Broken US Healthcare System

[bave]

If the cost of healthcare keeps rising, what makes you think everyone will gravitate towards it?
The current national health care system is nearly worthless. The massive profits by funds and doctors is staggering. Have a glance at current health care rates for an average family. Most cannot afford it.


I don't know when but someday there will be a total care and it will be funded by the government and levies etc. For health funds to maintain higher charges from doctors and private hospitals, it must increase charges or continue to decline claims because they can. They won't sacrifice one dollar for one life. Never.

Ultimately a market is determined by the amount of demand, we both agree. If individuals cannot pay for a service and the government is refusing to pay for it, then the service must change or limit. This is what I feel will most likely happen. You will see a "lower end" healthcare service develop with less intervention and older therapies at a lower cost. It will be better for people with less severe issues but far worse for people with more severe issues. You will see a reluctance continue to develop at the government level to continue to pay for CABGs and cranial surgery for elderly patients. Similarly you will see limited care for newborns. Eventually healthcare becomes a function of economics really. You don't invest $1MM of public money into repairing an 80 year old or an 8 week old. There is limited economic benefit in either situation. The problem I have is that people on the left think we have unlimited resources when in reality we have to decide how to best use the limited resources we have. The primary reason why healthcare is so expensive, imo, is that we have all the development cost being born by a small percentage of the global end user base combined with a relatively few number of "lost causes" consuming vast amounts of healthcare dollars for minimal results.

The idea that doctors are massively profiting is grossly ignorant. Let me give you my background a moment. I am a mid 40's retired american. My wife retired as a physician (sub specialty surgeon) shortly after we married ~10 years ago. I worked in finance (private equity) with a specialty in healthcare and retired a few years ago. So this is solidly my wheelhouse. If someone asks me about their kid going to medical school here is my response, "don't". It is a terrible deal frankly. Spend 12 years of your life along with $400,000 for an education that will eventually entitle you to make $300k/yr in exchange for 60-80 hour work weeks and extremely high stress. That is a horrific return on investment and career path. Someone smart enough to be a physician can do many other things and make similar amounts of money with less stress, less hours, less education, less educational cost, and ignoring the opportunity cost of the time. In the US at least the average physician is making ~$240-260k or thereabouts when you weight it out by specialty. Want the best example? The match program for neurosurgery and CT surgery are failing year after year. That means residency programs can't *find* enough medical students who want to become heart and brain surgeons. Why? It is a grueling, thankless, shitty job. Sure they make $500-700k a year, but you are absolutely shortening your life from work load and stress. Kids learned to avoid that. Instead the highest demand residency slots? Dermatology.

Hell, just look at reimbursement. If you look at physician reimbursement for the same procedure 20 years ago and compared it to today, you realize that they are largely flat, right? I am talking nominally flat. That means adjusted for inflation they are down ~35-40%. Want to know why physicians are usually assholes to patients? There it is. They are getting paid less each year for more work and more liability.

The idea that the government will be *able* to provide cadillac healthcare to everyone is simply comical, it isn't in the cards. I did my thesis on healthcare economics and universal care systems around the world.

Edit: Not trying to be a jerk to you, I get frustrated when I see people mention how easy the solution is when in reality I think healthcare economics is probably the most difficult economic scenario in the world right now and specifically the US. The solutions aren't easy and fixing one problem creates two others regardless of your ideological point of view. The fundamental problem is that the healthcare system of the last 40 years has demanded more and more from the people in the system while shoveling more money into development of therapies, but the underlying failure of the system is the patients themselves. You can't provide enough resources to keep a population healthy that is largely intent on killing themselves with poor choices.

 

[Colin Norris]

Ultimately a market is determined by the amount of demand, we both agree. If individuals cannot pay for a service and the government is refusing to pay for it, then the service must change or limit. This is what I feel will most likely happen. You will see a "lower end" healthcare service develop with less intervention and older therapies at a lower cost. It will be better for people with less severe issues but far worse for people with more severe issues. You will see a reluctance continue to develop at the government level to continue to pay for CABGs and cranial surgery for elderly patients. Similarly you will see limited care for newborns. Eventually healthcare becomes a function of economics really. You don't invest $1MM of public money into repairing an 80 year old or an 8 week old. There is limited economic benefit in either situation. The problem I have is that people on the left think we have unlimited resources when in reality we have to decide how to best use the limited resources we have. The primary reason why healthcare is so expensive, imo, is that we have all the development cost being born by a small percentage of the global end user base combined with a relatively few number of "lost causes" consuming vast amounts of healthcare dollars for minimal results.

