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Old 10-16-2013, 03:12 PM   #41
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I have to make this post to ensure that my earlier post about a foreign cancer patient blog would not get misunderstood.

When I said that her cancer had metastasized and that she was deceased, it was not meant to imply that she would have lived with a different treatment. Cancer does not have a sure cure. This woman had a bad reaction to the common drugs that were used, and did not even complete the standard course of treatment. And even if she did, the same course of treatment will have different results in different people.

And I have read in a recent article in Time that there are some very expensive cancer drugs used in the US that have nebulous results, such that doctors at Sloan-Kettering have refused to prescribe for their patients. The only sure thing these drugs brings to their patients is bankruptcy. Yet, this article said that one patient wanted to extend his life for a few weeks, cost be damned. So he did, and left his wife with a bill of several hundred grands.

I was disappointed when reading this article, because I thought initially that the drugs would bring some results that would justify the cost. And I remember a few years ago, following the story on new drugs in order to make investment decisions, I saw that they were called "miracle drugs" and were announced with great fanfare.
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Old 10-16-2013, 03:22 PM   #42
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Originally Posted by NW-Bound View Post
While I do not claim to be a healthcare expert, I think the high healthcare cost in the US is due to hospitalization costs, not the routine health care as I pointed out in the examples above. Additionally, the cost for end-of-life treatment is horrendous in the US, and it is going to go a lot higher. That's what needs to be addressed.
+1. YES!!!! But I'll take it further: most of our uninsured and unemployed visit the emergency room for their health care because emergency departments have the only legal mandate to provide health care: the Emergency Medical Treatment and Labor Act (EMTALA). That is THE most expensive care one can find, and then you couple that with the fact they won't be paying any of their bill, well, there you go.

Don't even get me started on end-of-life care. Kaiser has some very interesting reading and stats on this topic, but when you try to open that discussion the death panel kooks come out of the woodwork.

I just think it's sad that the richest country in the world has turned health care for its citizens into such a divisive political battle.
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Old 10-16-2013, 03:23 PM   #43
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I have to make this post to ensure that my earlier post about a cancer patient blog would not get misunderstood.

When I said that her cancer had metastasized and that she was deceased, it was not meant to imply that she would have lived with a different treatment. Cancer does not have a sure cure. This woman had a bad reaction to the common drugs that were used, and did not even complete the standard course of treatment. And even if she did, the same course of treatment will have different results in different people.

And I have read a recent article in Time that there are some very expensive cancer drugs used in the US that have nebulous results that doctors at Sloan-Kettering have refused to prescribe for their patients. The only sure thing these drugs brings to their patients is bankruptcy. Yet, this article said that one patient wanted to extend his life for a few weeks, cost be damned. So he did and left his wife with a bill of several hundred grands.

I was disappointed when reading this article, because I thought initially that the drugs would bring some results that would justify the cost. And I remember a few years ago, following the story on new drugs in order to make investment decisions, I saw that they were called "miracle drugs" and were announced with great fanfare.
There was a local guy who had leukemia and dedicated his last few years of life trying to find a cure. No formal education but he came up with the idea of using radio waves to kill cancer cells. I'll be damned if it's not being tested with promising results. This is where America really excels. Private citizens inventing amazing stuff in their garages!
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Old 10-16-2013, 03:29 PM   #44
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The last time WHO did a study of health care by country, the U.S. was first in cost (by a wide margin) and 38th in quality.

A more recent study on the health of the population of 17 developed countries, all with some form of universal care except the U.S., the U.S. came in dead last -

New Health Rankings: Of 17 Nations, U.S. Is Dead Last - Grace Rubenstein - The Atlantic
Why are there so many foreigners, including the Premier of Newfoundland, made special trips to the US, to pay big bucks to get your alleged sub-par medical treatments?
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Old 10-16-2013, 03:30 PM   #45
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Why are there so many foreigners, including the Premier of Newfoundland, made special trips to the US, to pay big bucks to get your alleged sub-par medical treatments?
Well, he is a Newfie.

