Doesn't anyone think it's odd that we all know the private insurance system sucks, that we are the only Western/industrialized nation in the WORLD that doesn't guarantee health care to all its citizens, and yet we don't even consider the alternatives to what we have.
On the same lines, we are the only industrialized nation in the West to cling to capital punishment. Yet we have one of the highest crime rates in the world.
Is there some strange disconnect in our thinking processes?
"I'm a lumberjack, and I'm okay." Thread killer Extraordinaire
Where am I and what am I doing in this handbasket?
Vineyridge - here's some stats you can noodle over...
IMR is 7 (IMR = infant mortality rate)
Life expectancy is 77
Health Expenditure as % of GDP is 14
Actual $$ per person is $4,090
IMR is 4
life expectancy is 80.3
health expenditures as a % of GDP is 7.2
Actual expenditure per person is $1,741
and for giggles....
IMR is 10
life expectency is 72
health expenditures as a percent of GDP is Zippo
So best as I can tell, we spend a lot more to die earlier than people who spend a lot less, and we get to live a little bit longer than those who have not even catagorized how little they spend on health care.
Snowbird - you can self insure - MSA's are part of Medicare, and have been for a few years - part of the BBA '97 act...
and thanks, DMK, for those stats - i think if more US citizens knew the numbers (especially those high infant mortality figures) compared with other countries in the "developed" and "undeveloped" world, attitudes might change.....maybe.
More rates to look at. In the USA it appears we have made great progress DECREASING the IMR since the 1950's in spite of more drug and alcohol abuse by pregnant mothers. I left school district work as the second wave of crack baby's became "of age" so I was surprised to see the low number.
But isn't one of the main hang-ups health care reform stalls in the U.S. is because any meaningful reform will have to include discussion of health care rationing? For example, we would have to talk about who could receive some of the more expensive procedures, like organ transplants. Or how much we were willing to spend when someone's fertility treatment results in the birth of 7 or 8 critically premature infants.
Even liberal tree-hugging me has trouble with that one. In theory, I could set limits. But if it were my elderly parents being told "no", things would look a little different.
Anyone know how the Japanese are able to control costs?
or at world rates, of course they're not. But even with those stats (which does show a decline in us rates to 6.8), most western european countries are between 4 and 5, and canada is at 5 (yes, some provinces are higher but that is because of some regions being poorer than others, not because they have privatized medicine)...can the us really claim their medical system works better? are they satisfied with that rate of infant death?
oh and by the way, Cuba is just over 7 despite the prolonged period of US embargo....
that Japan spends less on health care because of the way they live. The traditional Japanese diet is mostly rice, vegetables and fish and they also use alternative medicine for chronic conditions. In the last 10 or 20 years, many Japanese have adopted a more "western" diet, which consists of lots of Montana steaks, and their rates of heart disease have risen quite a bit.
Betsy (in Md.) who also likes tofu ....not like a granola health girl, but like a Japanese snack. [img]/infopop/emoticons/icon_smile.gif[/img]
The truth is rarely pure, and never simple. Oscar Wilde
Where am I and what am I doing in this handbasket?
SLW - nobody is arguing that starving countries have a higher IMR than the US - that might possibly fall into the "no duh" category. And nobody - least of all me - is arguing that this is not a great country. In fact I would venture to suggest that our system of free market medicine has helped with a lot of great advances in research.
Conversely, I do not believe that anyone should hold our health stats up to the rest of the developed world as superior in any way, as that flies in the face of logic (never mind provinces in Canada, try suburbs in Detroit and the Ozarks - EVERY country has variations, but as long as the same sampling logic is applied universally, the variations are equal). Nor should we solely take claim for all the great advances in medicine as a result of our free market system (which if you understand health care delivery, is clearly not so free market).
Our system of health care is clearly unhealthy in every possible aspect of the system. I doubt you will find too many people who are in the field to disagree with that statement. Nobody has any clue how to fix it to even the partial satisfaction of most of the parties, and most - myself included - are unsure about socialized medicine as a workable aspect for this nation. Still, Houston, we have a problem...
Interestingly enough, that decline in IMR has been almost the sole reason the average age life expectancy has "increased". Take away IMR deaths and look at the life expectancy, and you will find that we do not live that much longer than we did 75 years ago. Interesting considering how much we spend on trying to live longer.
As for rationing health care, it is indeed an uncomfortable thought, but to be quite honest, right now every American has their health care rationed. For the uninsured, the limits are obvious, for the insured, there are maximums on lifetime or annual coverage, limits on procedures and drugs, certain cutting edge care (experimental) is rarely covered, many optional procedures (cosmetic) are not covered and so on. They are just the limits we are familiar with, rather than the unknown limits.