The idea that doctors are massively profiting is grossly ignorant. Let me give you my background a moment. I am a mid 40's retired american. My wife retired as a physician (sub specialty surgeon) shortly after we married ~10 years ago. I worked in finance (private equity) with a specialty in healthcare and retired a few years ago. So this is solidly my wheelhouse. If someone asks me about their kid going to medical school here is my response, "don't". It is a terrible deal frankly. Spend 12 years of your life along with $400,000 for an education that will eventually entitle you to make $300k/yr in exchange for 60-80 hour work weeks and extremely high stress. That is a horrific return on investment and career path. Someone smart enough to be a physician can do many other things and make similar amounts of money with less stress, less hours, less education, less educational cost, and ignoring the opportunity cost of the time. In the US at least the average physician is making ~$240-260k or thereabouts when you weight it out by specialty. Want the best example? The match program for neurosurgery and CT surgery are failing year after year. That means residency programs can't *find* enough medical students who want to become heart and brain surgeons. Why? It is a grueling, thankless, shitty job. Sure they make $500-700k a year, but you are absolutely shortening your life from work load and stress. Kids learned to avoid that. Instead the highest demand residency slots? Dermatology.

Hell, just look at reimbursement. If you look at physician reimbursement for the same procedure 20 years ago and compared it to today, you realize that they are largely flat, right? I am talking nominally flat. That means adjusted for inflation they are down ~35-40%. Want to know why physicians are usually assholes to patients? There it is. They are getting paid less each year for more work and more liability.

The idea that the government will be *able* to provide cadillac healthcare to everyone is simply comical, it isn't in the cards. I did my thesis on healthcare economics and universal care systems around the world.

Edit: Not trying to be a jerk to you, I get frustrated when I see people mention how easy the solution is when in reality I think healthcare economics is probably the most difficult economic scenario in the world right now and specifically the US. The solutions aren't easy and fixing one problem creates two others regardless of your ideological point of view. The fundamental problem is that the healthcare system of the last 40 years has demanded more and more from the people in the system while shoveling more money into development of therapies, but the underlying failure of the system is the patients themselves. You can't provide enough resources to keep a population healthy that is largely intent on killing themselves with poor choices.

You went to a lot of trouble to say nothing.
Those scenarios are well worn and nothing has changed. Big health and doctors make sqiillions from the suckers who pay it because they know they will not tolerate any type of care they think is socialist.
But the same people don't mind hospitals, universities, road, police, courts,nurses, ambulances, trains etc, all funded by their taxes etc.

If the people haven't enough brains to see who's screwing them, let them suffer.

As for you knowing all the answers, don't make me vomit.

 

[bave]

You went to a lot of trouble to say nothing.
Those scenarios are well worn and nothing has changed. Big health and doctors make sqiillions from the suckers who pay it because they know they will not tolerate any type of care they think is socialist.
But the same people don't mind hospitals, universities, road, police, courts,nurses, ambulances, trains etc, all funded by their taxes etc.

If the people haven't enough brains to see who's screwing them, let them suffer.

As for you knowing all the answers, don't make me vomit.

Ok, if you want to be infantile about it, go ahead. The reality is you don't know a damned thing about the situation. That much is evident about some of your previous gross misstatements and calling me a liar for things that are rather basic and widely known.

If you would like to discuss specific points, policies, or an aspect of the healthcare economy/business then do so. However your nebulous complaints and insults with no specific grievance (let alone facts) is precisely what I have come to expect from people holding your views.

 

[Colin Norris]

Ok, if you want to be infantile about it, go ahead. The reality is you don't know a damned thing about the situation. That much is evident about some of your previous gross misstatements and calling me a liar for things that are rather basic and widely known.

If you would like to discuss specific points, policies, or an aspect of the healthcare economy/business then do so. However your nebulous complaints and insults with no specific grievance (let alone facts) is precisely what I have come to expect from people holding your views.

