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ATWT Discussion Group
I am telling you, there has got to be a better way. A friend of mine is preparing to be laid off (again)- has 5 children, some of whom have asthma and a history of brain tumors- and a wife with a bad back. On no planet can he afford COBRA and his mother left him 30K when she died- his only savings now. That 30K will keep him from being able to get assistance from the state to cover his children while he is laid off. With their pre-existing conditions- insurers would laugh long and hard at the idea of covering his family- even if he could afford it. If he does not find a job immediately his choices are hold on to the money for healthcare- even though 30k is maybe enough to cover a few days in the hospital and nothing more- spend that small inheritance quickly to get his kids some coverage from the state- or do nothing and hope they don't need the coverage in the meantime. I am sick just thinking about it. This is one family- there are millions like him. What sense does it make to bankrupt a family in order for them to have access to medical care? Why can't those who don't qualify for Medicare pay a tax towards coverage for themselves and their families- even if they only avail themselves of it for dire situations like this? We need a public option in this country- it is a no brainer. The only ones that truly stand to lose if we just have an OPTION- are health insurance companies. They do not want us to have an alternative.
Metsfan, if you don't have insurance in the US, you should hope you are in Canada if you have a serious health problem. I availed myself of Canadian health care on an emergency basis. I received quick and efficient care, and accurate according to my US doctor when he read the Canadian doctor's report. Although I have great US insurance, I recognize that many citizens do not have coverage. Being poor should not be a death sentence for those with health issues and no insurance. 'Death squads?' The real death squads are comprised of the wealthy and privileged in this country who protest federal spending on health care while yowling for better highways (federal money) to get them to the beach.
PS my nephew who lives in Ireland has great health care, but the roads in rural areas are marginal. But when I visit, I can still make my way to the beach.
If your information came from some other source, please provide it for us. This should not be difficult, since you claim it's a "fact you know for sure" (paraphrased).
This is the heart of what's destructive about the current healthcare debate - misinformed gullible people believing and repeating false statements without making the slightest attempt at verification. They just "know" their "facts." We all must be diligent to ensure that important policy isn't set by the willfully ignorant among us.
A Bogus Cancer Statistic
October 30, 2007
Giuliani falsely claims that only 44 percent of prostate cancer patients survive under "socialized medicine" in England.
Summary
In a new radio ad, Rudy Giuliani falsely claims that under England’s “socialized medicine” system only 44 percent of men with prostate cancer survive.
We tracked down the source of that number, which turns out to be the result of bad math by a Giuliani campaign adviser, who admits to us that his figure isn’t "technically" a survival rate at all. Furthermore, the co-author of the study on which Giuliani’s man based his calculations tells us his work is being misused, and that the 44 percent figure is both wrong and “misleading.” A spokesperson for the lead author also calls the figures "incorrect survival statistics."
It’s true that official survival rates for prostate cancer are higher in the U.S. than in England, but the difference is not nearly as high as Giuliani claims. And even so, the higher survival rates in the U.S. may simply reflect more aggressive diagnosing of non-lethal cancers, according to the American Cancer Society.
Actually, men with prostate cancer are more likely to die sooner if they don’t have health insurance, according to a recent study published in one of the American Medical Association’s journals. Giuliani doesn’t mention that.
Analysis
Rudy Giuliani's latest radio ad, which began airing in New Hampshire this week, draws a stark picture for anyone diagnosed with prostate cancer in England. "I had prostate cancer, five, six years ago," the Republican presidential candidate says in the ad. "My chance of surviving prostate cancer, and thank God I was cured of it, in the United States, 82 percent. My chances of surviving prostate cancer in England, only 44 percent under socialized medicine.”
Giuliani Radio Ad:
"Chances"
Giuliani: I had prostate cancer, five, six years ago. My chance of surviving prostate cancer, and thank God I was cured of it, in the United States, 82%. My chances of surviving prostate cancer in England, only 44% under socialized medicine.
