babies as before, and many women are delaying childbirth until after having a career. One issue though that disturbs me about the childbirth in the USA is the rising use of c-sections, many of which are unneeded. Doctors are doing this in many cases to make more money. I'm willing to bet if more women spoke out against having a c-section unless necessary we would see a drop.

  9. #8
    God/dess Smurfette's Avatar
    Joined
    May 2010
    Posts
    2,134
    Thanks
    3,336
    Thanked 5,934 Times in 1,334 Posts

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    ^^ I spent most of my 1st pregnancy in the US. One thing I noticed was that stuff like bottle-feeding and epidurals were pushed by doctors/nurses. Doctors said stuff like, "You're probably going to need an epidural when the time comes, most women do". And I got some weird reactions from telling people I wanted to breastfeed instead of using formula. As if breastfeeding isn't normal. And I noticed a lot of people down there PLAN to get c-sections for no particular reason. Just because they want to.

    But I ended up having the baby as well as my second kid in Canada and the tone was totally different. Lots of emphasis was placed on breastfeeding, natural birthing methods, staying away from drugs, etc. I was told that epidurals were only used rarely, during long and painful labors, and c-sections were absolutely 100% avoided unless the mother or baby were in immediate danger. I wasn't given any drugs at all.

    So yeah, I noticed a major difference. On a cursory glance it would seem America = pills, drugs, surgeries, formula, whereas Canada = preventative medicine, natural birth, breastfeeding, etc.

  10. #9
    Banned
    Joined
    Jul 2005
    Posts
    11,037
    Thanks
    1,891
    Thanked 5,124 Times in 3,086 Posts

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    I think that is true, though I'm not sure about breastfeeding. I've never been pregnant but my friends that have were pushed into breastfeeding even if they didn't want to for many reasons. I suppose it depends on the doctor though. I do know they've told me about getting to the hospital and being hooked up to monitors right when they got there and if labor didn't progress fast the doctor wanted to do a c-section. I have read too that it depends on when the baby is being borh whether the doctor suggests a c-section, for instance on the weekends it's more likely.

    One thing my relatives told me in England (and probably true with Canada too)is that they went to midwives and most women go to midwives unless they are very high risk (like serious diseases). Here, midwives is generally discouraged for most because of the risks but I'm willing to bet doctors create a lot of those risks.

  11. #10
    Banned Melonie's Avatar
    Joined
    Jul 2002
    Location
    way south of the border
    Posts
    25,932
    Thanks
    612
    Thanked 10,563 Times in 4,646 Posts
    Blog Entries
    3
    My Mood
    Cynical

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    ^^^ In the USA, the extra expense of pills, drugs, surgeries, formula etc. are picked up by private insurance companies ... with private Doctors and Hospitals generating more profit / income if they are able to 'sell' more expensive stuff. In Canada, those costs would have to be picked up by Canadian taxpayers. Thus the Canadian gov't 'owned' health care system has a vested financial interest in recommending less expensive options.

    As to midwives, similar gov't cost reduction incentives probably apply. One thing that DOES apply is that, in the USA, the potential for malpractice lawsuits and hugely expensive settlements tend to incentivize 'defensive' medicine decisions ... which makes for a financial situation where doctors must handle ( on paper at least ) childbirths. In the UK or Canada, the potential for successful malpractice lawsuits is MUCH lower, thus a 'less qualified' person can deal with childbirths in the absence of known high risk.

  12. #11
    Veteran Member
    Joined
    Oct 2009
    Posts
    493
    Thanks
    32
    Thanked 211 Times in 137 Posts

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    ^^^In the US the price of the pills, drugs etc. are very often marked up many times over what they cost outside the US, therefore there is much less to be "picked" up by the foreign taxpayer. In addition, because many of those foreign medical systems also have much better preventative care, there is a decent chance that there won't even be cost that needs to be picked up as the pills, drugs and surgeries won't be needed in the first place.