If I want to discuss anything it will not be with people like you. You project yourself as an intellectual mountain.
You're not.

 

[bave]

If I want to discuss anything it will not be with people like you. You project yourself as an intellectual mountain.
You're not.

If you want to debate a complicated topic, I would suggest you learn a few of the basics first before you call people far more knowledgeable on the topic liars. You made yourself a fool, now play the role.

 

[Colin Norris]

If you want to debate a complicated topic, I would suggest you learn a few of the basics first before you call people far more knowledgeable on the topic liars. You made yourself a fool, now play the role.

Don't let your arrogance overflow where it influences your self assessment.
I know more about government health care than your average punter here.
Basically your putting colourful clothing on the rip off private health schemes to hide their disgusting treatment of people.
And then there's that old chestnut it is creeping socialism which always scares the punters and we all know what ignorant people understand about that.

 

[bave]

Don't let your arrogance overflow where it influences your self assessment.
I know more about government health care than your average punter here.
Basically your putting colourful clothing on the rip off private health schemes to hide their disgusting treatment of people.
And then there's that old chestnut it is creeping socialism which always scares the punters and we all know what ignorant people understand about that.

Do you have anything specific to discuss or are you going to continue to play the role of the clown?

 

[RealityChecker]

Don't let your arrogance overflow where it influences your self assessment.
I know more about government health care than your average punter here.
Basically your putting colourful clothing on the rip off private health schemes to hide their disgusting treatment of people.
And then there's that old chestnut it is creeping socialism which always scares the punters and we all know what ignorant people understand about that.

Actually bave is largely correct about healthcare. Of course, calling it healthcare is more euphemism than descriptive. It is really medical diagnosis and treatment. Some like antibiotics for infectious diseases and vaccines can be very cost effective and cure diseases that once markedly reduced life expectancy. But microbes evolve and become resistant to effective vaccines and antibiotics so we need research to develop new and better ones. This is generally a good investment.

Most, probably about 3/4 of medical expenditures in the USA go to medically diagnose and then medically treat (mostly with drugs and surgeries) diseases largely caused by poor diet and lifestyle choices. A study found that men in their 60s with a BMI of 30 or more had 6X more cases of advanced osteoarthritic knees than men the same age with a BMI <25. Most of the bad knees in the normal weight men were the result of injuries they got playing sports like football in high school or college. Knee replacement surgery certainly is effective at improving the quality of life for people who have bad knees, but this is very expensive. These same operations cost maybe 1/5 as much in India and other countries as the US and in most cases the outcomes are the same. So clearly there is a lot of profiteering by the medical establishment.

Then we have percutaneous interventions (PCIs) for narrowed coronary arteries (CAD). In nearly all cases those arteries are clogged with atherosclerotic plaques caused largely by the standard American diet (SAD) and other lifestyle choices. These PCIs in patient with stable CAD have been proven to do very little or no good. But Medicare and private insurers still pay for them. Now if one has a heart attack PCI can make a big difference but who should pay? So the same procedure can be expensive and largely useless or it can save a person's life, sometimes adding many quality of life years. In both cases the patient largely caused their CAD. Now if you are a cautious driver and own your car outright you are not required to buy collision insurance and it is a bad deal because you are forced to cover those who drive recklessly. Auto-insurance premiums at least partially reflect risk based on tickets and accidents the driver has had. Age and miles driven are also factored in as risk factors. But with medical insurance people who have risky lifestyles mostly pay the same as their peers who are risk averse. This destroys the economic incentive to adopt a healthy lifestyle.

So there are many ways we could cut medical expenditures and still live longer and healthier lives but it would require people to adopt a very different diet and lifestyle than is currently the norm in the USA. Just stop paying for medical tests and procedures that do little or no good could cut medical costs even if people did not adopt healthier lifestyles. Food For Thought (FFT)

 

[soylentgreen]

First off, your comparison with insulin is ignorant. Not all insulin is the same. You can buy insulin at Walmart for ~$20 a bottle as well. The problem is in the US most people people insulins such as Humalog which is far more effective and controllable, but also more expensive.