You and I should be making the decisions about what kind of health care we get with our doctors, not with a government bureaucrat. What we need to do is to give people a $15,000 deduction for a family, a $7500 deduction for an individual so they can go out and by their own health insurance.
If we do that, and we end up with a market of 50, 60 million Americans buying their own health insurance, without a mandate, the cost of health insurance will come down and the quality will come up.
Government has never been able to reduce costs. Government never increases quality.
We have the best health care system in the world. We just have to make it better.
Announcer: Rudy Giuliani. Leadership. Principle. Results.
Giuliani: I’m Rudy Giuliani and I approved this message.
Announcer: Paid for by Rudy Giuliani Presidential Committee Incorporated. Visit joinrudy2008.com
Giuliani is wrong about that. Fortunately for the English, their chances of surviving prostate cancer are far better than Giuliani claims: The actual five-year survival rate is 74.4 percent, according to the United Kingdom's Office of National Statistics. Even those in the U.S. have a better chance than what Giuliani states: The five-year survival rate is 98.4 percent in this country, according to the National Cancer Institute. (Furthermore, Milton Eisner, a statistician with the SEER program of NCI, which compiles these numbers, warns that the two countries’ statistics are “probably not comparable because they’re not done on the same scale.”)
Giuliani got his figures from a campaign adviser whose methods would make scientists and statistics professors cringe. Indeed, one of the authors of the report cited by the adviser says the figures in the ad are "misleading" and the math employed is "absolutely not" a legitimate way to calculate survival rates.
A Tale of Bad Math
Giuliani pulled these stats on prostate cancer from an opinion piece in this summer's issue of City Journal, a publication of the conservative Manhattan Institute think tank. Giuliani spokeswoman Maria Comella says the former mayor saw the statistics himself and first cited them in a campaign stop. The article, titled "The Ugly Truth About Canadian Health Care," was written by Dr. David Gratzer, a physician, senior fellow at the institute and a health care adviser to Giuliani. Gratzer states, without attribution: "The survival rate for prostate cancer is 81.2 percent here, yet 61.7 percent in France and down to 44.3 percent in England—a striking variation."
What we find truly striking is Gratzer’s lack of thoroughness in checking his facts. His source, he says, is a 2000 report for the Commonwealth Fund by Gerard F. Anderson and Peter S. Hussey, of Johns Hopkins. When we checked with Hussey, now with the RAND Corp., he said Gratzer made inappropriate use of his report and was simply wrong.
The report, titled “Multinational Comparisons of Health Systems Data,” used data from the Organization for Economic Co-operation and Development (OECD) to compare health care indicators in several countries. It included a chart showing that for every 100,000 men in the United Kingdom (not just England) during the single year 1997, 49 were diagnosed with prostate cancer and 28 died. Gratzer says he looked at the number who died over the people who were diagnosed. Specifically, he calculated, incorrectly, that 21 had survived, and calculated that number as a percentage of those diagnosed. His math was off; that equation actually produces a "rate" of 43 percent, not 44. (He also took figures that applied to the U.K. and said they were only about England.) But either way, such back-of-the-envelope calculations don't produce anything that public health officials recognize as a "survival rate," which is usually given as the portion of patients who are still living five years after they are diagnosed.
"In fact, the five-year survival data cited in the City Journal article do not come from The Commonwealth Fund report, and cannot be calculated from that report," reads a statement by the Commonwealth Fund sent to us at lead author Anderson's request. "Five-year survival rates cannot be calculated from incidence and mortality rates, as any good epidemiologist knows."
Hussey says of Giuliani's figure: “It’s misleading, because to calculate a survival rate you need to track a population who get the disease.” He adds, “What you’re looking at here [in his report] is two different populations. One who is being diagnosed with the disease, and another who has died from the disease.” To calculate a valid five-year survival rate, those who were diagnosed with prostate cancer in 1997 would need to be followed to figure how many would live until 2002.