Ha
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Old 10-16-2013, 03:36 PM   #46
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Why are there so many foreigners, including the Premier of Newfoundland, made special trips to the US, to pay big bucks to get your alleged sub-par medical treatments?
Didn't even glance at the article, didja?
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Old 10-16-2013, 03:56 PM   #47
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Wow, all these posts and no bacon yet.
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Old 10-16-2013, 03:57 PM   #48
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Why are there so many foreigners, including the Premier of Newfoundland, made special trips to the US, to pay big bucks to get your alleged sub-par medical treatments?
Instead of anecdotal incidents, like what anonymous bloggers write or the the actions of a single politician for one specific health issue, an alternative source of information might be studies by international nonprofit organizations like WHO and the OECD that use metrics like life expectancy and infant mortality rates to rate health care systems.

Here is another article on US health care versus the rest of the developed world -

Costly U.S. health system delivers uneven care: OECD | Reuters

"The cost of healthcare in the United States is 62 percent higher than that in Switzerland, which has a similar per capita income and also relies substantially on private health insurance.

Meanwhile, Americans receive comparatively little actual care, despite sky-high prices driven by expensive tests and procedures. They also spend more tax money on healthcare than most other countries, the study showed."

"Pharmaceuticals also cost about 60 percent more than in a range of European countries.

Pearson said one reason prices are higher in the United States is that the healthcare system lacks what other countries have: an effective government mechanism that acts to keep prices down."
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Old 10-16-2013, 04:05 PM   #49
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Instead of anecdotal incidents, like what anonymous bloggers write or the the actions of a single politician for one specific health issue, an alternative source of information might be studies by international nonprofit organizations like WHO and the OECD that use metrics like life expectancy and infant mortality rates to rate health care systems.
True, but be sure to compare apples to apples. Very many countries (including some in Europe) don't count live births the same as we do in the US, so their infant mortality figures look better than they would if they used the same criteria. And there is plenty of US morbidity and mortality that has nothing to do with US healthcare. If people in Germany ate and exercised as Americans do, their life expectancy would be different.
Control for these factors and the quality of US medical care actually looks very good. The cost, however, still does not.
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Old 10-16-2013, 04:18 PM   #50
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And there is plenty of US morbidity and mortality that has nothing to do with US healthcare. If people in Germany ate and exercised as Americans do, their life expectancy would be different.
Control for these factors and the quality of US medical care actually looks very good. The cost, however, still does not.
I haven't seen anything to suggest that in any of the research reports I have read. Perhaps you have some references to back that up? The summary of the link above has comments like these:

"Meanwhile, Americans receive comparatively little actual care, despite sky-high prices driven by expensive tests and procedures. They also spend more tax money on healthcare than most other countries, the study showed."

"Americans have fewer doctors and hospital beds, make fewer doctor visits, go to the hospital less often and stay for shorter lengths of time than about three-quarters of the other OECD countries."

Plus there is the whole 50 million uninsured issue.
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Old 10-16-2013, 04:26 PM   #51
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The new laws already open up access to health care, and provide subsidies and all that. Why are people bringing up the old stuff?

The new system will not be truly active until 1/1/2014, so can we just wait to see how it works?

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Lol. Ready to ditch Obamacare already?
Perhaps because they see that it still costs them something. As if it were really free in other countries.

PS. Being an American, I still have to admit that with our lifestyle and health habits, if we send our citizens overseas to be treated by other countries, we would bankrupt the system over there in a hurry.

When traveling overseas, I have never had to visit their hospital, nor learned much about their healthcare. However, just from looking at how trim and fit their residents are, I figure that it's got to make a difference in their healthcare cost. The mademoiselles (well, some not so young) do look so shapely, kind of like DW . And their men rarely sport a beer belly, even in Belgium where the beers are so good, and they do drink a lot of it. How do they do it?