Second off, the US makes up about ~23% of global pharma sales by revenue yet nearly 90% of the global profit of those corporations. If the US had "average" EU reimbursement for medications pharma companies would stop developing new treatments overnight. Like I said, most major pharma companies run 7-10% profit margins. Take away the US profit levels and suddenly that collapses to 0-3%, no one runs a business for 0-3% returns, no one.

Third, quoting Vox is a great way to look like a partisan dope in any argument. It is roughly equivalent to quoting The Koch Foundation.



Medicaid covers 100% of all medically necessary care and is 100% free to the patient. Anything else or just keep throwing haymakers from New Zealand?

No that is just nonsense. if It were true or even if insurance did a good job it is still a fact that americas ranks low in health services.

1. A lack of insurance coverage. A common talking point on the right is that health care and health insurance are not equivalent—that getting more people insured will not necessarily improve health outcomes. But according to Blumenthal: “The literature on insurance demonstrates that having insurance lowers mortality. It is equivalent to a public-health intervention.” More than 27 million people in the United States were uninsured in 2016—nearly a tenth of the population—often because they can’t afford coverage, live in a state that didn’t expand Medicaid, or are undocumented. Those aren’t problems that people in places like the United Kingdom have to worry about.

At best your insurance scheme is a poor equivalent.

 

[bave]

No that is just nonsense. if It were true or even if insurance did a good job it is still a fact that americas ranks low in health services.

At best your insurance scheme is a poor equivalent.

You can buy generic insulin vials in the US pretty easily for between $35-40, the same vial in Canada is going to run $28-34/vial. Not a material price difference. The issue is when you get to newer and more effective insulin (like modern humalog variants) that the price goes up dramatically. These are often not even offered/covered under many national formularies.

Are you seriously trying to lump illegal aliens into the universal care argument? No, I'm sorry an illegal interloper has no claim to social services *of any kind* of the country they are illegally in. That's like claiming someone who breaks into your home is entitled to room and board once they are in there.

 

[EMNofSeattle]

I watched the video and didn't see anything new. For starters, he blames obesity and related ailments on what someone eats and claims, remarkably, that to fix that we just need to eat better - go on diets, effectively. The problem is diets almost always fail. Every bit of data shows this - no matter the diet, after a year or two all the gains are reversed for the VAST majority of those trying them. And it cannot be because everyone going on a diet is a weakling, with no willpower, who we can blame because diets the data show almost never work don't work for them. If something fails maybe 90% of those who try it, maybe that something is the problem, not the person. We even know why - diets reduce base metabolism, so when you cut calories, your metabolism slows and you get on a cycle of having to cut ever more calories to lose weight, and as you do that, metabolism slows some more, requiring fewer calories, etc. So the person is hungry all the time. No wonder they fail. So suggesting cooking classes, as he did, as an answer to the problems of obesity and Type 2 diabetes is just nonsense. Yes, they might help a bit for a small number of people, but WHAT someone is eating appears to be at best only part of the problem.

Further, even if you could get individual A to change his diet, and lose weight, and exercise every day, and keep the weight off for years, for that to work at the level of the population would require a lot of food companies in the U.S. to go to zero, as we all ditch everything in about half the aisles of the grocery store, freezer section and restaurants to only eat veggies, lean protein and lots of olive oil. Well, those companies spend $billions each year to convince us NOT to do that but consume ever more of their offerings, in part subsidized by government that promotes corn and wheat and sugar, makes them cheaper to us, and also cheaper to those buying food for themselves and their families. When we went 'healthy' on our diet a few years ago, our grocery bill about doubled. Fresh veggies and berries and other healthy fruits aren't cheap, neither is lean protein. And not everyone can take the 2 hours per night it takes roughly to cook, eat, then clean up afterwards.

The best answer I've seen to obesity is some form of fasting - intermittent fasting effectively. When you don't eat anything, you don't spike blood sugar, and insulin doesn't spike and you don't have barriers to using your fat as fuel. But the point is that approach takes as a given that 'diets' fail, and promoting diets such as Atkins or low carb, etc. that just do not work are guaranteed to fail the vast majority of patients, and so offers a different and simple alternative. Whether that works long term is an open question, but what is simplistic and essentially worthless advice is to just say - eat better, and exercise. That's where the video is - promoting simplistic notions as solutions.