  13. #12
    Banned Melonie's Avatar
    Joined
    Jul 2002
    Location
    way south of the border
    Posts
    25,932
    Thanks
    612
    Thanked 10,563 Times in 4,646 Posts
    Blog Entries
    3
    My Mood
    Cynical

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    ^^^In the US the price of the pills, drugs etc. are very often marked up many times over what they cost outside the US, therefore there is much less to be "picked" up by the foreign taxpayer.
    That's true !!! In most cases 'newer' US drugs are much more expensive since US consumers must pay for the R&D costs of drug development as well as the production cost of those drugs. Other countries have the cost advantage of buying from generic drug manufacturers where no R&D costs are involved after the original drug patent has expired ... but this also often translates into 'newer' and still patented US drugs not being available through gov't run medical channels in other countries.

  14. #13
    Veteran Member
    Joined
    Oct 2009
    Posts
    493
    Thanks
    32
    Thanked 211 Times in 137 Posts

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    Quote Originally Posted by Melonie View Post
    That's true !!! In most cases 'newer' US drugs are much more expensive since US consumers must pay for the R&D costs of drug development as well as the production cost of those drugs. Other countries have the cost advantage of buying from generic drug manufacturers where no R&D costs are involved after the original drug patent has expired ... but this also often translates into 'newer' and still patented US drugs not being available through gov't run medical channels in other countries.
    What you say is often true, however there are many cases where the drugs are not new, are available in multiple countries and the price is still exponentially higher in the US. Ambien that in the US costs me $10 per pill, I can get for $1.45 in my current locale. In addition, where I live we also have access to pharmaceuticals that have been developed and manufactured in Colombia and Spain, depending on the particular pill, many times people prefer the non-US brand because of both effectiveness and limited side affects.

  15. #14
    Veteran Member
    Joined
    Jul 2011
    Posts
    455
    Thanks
    53
    Thanked 175 Times in 109 Posts

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    r&D.jpg


    Too tiny to read maybe..... But it shows marketing costs exceeding R&D costs, in some cases almost 4-1...... for many big name drug companies.
    The country has been looted.

  16. #15
    Banned Melonie's Avatar
    Joined
    Jul 2002
    Location
    way south of the border
    Posts
    25,932
    Thanks
    612
    Thanked 10,563 Times in 4,646 Posts
    Blog Entries
    3
    My Mood
    Cynical

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    But it shows marketing costs exceeding R&D costs, in some cases almost 4-1...... for many big name drug companies.
    Obviously, marketing of a new patented drug is a necessary component as well. And generic drug makers have reduced marketing costs thanks to carry-over of the original patented drug marketing done by the companiy that originally developed the drug they are also manufacturing now that the patents have expired, in addition to the fact that they don't have R&D costs to contend with. So I'm not sure of the relevance of attempting to compare the marketing cost component of new patented drug developers.

    I'll obviously concede that the USFDA adds significantly to the R&D expense of testing and receiving FDA approval for a 'new' drug ... high costs that drug developing companies in other parts of the world don't similarly have to bear if they don't plan to market their drug in the USA.

    What IS relevant is the high probability that, in the absence of an ability of drug developing companies to pass on / recover their R&D and original marketing costs, there will be far fewer 'new' drugs coming onto the market in future years. Gov't operated health care systems in the UK, Canada etc. do not allow for such passing on of costs, and essentially rely on low cost generic drugs that were actually developed 20 or more years ago.

  17. #16
    Banned Melonie's Avatar
    Joined
    Jul 2002
    Location
    way south of the border
    Posts
    25,932
    Thanks
    612
    Thanked 10,563 Times in 4,646 Posts
    Blog Entries
    3
    My Mood
    Cynical

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    But it shows marketing costs exceeding R&D costs, in some cases almost 4-1...... for many big name drug companies.
    Obviously, marketing of a new patented drug is a necessary component as well. And generic drug makers have reduced marketing costs thanks to carry-over of the original patented drug marketing done by the companiy that originally developed the drug they are also manufacturing now that the patents have expired, in addition to the fact that they don't have R&D costs to contend with. So I'm not sure of the relevance of attempting to compare the marketing cost component of new patented drug developers.