Gratzer, when we confronted him with this, conceded that his 44 percent figure "technically wasn’t a survival rate" – even though that's what he called it in his article. He now calls his figure "a very crude indicator" and claims it "does give you an indication of what’s going on." We disagree, as do other public health experts we consulted. The 44 percent figure is better described as a miscalculation based on decade-old data.
Hussey says the math that was performed on data in his report produces a number that is meaningless. “As somebody who’s trying to present facts I’m just disappointed that they were used in that way,” he says.
A "Misleading" Comparison
Official figures do show a discrepancy between survival rates for prostate cancer in the U.S. and England. The U.S. five-year survival rate is actually 98.4 percent, according to the National Cancer Institute. The rate in England is 74.4 percent, as we noted earlier. But do these figures support Giuliani's argument that "socialized medicine" can be lethal? Even using these figures, that's not so clear.
For one thing, according to the American Cancer Society, many more men are screened for prostate cancer in the U.S. than in Britain. This leads to more cases being diagnosed. And many who have prostate cancer live for years, without treatment, whether they are diagnosed or not. Thus, a higher number of diagnoses leads to a higher official survival rate. But this tells us nothing about the quality of treatment available to those who have the disease. A spokesman for the ACS told us that comparing rates in the two countries is "misleading."
On top of that, Eisner, with the National Cancer Institute, told us we would need to find numbers that are standardized to a world standard, not just compare rates given by the two countries' government agencies. He referred us to Cancer Mondial, a Web site of the International Agency for Research on Cancer, which maintains databases of such standardized numbers. We were not able to find prostate cancer survival rates for all of the U.S. and all of England (the data is broken down into smaller regions). The best figures we could find were comparable mortality rates in an IARC/World Health Organization database. For 2002, those rates (per 100,000 men) were 15.6 and 12.0, in the U.K. and the U.S., respectively.
Getting it Backward
Besides using a false statistic, Giuliani implies the health plans put forth by the Democratic candidates are the same as the government-run, "socialized medicine" system in England. That’s simply false.
British health care is universal, overwhelmingly provided through the publicly funded National Health Service; only 12 percent of the population has private insurance, according to Gerard Anderson’s 2006 report on multinational health systems. The leading Democratic candidates’ plans include expanding government-offered insurance but they also allow people to keep whatever insurance they have now. Barack Obama’s plan mandates coverage for children, but not adults. The only Democratic candidates advocating complete government-run care are Ohio Rep. Dennis Kucinich, who calls for an end to private insurance and “Medicare for all,” and former Sen. Mike Gravel, who calls for equal medical care provided through health care vouchers.
Giuliani's central argument is that if the Democrats have their way, the public’s health is in danger. As we've noted, that's simply not supported by the bogus statistic he gives as evidence. There is, however, ample evidence that lack of health insurance is hazardous to an individual's health, and that those who do have coverage (as Giuliani did as mayor) live longer.
When it comes to prostate cancer specifically, a 2003 study of cancer patients in Kentucky, published by the American Medical Association's Archives of Internal Medicine found: "Among patients with prostate cancer, 3-year relative survival proportion was 98% for the privately insured and 83% for the uninsured."
The study found similar disparities for breast cancer, lung cancer and colorectal cancers. For each type of cancer, those without insurance were more likely to die sooner. The study looked at 35,855 cancer patients in the state, including 6,959 men with prostate cancer.
The authors noted that earlier studies established that cancer patients who lack health insurance tend to be diagnosed later in the course of their disease, and also to receive different treatment, than those who have coverage. Similarly, a 2002 report by the National Academies' Institute of Medicine examined 130 research studies and found that “working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital.”
Conclusion
With the wealth of research available, Giuliani may well find other evidence to support his opposition to expanded federal health insurance programs. Indeed, when we challenged his bogus prostate-cancer figures, his campaign sent us links to a study by Lancet Oncology that found better cancer survival rates in the U.S. compared to Europe overall. But that's no excuse for feeding a false statistic to the public.