Lol diets fail because Americans are used to being guttonous and not suffering. In any event you can whine and cry all you want about it, but obesity is the largest expense of our Heath care and its causes by unhealthy choices

 

[Colin Norris]

Actually bave is largely correct about healthcare. Of course, calling it healthcare is more euphemism than descriptive. It is really medical diagnosis and treatment. Some like antibiotics for infectious diseases and vaccines can be very cost effective and cure diseases that once markedly reduced life expectancy. But microbes evolve and become resistant to effective vaccines and antibiotics so we need research to develop new and better ones. This is generally a good investment.

Most, probably about 3/4 of medical expenditures in the USA go to medically diagnose and then medically treat (mostly with drugs and surgeries) diseases largely caused by poor diet and lifestyle choices. A study found that men in their 60s with a BMI of 30 or more had 6X more cases of advanced osteoarthritic knees than men the same age with a BMI <25. Most of the bad knees in the normal weight men were the result of injuries they got playing sports like football in high school or college. Knee replacement surgery certainly is effective at improving the quality of life for people who have bad knees, but this is very expensive. These same operations cost maybe 1/5 as much in India and other countries as the US and in most cases the outcomes are the same. So clearly there is a lot of profiteering by the medical establishment.

Then we have percutaneous interventions (PCIs) for narrowed coronary arteries (CAD). In nearly all cases those arteries are clogged with atherosclerotic plaques caused largely by the standard American diet (SAD) and other lifestyle choices. These PCIs in patient with stable CAD have been proven to do very little or no good. But Medicare and private insurers still pay for them. Now if one has a heart attack PCI can make a big difference but who should pay? So the same procedure can be expensive and largely useless or it can save a person's life, sometimes adding many quality of life years. In both cases the patient largely caused their CAD. Now if you are a cautious driver and own your car outright you are not required to buy collision insurance and it is a bad deal because you are forced to cover those who drive recklessly. Auto-insurance premiums at least partially reflect risk based on tickets and accidents the driver has had. Age and miles driven are also factored in as risk factors. But with medical insurance people who have risky lifestyles mostly pay the same as their peers who are risk averse. This destroys the economic incentive to adopt a healthy lifestyle.

So there are many ways we could cut medical expenditures and still live longer and healthier lives but it would require people to adopt a very different diet and lifestyle than is currently the norm in the USA. Just stop paying for medical tests and procedures that do little or no good could cut medical costs even if people did not adopt healthier lifestyles. Food For Thought (FFT)

Actually he is not. Until the country has experienced national health, he will never understand or appreciate it. You can bellow about it being socialism all you like and big health love you for it.
Make no mistake, that has been the main weapon used for over 40 years and you're still clinging to it. No other reason. None.

 

[bave]

Actually he is not. Until the country has experienced national health, he will never understand or appreciate it. You can bellow about it being socialism all you like and big health love you for it.
Make no mistake, that has been the main weapon used for over 40 years and you're still clinging to it. No other reason. None.

For the third time, do you have any specific criticisms which you can support with data? So far the few times you have been specific I have pointed out you were factually incorrect and you have since retreated into ambiguous statements without even attempting to make and stand on a point.

Do you even have any credentials in healthcare economics? My background, education, and professional experience has given me quite a breadth and depth in global healthcare delivery systems and economics, you?

 

[aociswundumho]

It is the same in other countries where socialist welfare is happening. It needs to be a mix of private and social medicine.

The mix is needed in order to create the two-tier system that people like you desire.

As more people can afford private they should use private and leave the universal to those who need it.

As I said, you want a two-tier system. Note that we see the same thing in education: the wealthy send their kids to private schools, while the poor are stuck in failing public schools.

 

[aociswundumho]

Why is healthcare so expensive in America?

Well the number one reason is greed and our capitalistic healthcare system. Not a better outcome for sure.

Take drugs we pay an average of 256% of the average cost of drugs around the world.

Jane is a Type I diabetic, which means she requires insulin to keep living. The problem is a 10 mL bottle of insulin in the U.S. has a list price of about $450. Jane estimates it would cost her $3,000 a month to stay alive without insurance.