    I'll obviously concede that the USFDA adds significantly to the R&D expense of testing and receiving FDA approval for a 'new' drug ... high costs that drug developing companies in other parts of the world don't similarly have to bear if they don't plan to market their drug in the USA. Some would argue that thorough ( and expensive ) FDA testing requirements are a 'necessary expense' to protect US patients. Others would argue that the high potential litigation and settlement costs of 'new' US drugs causing nasty side effects after some period of time is another reason that drugmakers set high prices during the 'exclusive patent' period.

    What IS relevant is the high probability that, in the absence of an ability of drug developing companies to pass on / recover their R&D and original marketing costs, there will be far fewer 'new' drugs coming onto the market in future years. Gov't operated health care systems in the UK, Canada etc. do not allow for such passing on of costs, and essentially rely on low cost generic drugs that were actually developed 20 or more years ago.

  18. #17
    God/dess Zofia's Avatar
    Joined
    Apr 2002
    Location
    Durham, North Carolina
    Posts
    2,417
    Thanks
    2,964
    Thanked 2,370 Times in 934 Posts

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    Quote Originally Posted by Melonie View Post
    ^^^ In the USA, the extra expense of pills, drugs, surgeries, formula etc. are picked up by private insurance companies ...
    Must throw the red flag on that one. Formula is not covered by insurance.

    Thus the Canadian gov't 'owned' health care system has a vested financial interest in recommending less expensive options.
    Must throw the red flag again. The Canadian government does not own the health care system. Some hospitals are owned by the crown, some by local governments others are owned by private charities and some are for profits. Doctors have a multitude of choices of how to practice, from solo practices owned by the physician alone to large corporate group practices to working for the crown. What the Canadian government does own is the payment system. It is roughly similar to our Medicare system. It even has the same name.

    As to midwives, similar gov't cost reduction incentives probably apply. One thing that DOES apply is that, in the USA, the potential for malpractice lawsuits and hugely expensive settlements tend to incentivize 'defensive' medicine decisions ... which makes for a financial situation where doctors must handle ( on paper at least ) childbirths. In the UK or Canada, the potential for successful malpractice lawsuits is MUCH lower, thus a 'less qualified' person can deal with childbirths in the absence of known high risk.
    Midwives in the US pay much lower medical malpractice premiums than OB/GYNs. Mainly midwife malpractice insurance is cheap because midwives do not do surgery and do not do epidurals, the two riskiest undertakings in most births. Midwives also cost a lot less than a traditional OB/GYN. I used a midwife for my daughter's birth. Total cost was a little under $5,000 including the birthing center, pre-natal and post-natal care and the delivery. No complications and no real risk factors. One thing that impressed me greatly with my midwife was how she stayed with me from the time I came to the birthing center to when I was ready to go home. Then her visiting nurse came to see me at home and I had follow up visits at her office. I can't say enough good things about my midwife and birthing experience. We need far more midwives and far fewer OB/GYN's.

    Z

  19. #18
    Banned Eric Stoner's Avatar
    Joined
    Oct 2006
    Location
    NYC
    Posts
    5,150
    Thanks
    1,261
    Thanked 1,430 Times in 888 Posts

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    No system is perfect. The U.S. "system" is hideously expensive and there are many reasons for it : medical malpractice encouraging defensive medicine ; an overweight population ; an aging population etc. etc. Now add in the fee for service model coupled with employer provided health insurance plus Medicare and Medicaid and you have a system where almost nobody has an incentive to control costs. They just try to pass them along to someone else.

    Regardless of the causation for the current state of our system we simply can't afford to provide everything to everybody. Choices have to be made. Increasing emphasis on preventive care is fine BUT we are short on primary care doctors. And it also means that we won't be able to be so heroic for everybody.