– by Lori Robertson, with Jess Henig
Sources
United Kingdom. Cancer Survival, rates for adults diagnosed during 1999 – 2003, England. Office of National Statistics. 21 Aug. 2007.
United States. Cancer Stat Fact Sheets: Cancer of the Prostate. Survival rates for 1996-2003. National Cancer Institute. 2007.
Gratzer, David. “The Ugly Truth About Canadian Health Care.” City Journal. Summer 2007.
Anderson, Gerard F. and Peter S. Hussey. “Multinational Comparisons of Health Systems Data, 2000.” The Commonwealth Fund. 1 Oct. 2000
Cylus, Jonathan and Gerard F. Anderson. “Multinational Comparisons of Health Systems Data, 2006.” The Commonwealth Fund. May 2007.
McDavid, Kathleen, PhD, MPH; Thomas C. Tucker, PhD; Andrew Sloggett, MSc; Michel P. Coleman, MD, MSc, MFPHM. "Cancer Survival in Kentucky and Health Insurance Coverage." Archives of Internal Medicine. 13 Oct. 2003: 2135-2144.
Institute of Medicine of the National Academies. "Care Without Coverage, Too Little, Too Late." Washington, DC, 2002: 161-65.
Verdecchia, Arduino, et al. “Recent cancer survival in Europe: a 2000–02 period analysis of EUROCARE-4 data.” Lancet Oncology. Sept. 2007.
I have not gotten involved in this healthcare issue, as the whole thing looks like a smokescreen all the way around to me, and I didn't want to put months into figuring it out. Though it does look to me like with all the screaming I've heard about in the townhall meetings, like someone is REALLY stirring the pot for some reason. My guess would be someone with lots of moolah is being threatened, and is paying people to scream, as well as trying to incite people.
I really admire BO for going into this presidency and trying so hard to get things done, in the shambles that was left to him. And it ticks me off that people act like he's supposed to solve everything in a few months, after what he was left to tackle! More pot stirrers.
I have a few healthcare comments in passing. I had a very good friend from Canada, who was trying to immigrate to the US, and was unable to do so, though he tried for years. He would get sick sometimes, and would tell me that if he was in Canada, he could get this taken care of right away, and it wouldn't cost anything. However here, he couldn't afford to get treatment at all. He and I used to try to come up with home remedies for him, as he had no choice for anything else.
My son does not have insurance. He has a growth on his sternum, and we don't know what it is. He works but has a job with no benefits, and is unable to afford private insurance. My insurance does not cover him. He is unable to find out what the lump is on his sternum. With the economy the way it is, he can't even afford a visit to my doctor, which now costs about $65 (they give him a break).
About 15 years ago, I was going with a man, and he went and had something done through the good insurance that we have where we work. (We have great insurance, for the most part!) When he got his itemized bill from the hospital, they had several procedures they had added on which had NOT been performed. He called the insurance company to tell them, and they wouldn't even talk to him about it. They flat out didn't CARE! That told me right there that there's a lot more stuff going on here than we know about. Hospitals padding the bills, and the insurance company doesn't care. Hhhmmmmmmmmmmmm!!!!
Janie, you remind me of the fat doctor, who tells you that you need to lose weight! And you look at him and say, ''yeah, right!!!!''
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Ok, gals and guys, I've been gone for the weekend and I knew my 'fact' post would get a lot of responses. However, I did post it with tongue in cheek, as it was from an email I got from a friend. Many of you took it much more seriously than it was meant it to be.
Bottom line here is as I posted originally, I do believe we need a better health care system in this country, I just do not believe that this bill is it for the reasons I've posted before.