OK, OK, I knew a few things that they did differently. But it would be tough for me to follow. My BMI is 25 at the highest, and blood pressure and blood sugar are similarly in the high end of the normal range, but to improve it further requires sacrifices I have not been willing to make.
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Old 10-16-2013, 04:34 PM   #52
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Don't know about the finances of hospitals but their CEOs are well-paid:

Chart: Hospital CEO Pay And Incentives - Kaiser Health News

And here is the CEO pay of the top non-profit hospitals:

CEO Compensation of the 25 Top-Grossing Non-Profit Hospitals
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Old 10-16-2013, 05:19 PM   #53
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I haven't seen anything to suggest that in any of the research reports I have read. Perhaps you have some references to back that up?
"That"?
I assume you don't take exception to my assertion that our cost of care is high. Right?
I assume you agree that Germans would be less healthy if they were as fat and sedentary as Americans. Right?
I assume you agree that a lot of Americans are in poor health because of their lifestyle choices (eating, smoking, lack of exercise) not their medical care, right?
If so, then we are in agreement regarding most of what you excerpted from my post.
Americans (all inclusive) who have been diagnosed with many types cancer, heart disease, diabetes, and many other diseases live longer and have better outcomes than do people with similar diagnoses in many (or all) other industrialized countries. The below quotes are from an article by Dr Scott Atlas.

Cancer:
Quote:
American cancer patients, both men and women, have superior survival rates for all major cancers. For some specifics, per Verdecchia, the breast cancer mortality rate is 52 percent higher in Germany than in the US, and 88 percent higher in the United Kingdom; prostate cancer mortality rates are strikingly worse in the UK, Norway, and elsewhere than in the US; mortality rate for colorectal cancer among British men and women is about 40 percent higher than in the US. Removing “lead-time bias,” where simply detecting cancer earlier might falsely demonstrate longer survival, death rates from prostate and breast cancer from the early 1980’s to 2005 declined much faster in the US than in the 15 other OECD nations studied (Australia, Austria, Canada, Finland, France, Germany, Greece, Italy, Japan, the Netherlands, Norway, Spain, Sweden, Switzerland, and UK).
Heart disease:
Quote:
Another comparison study showed that fewer Americans than UK residents die (per capita) from heart attack despite the far higher burden of risk factors in Americans for these fatal events. In fact, the heart disease mortality rate in England was 36 percent higher than that in the US. These superior outcomes from US medical care are particularly impressive, considering that American patients have far more risk factors (diabetes, obesity, chronic kidney disease) that worsen outcomes and death rates after heart attack and after heart surgery.
Diabetes:
Quote:
A 2007 comparison of Canadians and Americans showed the same -- a higher percentage of American diabetics than Canadian diabetics actually receive treatment. In the same WHO analysis, the US also performed best by several different quality measures, including blood glucose control, as well as effective management for all three key factors in diabetics (blood glucose, blood pressure, and blood cholesterol), approximately twice the success of England and Scotland. Here’s the bottom line: if you had diabetes, you were more likely to receive treatment and be treated successfully for the disease and the important risk factors for its serious sequelae in the US than in any other country studied
Is this a peer-reviewed article? No. Of course, but neither is an article in Time or The Atlantic. But I've read "real" studies that generally tracked the same way: Once you are sick (and including those wth and witout insurance), Americans had better health outcomes than citizens of many other developed countries. It is just not reasonable to disregard lifestyle choices and other important factors and assume that healthcare (or "access" to healthcare in our buzzspeak) is the prime determinant of life expectancy or morbidity.
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Old 10-16-2013, 05:42 PM   #54
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Well, if you want to use one article written by one person on a Fox News web site instead reports from WHO, OECD and the Common Wealth Fund -

(U.S. Ranks Last Among Seven Countries on Health System Performance Based on Measures of Quality, Efficiency, Access, Equity, and Healthy Lives - The Commonwealth Fund

and this metrics based chart from Bloomberg.com

http://www.bloomberg.com/visual-data...care-countries

there isn't much else for me to add.
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Old 10-16-2013, 05:48 PM   #55
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None of these other countries has a population even remotely like the US. Look how many excess US deaths are caused by people killing other people. Most of these other countries have much better educated populations, more law abiding, more literate and enumerate. On a population wide basis, Americans are astoundingly stupid, ill educated, violent group. Also, the sheer size of our country means that some things are more likely to be lethal here than in much smaller, more densely populated countries.