  20. #19
    Banned Eric Stoner's Avatar
    Joined
    Oct 2006
    Location
    NYC
    Posts
    5,150
    Thanks
    1,261
    Thanked 1,430 Times in 888 Posts

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    Quote Originally Posted by Zofia View Post
    Must throw the red flag on that one. Formula is not covered by insurance.

    Must throw the red flag again. The Canadian government does not own the health care system. Some hospitals are owned by the crown, some by local governments others are owned by private charities and some are for profits. Doctors have a multitude of choices of how to practice, from solo practices owned by the physician alone to large corporate group practices to working for the crown. What the Canadian government does own is the payment system. It is roughly similar to our Medicare system. It even has the same name.

    Midwives in the US pay much lower medical malpractice premiums than OB/GYNs. Mainly midwife malpractice insurance is cheap because midwives do not do surgery and do not do epidurals, the two riskiest undertakings in most births. Midwives also cost a lot less than a traditional OB/GYN. I used a midwife for my daughter's birth. Total cost was a little under $5,000 including the birthing center, pre-natal and post-natal care and the delivery. No complications and no real risk factors. One thing that impressed me greatly with my midwife was how she stayed with me from the time I came to the birthing center to when I was ready to go home. Then her visiting nurse came to see me at home and I had follow up visits at her office. I can't say enough good things about my midwife and birthing experience. We need far more midwives and far fewer OB/GYN's.

    Z
    I know a LOT of Canadians and have been to Canada many times. For the most part, they like their health care system. The big drawbacks from their pov are the waiting times for elective surgery and the waiting time to get appointments with specialists.

    I also know that when Taiwan was designing their national health care system they looked at the U.S. system and have said that they learned what NOT to do. They had some sort of super committee that literally traveled the world to see what was working at what cost.

  21. #20
    Banned Melonie's Avatar
    Joined
    Jul 2002
    Location
    way south of the border
    Posts
    25,932
    Thanks
    612
    Thanked 10,563 Times in 4,646 Posts
    Blog Entries
    3
    My Mood
    Cynical

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    Formula is not covered by insurance.
    prescribed 'special' infant formula is indeed covered by most US insurance. Grocery Store formula obviously is not. Small point in any case.


    The Canadian government does not own the health care system. Some hospitals are owned by the crown, some by local governments others are owned by private charities and some are for profits. Doctors have a multitude of choices of how to practice, from solo practices owned by the physician alone to large corporate group practices to working for the crown. What the Canadian government does own is the payment system.
    thus my use of quotes in regard to 'owned'. Indeed the Canadian gov't does own the payment system, which essentially implements fixed priced reimbursement for medical services. Thus Canadian doctors may be free to remain in private practice, but they aren't necessarily free to generate an operating profit if they do so.


    The big drawbacks from their pov are the waiting times for elective surgery and the waiting time to get appointments with specialists.
    And herein lies the major difference. Canada 'controls' health care costs by 'rationing' the availability of specialist doctors, as well as by 'rationing' the availability of specialized diagnostic equipment such as MRI machines. And the wait times for surgeries isn't limited to just elective surgeries. This in fact has created a new market for US hospitals near the Canadian border accepting 'out of pocket' payment from wealthy Canadians for immediate treatment of cancer, cardiac etc. problems where the wait time under the Canadian system may be longer than their available lifespan if left waiting for treatment. Skeptics would say this is another aspect of Canada attempting to 'control' health care costs.

  22. #21
    Senior Member Well's Avatar
    Joined
    Jul 2012
    Location
    Toronto
    Posts
    131
    Thanks
    25
    Thanked 30 Times in 24 Posts
    My Mood
    Yeehaw

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    Quote Originally Posted by Eric Stoner View Post
    I know a LOT of Canadians and have been to Canada many times. For the most part, they like their health care system. The big drawbacks from their pov are the waiting times for elective surgery and the waiting time to get appointments with specialists.