“So here is this medicine — it is life-saving, keeps me alive — and here we have a few companies who are preying upon people who don’t have a choice but to take this medication or we die,” she said. “So, how do we get it? How do we afford it? Where do we get it? Where are we being forced to go? The U.S. is the only country that gouges [patients]. It’s insane.”

Jane buys her insulin illegally from Canada, where a comparable bottle of insulin costs about $21.

Yes, because the rotten corrupt government that you worship, and that you expect to "fix" the healthcare system, prohibits importation of insulin for resale.

 

[JasperL]

Lol diets fail because Americans are used to being guttonous and not suffering. In any event you can whine and cry all you want about it, but obesity is the largest expense of our Heath care and its causes by unhealthy choices

So, in 1950 virtually no one in America was "guttonous" and suffered and made 'healthy' choices, but for some reason between 1950 and 2021 about one third to 2/5 of the population became "guttonous?" and no longer suffers and makes "unhealthy" choices? That's your explanation of the obesity crisis?

It's amazing how people can be so confidently ignorant.

 

[EMNofSeattle]

So, in 1950 virtually no one in America was "guttonous" and suffered and made 'healthy' choices, but for some reason between 1950 and 2021 about one third to 2/5 of the population became "guttonous?" and no longer suffers and makes "unhealthy" choices? That's your explanation of the obesity crisis?

It's amazing how people can be so confidently ignorant.

It is true objectively that we are more gluttonous. Look at portion sizes in 1950 versus today. Soda sold in 8 ounce bottles was considered a share size

 

[JasperL]

It is true objectively that we are more gluttonous. Look at portion sizes in 1950 versus today. Soda sold in 8 ounce bottles was considered a share size

Well there you go. SCIENCE!!!

So obesity is all Coca Cola’s fault. Someone should sue and when we ban sugary sodas the obesity problem will be over!!

 

[upsideguy]

The prob w/ socialism is that eventually u run out of other people's money. Healthcare will always be limited, either by cost or by long lines --so long that u could die while waiting. Let's not play games like wondering what "charity work" means. We can work together or u can play by yourself, but I'll warn u, if u play it by yourself too much u can go blind.

Nice quip, except that the American privatized system is the costliest and among the least effective in the world. When it comes to "socialism" the one thing that is clear is that it works better in delivering healthcare than the free enterprise approach. The American private sector has failed miserably at delivering effective health care and should be relieved of duty.

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[soylentgreen]

You can buy generic insulin vials in the US pretty easily for between $35-40, the same vial in Canada is going to run $28-34/vial. Not a material price difference. The issue is when you get to newer and more effective insulin (like modern humalog variants) that the price goes up dramatically. These are often not even offered/covered under many national formularies.

Are you seriously trying to lump illegal aliens into the universal care argument? No, I'm sorry an illegal interloper has no claim to social services *of any kind* of the country they are illegally in. That's like claiming someone who breaks into your home is entitled to room and board once they are in there.

No this has nothing to do with illegals. It is about your own poor who are left to die.

 

[soylentgreen]

The mix is needed in order to create the two-tier system that people like you desire.



As I said, you want a two-tier system. Note that we see the same thing in education: the wealthy send their kids to private schools, while the poor are stuck in failing public schools.

yes that is because your government does not support public schools but instead lets them run down, be over crowded and with teachers who are paid poorly.

There is nothing wrong with a two tier system.

 

[Colin Norris]

For the third time, do you have any specific criticisms which you can support with data? So far the few times you have been specific I have pointed out you were factually incorrect and you have since retreated into ambiguous statements without even attempting to make and stand on a point.

Do you even have any credentials in healthcare economics? My background, education, and professional experience has given me quite a breadth and depth in global healthcare delivery systems and economics, you?

Your background, education and professional experience certainly has done you any service. I don't care if you are an intellectual mountain. That doesn't impress me.
You know nothing about government health insurance because you've never experienced in americ as. You've been fed a steady diet of capitalist rubbish and sucked it up like a sponge.

 

[bave]

Yes, because the rotten corrupt government that you worship, and that you expect to "fix" the healthcare system, prohibits importation of insulin for resale.