Oh, and BA, I am certainly not the computer expert that you are in searching for answers but I do know a little about health care. Although this in not my speciality area, I do know that prostate cancer which usually occurs in older men, 70 and older, is such a very slow growing cancer that it is often not even treated at all because most men this age usually die from something else before they die of prostate cancer
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I guess I have to answer my own post here. I'm not afraid or intimidated by you all. I know my facts for sure. My original post was about Barack Obama, the health care bill has been his latest faux pas. The response has been beyond crazy. Good job.
By the way , does everyone know that there is a 40% difference in the US and Canada in curing prostate cancer. Canada is on the losing end. Maybe that's because there is a 3 or 4 or 6 month wait to see a doctor.
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I've reading all the posts about Obama's attempt to get health care in the U.S reformed and as a Canadian I am amazed at the misinformation so many people are promoting about our system. True there are problems with it. We are a large country, the second largest country geograhically in the world with a population one tenth of the U.S.. Most of the population live within one hundred miles of the U.S. border so that most of the medical facilities are located there which means that people who live in the far north often have to be flown to larger cities for specialized treatment.
Most of the people who specialize in things like heart operations, hip operations prefer to live in and around Vancouver and area and just like in the U.S. we are short of specialists in these areas as well as nurses.
I would like to tell metsfans about my sister-inlaw, who sadly passed away December 31 this year. In 1983 she was diagnosed with bowel cancer and was operated on, fortunately she didn't need to have a colostomy bag but was montored constantly first every three months, then six months and later every year. 12 years ago she was diagnosed with ovarian cancer and received several rounds of chemo. Shortly after that she had to have a valve replaced in her heart. During all this time she never received a bill for any of these treatments and her care was the best available.
She died because she was injured avoiding a young guy speeding in his car, fell and broke her left arm, which btw she had broken several times before. She was 83 years old and the trauma brought on pneumonia which despite her efforts she was unable to recover from.
So as you can see having a serious illness in Canada isn't a death sentence as metsfan would have you believe.
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How about these facts?
Let me get this straight.
Obama's health care plan will be written by a committee whose head says he doesn't understand it, passed by a Congress that hasn't read it, signed by a president who smokes, funded by a treasury chief who did not pay his taxes, overseen by a surgeon general who is obese, and financed by a country that is nearly broke.
What possibly could go wrong?
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I'm really puzzled and quite disturbed by the people who are disrupting town hall meetings. A lot of them seem to be older people. I'm wondering if these are the same people (especially in Florida) who thought President Obama was going to solve all their problems. I recall the commedienne Amy somethingorother who began a campaign, tongue-in-cheek, for young people to tell their grandparents in Florida they wouldn't come to visit them if they didn't for for Barack Obama. It was called ''schlepping for Obama.''
I have done some studying of the bill going through the House of Representatives (3200). Although there are no cuts in Medicare per se, it does propose to cut subsidies to Medicare Advantage which is a supplement to Medicare and is usually cheaper than the Medi-cap policies which are getting more expensive. (A friend just told me that his medigap premiums were going up 35%). I have heard that contrary to being opposed to the ''reforms'' insurance companies are for it. And this may be one reason why.
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I think your statement grossly over simplifies the situation.
I didn't know this until this past weekend but Teddy Roosevelt called for universal health care and national health insurance in 1912. Since then presidents Franklin Roosevelt, Harry Truman, John F. Kennedy, Lyndon Johnson, Jimmy Carter and Bill Clinton all made attempts at health care reform, some with more success than others. So this is a problem that's been festering for close to 100 years. The fact that Obama has not solved it in seven months doesn't mean he is without a clue.
What's hurt health care reform is the deliberate efforts to waylay reform with an objective of hurting Obama's presidency. Sarah Palin's STUPID death panel comment along with the organized campaign from lobby groups masquerading as grassroots citizens has squashed any serious attempt at a conversation on health care reform.
Yelling, screaming and acting a fool in town hall meetings does not move the conversation along, but it does impede progress.