OK - back to the real subject before Erin comes and beats this post with a big stick [img]/infopop/emoticons/icon_biggrin.gif[/img]
<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR> Anyone know how the Japanese are able to control costs? <HR></BLOCKQUOTE>
Easy, they don't eat a double whopper with cheese, biggie fries, washed down with a 1/2 gallon of coke for lunch...
I am also amazed at how many people don't exercise in this country, especially young people. I'm an overweight person - mainly cause I wash my veggie burger down with a 1/2 gallon of coke... and I am shocked by how many "normal" people can't keep up with me on a hike, or a bike ride. Even the young people I'm in school with don't exercise - then they smoke and never eat veggies - a recipe for heart disease and diabetes.
Clarksdale, MS--the golden buckle on the cotton belt
I'd be riding to the doctor.
How about health department clinics for most things, and universal single pay basic and preventative care, including mental, dental and vision, paid for out of employment (SS type) tax dollars, with government funding for the working poor and the unemployed and retired? With an annual maximum per individual?
Private catastrophic insurance (like current cancer and nursing home insurance) for those who can afford it? So we can continue to ride our horses, ski, and play sports.
Home health care for the aged. Hospice care for the dying.
Education, so we can all understand that one human life is not worth infinite cost--that death is a part of life, not to be feared. That humans don't have the right to life at the expense of the community. Courses in death and dying, parenting, and basic health in all high schools. This can be paid for by de-emphasizing contact sports.
Health care is already rationed for many Americans simply because of the cost.
I have a bone to pick with the system because I'm personally uninsurable except in the State's high risk pool--and that would cost 4 grand or so a year.
Saw last night on the news projections of a 15 percent increase in insurance costs for large companies, and up to doubling for small employers.
The system really is broke,just like the USET.
(Notice horses mentioned thrice in this post)
"I'm a lumberjack, and I'm okay." Thread killer Extraordinaire
I think the reason that the US has high infant mortality rates compared to Sweden etc. is because it has some high poverty rates, and even if you aren't impoverished, it doesn't necessarily mean you can afford health care.
If you don't have insurance and can barely afford food, rent and transportation, you may not be able to afford prenatal care. There are many many people in this country barely getting by, but not so poor as to qualify for medicare. They work in stores, restaurants, clean houses and motels and work other low paying jobs. In Sweden, the govt. provides them health care, but in the US, it comes out of their pocket (if they can afford it).
There really aren't easy solutions - we either need to stay status quo, and hope people will move up the latter, require employers to pay a living wage, or we need to cover these "social" costs as a society. Basically, we are getting away with paying people less than they need to survive, and sooner or later, we need to make that up, be it thru higher medical costs because of high numbers of people not being able to pay bills, higher taxes, or higher prices for goods and services that underpaid people provide (or we just need to accept the social problems like high rates of infant mortality as a cost of our "system").
Karen Armstrong is on the NPR show Fresh Air RIGHT NOW! She is a completely brilliant scholar of religion, and is talking about Qutb and the rise of Islamic fundamentalism. Very good! To tune in on your 'puter, go to WHYY here:
Some public radio stations air Fresh Air twice a day - try to catch it later if you can't listen now, or check out the archived NPR shows on their web site for other Armstrong appearances on Fresh Air.
Whoops, just realized that this might be an old show that WHYY is airing now - they are doing a membership drive, so if you are not in the Philly area, you may be getting a different Fresh Air.
...but, how will our "system" of health care function if such exposures become commonplace? It's pretty clear that early treatment is very desirable...but the way the system is set up, waiting till a condition is advanced and then seeking ER care is the common practice for the uninsured, and for the insured, "unnecessary" care is discouraged by most HMO plans, where "better safe than sorry" type logic does not seem to apply! Also, I'm wondering if that pesky formulary of mine includes Cipro on its list...
Our NPR station in Charlotte is doing a fund drive right now. Every morning this week I am awakened by "If we can just get 10 pledges in the next 10 minutes, we'll be so happy!" "OOOOOOOooooo, now we only need 8 more, keep calling in!" "Only 3 minutes left, that's 2 calls a minute, c'mon, you can do it".
Maybe we can have NPR take over the afghan radio station. They'll surrender after listening to one day of the fund drive....
you're right, poverty does prevent people from getting adequate prenatal care - canada is a poorer country than the usa but we have a lower rate because we don't have private medical insurance. So it puzzles me why the us hangs on to that system, despite the evidence of the harm it does - not to the rich, but to the poor. It's not because private medical insurance is cheaper, because it's not....
I think it is the whole free market thing. I think most americans feel our government is very incompetant and inefficient at providing services, and would rather rely on competition between corporations to ensure quality service than the government... and there is a lot of fear of "socialism" in this country. Any attempt to help the poor - living wages, gvt healthcare etc. is seen as socialism, which is a threat to the free market, and hence, democracy. Which I think stinks, but then again, I complain about taxes being too high....