    I also know that when Taiwan was designing their national health care system they looked at the U.S. system and have said that they learned what NOT to do. They had some sort of super committee that literally traveled the world to see what was working at what cost.

    Yes the waiting times is crazy. Canadian healthcare isn't better than USA. We pay our healthcare through taxes. Each province is responsible for their health care system. You think health care is good in Canada? People have died waiting for treatment while having a heart attack. They waited as long as 8 hours.
    What we need to do is take responsibliity for own health. If you eat properly you are less likely to have health problems. I have done my research and the process of changing my diet slowly. It's not easy but it's worth it in the end. I don't want to end up like my father who took medication which caused more problems later in life.

  23. #22
    Senior Member Well's Avatar
    Joined
    Jul 2012
    Location
    Toronto
    Posts
    131
    Thanks
    25
    Thanked 30 Times in 24 Posts
    My Mood
    Yeehaw

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    Quote Originally Posted by Eric Stoner View Post
    I know a LOT of Canadians and have been to Canada many times. For the most part, they like their health care system. The big drawbacks from their pov are the waiting times for elective surgery and the waiting time to get appointments with specialists.

    I also know that when Taiwan was designing their national health care system they looked at the U.S. system and have said that they learned what NOT to do. They had some sort of super committee that literally traveled the world to see what was working at what cost.

    Yes the waiting times is crazy. Canadian healthcare isn't better than USA. We pay our healthcare through taxes. Each province is responsible for their health care system. You think health care is good in Canada? People have died waiting for treatment while having a heart attack. They waited as long as 8 hours.
    What we need to do is take responsibliity for own health. If you eat properly you are less likely to have health problems. I have done my research and the process of changing my diet slowly. It's not easy but it's worth it in the end. I don't want to end up like my father who took medication which caused more problems later in life.

  24. #23
    God/dess cherryblossomsinspring's Avatar
    Joined
    Nov 2010
    Posts
    3,244
    Thanks
    2,454
    Thanked 4,800 Times in 1,707 Posts
    My Mood
    Angelic

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    I heard it was behind Cuba . Isn't satellite tv illegal in Cuba without special government permission? Hmmm sad reality , I'm just not sure which is worse. lol

  25. #24
    Banned
    Joined
    Jul 2005
    Posts
    11,037
    Thanks
    1,891
    Thanked 5,124 Times in 3,086 Posts

    Default Re: Health Care - Where does the U.S. REALLY rank ?

    Quote Originally Posted by Well View Post
    Yes the waiting times is crazy. Canadian healthcare isn't better than USA. We pay our healthcare through taxes. Each province is responsible for their health care system. You think health care is good in Canada? People have died waiting for treatment while having a heart attack. They waited as long as 8 hours.
    What we need to do is take responsibliity for own health. If you eat properly you are less likely to have health problems. I have done my research and the process of changing my diet slowly. It's not easy but it's worth it in the end. I don't want to end up like my father who took medication which caused more problems later in life.
    Many people don't realize that if you eat certain things, exercise and a variety of other things you can prevent many medical issues. Not to mention many drugs are used to many conditions worse so the person become dependent on them.

Similar Threads

  1. How will Health Care Reform Impact Us?
    By Paul in Saudi in forum Dollar Den
    Replies: 26
    Last Post: 03-27-2010, 05:17 AM
  2. what's the best health care practices?
    By orchidflower in forum Body Business
    Replies: 3
    Last Post: 04-29-2008, 09:19 PM
  3. Canadian Health Care-good or bad?
    By UtahMike in forum The Lounge
    Replies: 48
    Last Post: 11-21-2007, 10:15 AM
  4. How to save billions in health care costs
    By Will in forum The Lounge
    Replies: 0
    Last Post: 04-11-2006, 03:05 PM
  5. Health care
    By compugirl in forum Dollar Den
    Replies: 6
    Last Post: 03-12-2006, 05:08 PM

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •