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About that "World's Best Healthcare System" the U.S. is supposed to have...

You just knew that bkf would use this subject to go into one of his "Wake students are a bunch of elitist snobs" rant.
 
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I can assure you my head (and ass) are not influenced by blind patriotism on this issue. And agin, Im not saying we do it "better", just that our system is high quality once you are sick and insured...

I need to get you stuff to read other than the incidental economist :)

Always ready to learn. Feel free to post some links.

No one is asserting that the US system (or at least, parts thereof) is not " high quality". The assertion is that overall, the US health system delivers worse overall health and lower customer satisfaction than many peer countries, and charges far more to do so. This is so even when differences in populations are taken into account.
 
This is a good post, except that the Mayo clinic is in network :) and that travel benefits are becoming more of the norm. But I digress....

Id argue that the majority of americans have access to pretty good health care, better than many people get in many other countries. There are a lot of teachers, union workers, public sector employees, etc. who have access to incredible care at a very low cost to them. Do we use insurance responsibly? No. Is care delivered efficiently, no. Are we the healthiest? No. Do we incent providers efficiently, no. Does our tax system have the right incentives? No. Do we as consumers engage? No.

But, if you have insurance, this is the place to get sick. And its not for the elite. Its for the insured (ex. Medicaid). There are few places in the world that someone like Ted Kennedy gets care at Duke from the same provider as a person making $20,000/year. I

The shame of the system is really multifold...Our disregard for managing the care of the uninsured AND those on public assistance (Medicaid). The horribly inefficient way we pay docs (see Medicare). Insulating consumers from costs in making efficient decisions. Our chosen lifestyles.

Ive said it before and I'll say it again...Single payor would be a disaster in the IS based on the past 60 years of how we've delivered care.

I disagree. We've seen physical therapy copays for those public employees go from ~$30 to ~$70 in the last few years. That's untenable for a lot of people, even though insurance companies should be incentivizing people to come get preventative care like PT.
 
I disagree. We've seen physical therapy copays for those public employees go from ~$30 to ~$70 in the last few years. That's untenable for a lot of people, even though insurance companies should be incentivizing people to come get preventative care like PT.

Thanks obama
 
CH, I respect your knowledge on insurance matters, but I take issue with the assertion that America is a great place to get sick, insured or not. Even among insured Americans, health outcomes are not as good and satisfaction with the system much lower than in peer countries. http://theincidentaleconomist.com/w...lity-of-the-us-health-care-system-conclusion/

Americans need to get their patriotic heads out of their asses and realize that plenty of other countries do healthcare a lot better than the US of A.

Whether right or wrong, you're using two measuring sticks that aren't black-and-white measuring sticks. How do you measure health outcomes unless you are looking at comparable patients with the exact same contributing factors (a 300lb Amercian with heart disease eating McDs every day with a family history, versus a 300lb Italian eating McDs every day with that same family history). There are too many factors out of the health care providers' control and in the individual's control, that make it difficult to simply say our health outcomes are not as good. Our health care providers are starting at a disadvantage compared to peer countries based on the average American lifestyle choices.
And satisfaction is the same way. Americans today whine about everything (thanks, Millenials). Just because people bitch and moan has minimal to do with the underlying care. What are they comparing it to? The results they see on Private Practice on TV?
 
I disagree. We've seen physical therapy copays for those public employees go from ~$30 to ~$70 in the last few years. That's untenable for a lot of people, even though insurance companies should be incentivizing people to come get preventative care like PT.

Well then stop charging so much, you greedy bastard. You're just a 1%er sucking the cash from the poor to fund your $60k/year Mitt Romney education.
 
Whether right or wrong, you're using two measuring sticks that aren't black-and-white measuring sticks. How do you measure health outcomes unless you are looking at comparable patients with the exact same contributing factors (a 300lb Amercian with heart disease eating McDs every day with a family history, versus a 300lb Italian eating McDs every day with that same family history). There are too many factors out of the health care providers' control and in the individual's control, that make it difficult to simply say our health outcomes are not as good. Our health care providers are starting at a disadvantage compared to peer countries based on the average American lifestyle choices.
And satisfaction is the same way. Americans today whine about everything (thanks, Millenials). Just because people bitch and moan has minimal to do with the underlying care. What are they comparing it to? The results they see on Private Practice on TV?

So, you're going to just shrug off all the international studies that uniformly say the same thing about American health care, and have for years, because McDonald's and Millennials? OK. You know these studies adjust for things like population demographics, smoking rates, and so forth, right? Maybe not. If it makes you feel better to just ignore real data in favor of "Merica, hell yeah" go ahead. I prefer to actually know something about the world around me, and prefer to vote for politicians that I think will make decisions on that basis as well.
 
I disagree. We've seen physical therapy copays for those public employees go from ~$30 to ~$70 in the last few years. That's untenable for a lot of people, even though insurance companies should be incentivizing people to come get preventative care like PT.

There is a ton of data which shows that public sector health benefits > private. I suspect this will change given the age/health of the public sector employee base coupled with fiscal issues. The big change on the horizon is the move away from defined benefits for post 65 retirees. Private exchanges are comingto a retiree near you.

PT is a wildly abused benefit. While there is a case to say it is preventive in limited cases, the overwhelming majority of PT isn't preventive. Unlimited cheap PT can cost a lot of $ to payors (insurers and citizens).
 
So, you're going to just shrug off all the international studies that uniformly say the same thing about American health care, and have for years, because McDonald's and Millennials? OK. You know these studies adjust for things like population demographics, smoking rates, and so forth, right? Maybe not. If it makes you feel better to just ignore real data in favor of "Merica, hell yeah" go ahead. I prefer to actually know something about the world around me, and prefer to vote for politicians that I think will make decisions on that basis as well.

Uh, no, i'm shrugging off the two measuring points that: (1) you cherrypicked from an article wherein the author admits that he made up the scorecard system himself; and (2) don't even say what you said they say. So yes, I do try to actually know something before making blanket statements, but I would hope that I wouldn't make any choices based off of garbage like that article. But hey, your informed decision got us Obamacare, so you've got plenty to be proud of.
 
The thread starter kicked the shit out of that straw man!
 
Uh, no, i'm shrugging off the two measuring points that: (1) you cherrypicked from an article wherein the author admits that he made up the scorecard system himself; and (2) don't even say what you said they say. So yes, I do try to actually know something before making blanket statements, but I would hope that I wouldn't make any choices based off of garbage like that article. But hey, your informed decision got us Obamacare, so you've got plenty to be proud of.

I voted for the Libertarian candidate in 2008, not that it matters.

So now your assertion is that the authors of the study were just "making things up"? OK. Here's the actual study. I'm sure you know more about international health systems than these four authors, and the authors of the studies cited in the footnotes. Since you are so informed, I'm sure you'll be happy to provide links to your sources refuting these claims.
 
I voted for the Libertarian candidate in 2008, not that it matters.

So now your assertion is that the authors of the study were just "making things up"? OK. Here's the actual study. I'm sure you know more about international health systems than these four authors, and the authors of the studies cited in the footnotes. Since you are so informed, I'm sure you'll be happy to provide links to your sources refuting these claims.

Dude, can you read? Again, I am not questioning the underlying Commonwealth Fund study or its authors. I am questioning the the conclusion that you made from said study (which was apparently influenced by the conclusions that the Incidental Economist's author apparently derived). Hence why I bolded in your first quote you statement that "health outcomes are not as good and satisfaction with the system much lower than in peer countries". The underlying study cited doesn't say either of those. We ranked just fine on the quality of care (especially when those countries who outperformed us are generally homogenous countries dealing with a more streamlined genetic base). Additionally, in the actual study we ranked 4th out of 11 on "Patient-Centerdness", which would speak to satisfaction. That of course didn't meet with the Incidental Economist's objectives, of course, so he jumped away from the hard measurables and resorted to citing a freaking telephone survey of a grand total of less than 12,000 people worldwide to measure patient satisfaction. Sorry if I'm not drawing any conclusions from that.
Where we suck is on access to care and efficiency of care, which I don't think anyone denies.
 
The Commonwealth Fund is a private foundation that aims 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.

Not exactly the most objective source, IMO.
 
Health quality / outcomes is a really tough thing to measure within a state, country and even harder across national borders. Not only is the data hard to interpret, its even harder to agree on what is a good set of metrics that proxy quality. While I studied public health, that field looks at quality very differently than say an average consumer of health care.

While there are macro level stats that show poor outcomes that are deeply troubling in the US, there are a lot of micro stats (cancer survival rates, premie survival rates, stroke recovery, infectious disease recovery, etc) that are good indicators IMHO of quality for those with very serious conditions.

I'm just thankful that I have good coverage in an area with great hospitals (Duke and UNC).
 
Again, I invite anyone on this thread to post a link to studies refuting the conclusion that the US healthcare system is behind most of the industrialized world in the quality of the healthcare system. While it's very nice that we have a distinguished healthcare economist like 2&2 whose personal opinion trumps the studies posted, I would like to see a little more evidence.

BTW, here's the bio of the hack from the incidental economist with whom 2&2 disagrees.

Aaron E. Carroll, MD, MS is a Professor of Pediatrics and Assistant Dean for Research Mentoring at Indiana University School of Medicine. He is also the director of the Center for Health Policy and Professionalism Research. He earned a BA in chemistry from Amherst College, an MD from the University of Pennsylvania School of Medicine, and an MS in health services from the University of Washington, where he was also a Robert Wood Johnson Clinical Scholar.

By the way, 2&2, the telephone study you are so exercised about was conducted by the commonwealth fund and was a part of the report. I thought you said you read their report?
 
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The Commonwealth Fund is a private foundation that aims 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.

Not exactly the most objective source, IMO.

Please post a refuting study from a more objective source, then.
 
perhaps this one is sufficiently objective, since it is in a peer-reviewed journal? This study focuses solely on outcomes, compares five English-speaking countries, and doesn't include any of the data about satisfaction or access to care.

http://content.healthaffairs.org/content/23/3/89.long

Shows the US being decidedly middle-of-the-road in this peer group on most outcomes. Best on a few, worst on a few, middling on several.
 
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