The insulin meme is so misguided it is comical. You can complain about a lot in the US pharma world, but insulin isn't a great target. The problem with the comparison is that you are comparing different insulins. You can't compare the "free" insulin of the UK which is 50 year old stuff to modern Humalog. They are extraordinarily different and have materially different costs as well. This is a classic example of why spending in healthcare matters. If you are in the UK, on NHS, and diabetic you are going to get the old porcine insulin more than likely. That leads to far worse outcomes more often. You save money on the pharma, but at the cost of the patient's health, but it is free, so it is better? Moreover, what does the world look like when companies lose the incentive to develop new drugs, like the new insulins? Do you think it is easy or cheap? If so, why isn't everyone doing it?

Nice quip, except that the American privatized system is the costliest and among the least effective in the world. When it comes to "socialism" the one thing that is clear is that it works better in delivering healthcare than the free enterprise approach. The American private sector has failed miserably at delivering effective health care and should be relieved of duty.

The problem with these analyses is how they control for variables (or don't) and how they weight the results. For instance, most of these studies put heavy weightings on access to care and child survival rates, but don't show how that skews the data inaccurate. The best example is that child mortality rates are measured by the WHO starting at either 4 or 6 weeks (I can't recall off hand). So all the sick babies that are born in universal (but lower intervention/quality) countries are long dead by then. Meanwhile in the US we are spending $2MM to keep a sick baby alive for 12 weeks that then dies and suddenly it dings the numbers. Then we are failing to control for population, ie: obesity rates etc. This is why France comes off shining like a Beacon. It scores perfect on accessibility because it is truly universal (at the GP level) but then when you need interventional specialty care (which is hardly weighted) it collapses. Meanwhile their healthy population is getting all sorts of free care for their runny noses and coughs and they are thankfully far less obese because they can't afford the calorie intake and walk everywhere.

It's all about comparing good data to good data.

One good piece of information I would offer. Compare the number of knee/hip replacements and cardiac stents done in the US to those in the UK. We spend a lot more money and invest a lot more into people who are old and sick, in the UK they simply tell you "you are old, tough".

 

[bave]

No this has nothing to do with illegals. It is about your own poor who are left to die.

Then why did you bring up illegals in your statistics?

yes that is because your government does not support public schools but instead lets them run down, be over crowded and with teachers who are paid poorly.

There is nothing wrong with a two tier system.

We spend more per capita on public education than any other major country in the world and have some of the worst results. Again, statistics, meet them sometime, eh?

Your background, education and professional experience certainly has done you any service. I don't care if you are an intellectual mountain. That doesn't impress me.
You know nothing about government health insurance because you've never experienced in americ as. You've been fed a steady diet of capitalist rubbish and sucked it up like a sponge.

I'm sorry, is this supposed to be english? I thought you spoke the King's English down there.

The idea that because I haven't been on Medicare or Medicaid means I don't know anything about the system is something a moron would say. That's what education is you see, learning about things you haven't experienced. It seems you sorely misunderstood the point of education and learning, which explains a great deal about your struggles to comprehend some of my most basic points.

I will ask a fourth time, do you have any specific points about healthcare delivery or economics you would like to discuss? If so, bring it to the table with some statistics. The last few times you did that you had to crawl away like a spanked child though, so keep it in mind.

 

[Colin Norris]

Then why did you bring up illegals in your statistics?



We spend more per capita on public education than any other major country in the world and have some of the worst results. Again, statistics, meet them sometime, eh?



I'm sorry, is this supposed to be english? I thought you spoke the King's English down there.

The idea that because I haven't been on Medicare or Medicaid means I don't know anything about the system is something a moron would say. That's what education is you see, learning about things you haven't experienced. It seems you sorely misunderstood the point of education and learning, which explains a great deal about your struggles to comprehend some of my most basic points.

I will ask a fourth time, do you have any specific points about healthcare delivery or economics you would like to discuss? If so, bring it to the table with some statistics. The last few times you did that you had to crawl away like a spanked child though, so keep it in mind.

Firstly, I don't live there. How many times must you be told that.
You project yourself as an expert on this issue and you clearly are not. You have proven nothing but your opinion and that's less than my experiences. You don't know what it's like no matter how you tell yourself you do. I don't back away from arrogant upstart know all porcine like you.

I always know when people are out of ammo, they attack the grammar. Then comes the profile attack followed by internet searches to find some gossip.

See how you go now you pompous sanctamonious foghorn.