Ha
Very true; we not comparing apples to apples.
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Old 10-16-2013, 06:39 PM   #56
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The statistics and reports that samclem and daylatedollarshort cited did not contradict each other.

One said a lot of sick people did better with the US system than they would elsewhere (cost was not considered here).

The other set of reports said the US health care is expensive overall (one has to be under a rock to not know that), and that some people do not get healthcare.

These reports are complementary, and analyze different aspects of the problem.

So, the people who have been doing well under US healthcare must be having good insurance in order to pay for that. In the past 3-4 decades that my megacorp, then myself paid big bucks for healthcare insurance, I really used zilch of healthcare. In those years, my healthcare usage was peanuts compared to my dental cost, and that besides the fact that I still have most of my natural teeth, compared to many other people who spend tens of thousand on their teeth.

And then, just this year, I racked up big healthcare costs to make up for all those years. And I am grateful that the service was so prompt and good. Could the cost be lower? Sure, and that needs to be worked on. It requires drilling down to the specifics, not simply that we spend more, which everybody already knows.

If a population overall is sicker than his neighbors, then that population overall would have to pay more for healthcare, or if it wants expensive treatments that may still be experimental. Can it be any different?
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Old 10-16-2013, 06:47 PM   #57
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Whatever. You are not processing what I'm writing. These studies are not responsive to the points I raised.
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Old 10-16-2013, 07:00 PM   #58
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I don't find the results of this survey all that surprising. A very large majority here favor some form of universal access to insurance (we had a poll a couple of years ago where 75% felt we should leave the ACA in effect and work to improve it). This poll simply shows that many people here would prefer an even more progressive system. I agree with the posters who said (in effect) "the ACA is law so lets get on with it." If we and our reps would work toward implementing the darn thing we could eventually get on with improving it.
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Old 10-16-2013, 07:10 PM   #59
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I don't find the results of this survey all that surprising. A very large majority here favor some form of universal access to insurance (we had a poll a couple of years ago where 75% felt we should leave the ACA in effect and work to improve it). This poll simply shows that many people here would prefer an even more progressive system. I agree with the posters who said (in effect) "the ACA is law so lets get on with it." If we and our reps would work toward implementing the darn thing we could eventually get on with improving it.
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Old 10-16-2013, 07:18 PM   #60
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This poll simply shows that many people here would prefer an even more progressive system...

I agree with the posters who said (in effect) "the ACA is law so lets get on with it."...
Some people may be disappointed that ACA (Affordable Care Act) still costs them some money, because their definition might be "affordable = free".

Of course we all know that in reality "free = prepaid with taxes", or "free = OPM". And as ERs no longer work, they pay less income tax than workers, so they like what works for them. Progressive is good, if one can take advantage of it.

As an ER myself, I would be able to arrange my finances to have a low income, despite having good assets, which is just above average according to a poll here, but outrageous to the public at large.

I can see the headline now: "Rich early retiree got healthcare subsidy, used it to feed gas-guzzling motorhome". Oh boy! How long do we have until they do asset testing on ACA subsidy?

Remember that the government already has knowledge of, or can demand access to your 401k, bank and brokerage accounts, a rough estimate of your real estate, etc...

Enjoy the subsidy while it lasts, but I'd rather see the true cost of hospitalization gets driven down, such that heavy subsidies are not needed.
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