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I didn't vote for Obama but he is my President and I really hate all the sniping going on in my country right now. He inherited a big mess and he's trying to clean it up. I don't necessarily agree with how he's trying to do it, but he's at least trying to be innovative.
I can see, for instance, how the Cash for Clunkers plan was supposed to be a win-win-win situation...people get money to get rid of an old gas guzzler (they're happy) to buy a new car (car dealerships and manufacturers are happy) that are more efficient (environmentalists are happy) But someone didn't think this through. People are buying foreign cars. Not so wonderful for our Big 3. And this whole C4C program is putting people in car-debt, who might have otherwise stuck with their paid-for cars for another couple of years. On one hand, financial people are telling people NOT to incur any more debt, yet the government now is encouraging it. How much you wanna bet half these cars are repossessed in the next 12 months?
Health care - I know Canadians who have no gripes with their health plan. As someone put it so eloquently below, there's too much "poorly informed yapping" based entirely around anonymous email forwards, devised to put Americans in a false-panic. I'm ashamed to be an American when so many untruths are being told to scare people.
Obama's ratings are going down because his rise was too quick. His initial ratings were overly high because he was young, black and not a seasoned politician. His supporters put too much faith and hope in him. He himself said during the campaign that he was not going to be able to do all the things that people thought he could. I remember back then, there were sound bites from voters who truly believed he'd help them pay off their mortgages and take over their car payments for them. He was a Messiah to some people but he's just a man. He's got too many balls in the air --- health care, war, global warming, and the economy.
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I can't help but wonder why you said this, and what kind of evidence you have to back up your feelings. Please elaborate. Do you know any Canadians who've been seriously ill and had a bad experience with the Canadian healthcare system? Even one? My experience throughout this debate has been that the people who are complaining the loudest and are the most fearful are the people who've had absolutely no first-hand or even second-hand exposure to any other system. They are relying solely on scare-mongering reports that can inevitably be easily disproved.
An excellent case in point, just a few days ago, is the guy who is Chairman of the House Republican Health Care Solutions Group, Rep. Roy Blunt. You'd think he would know a thing or two about health care. But he's spreading stories that simply are not true. "I'm 59," Mr. Blunt said last week during a meeting with Post-Dispatch reporters and editors. "In either Canada or Great Britain, if I broke my hip, I couldn't get it replaced." This statement was then fact-checked. Turns out that least 63 percent of hip replacements performed in Canada last year and two-thirds of those done in England were on patients age 65 or older. More than 1,200 in Canada were done on people older than 85. Mr. Blunt was forced to back-pedal and admit he made his statement based on unchecked second-hand testimony - poorly-informed yapping, in other words. "I didn't just pull that number out of thin air," Mr. Blunt said in a subsequent interview. It came, he said, from testimony before the House Subcommittee on Health by "some people who are supposed to be experts on Canadian health care." "I had been given that example. I was told that 59 is the cutoff," he said. "I'm glad you pointed that out to me. I won't use that example any more."
Are you aware that, by universally accepted measurements of results, the Canadian healthcare system is vastly superior to ours and costs less money? Seriously less money.... Canada spends 10.1% of GDP while we spend 16% of GDP (according to the Wall Street Journal August 7th). Does it occur to you that most of that difference is going into insurance company coffers? Canada's system isn't the only one we can look to for providing better results for lower costs.
The following article is enlightening. By all means, do your own fact-checking about the contents:
5 Myths About Health Care Around the World
By T.R. Reid Sunday, August 23, 2009
As Americans search for the cure to what ails our health-care system, we've overlooked an invaluable source of ideas and solutions: the rest of the world. All the other industrialized democracies have faced problems like ours, yet they've found ways to cover everybody -- and still spend far less than we do.
I've traveled the world from Oslo to Osaka to see how other developed democracies provide health care. Instead of dismissing these models as "socialist," we could adapt their solutions to fix our problems. To do that, we first have to dispel a few myths about health care abroad:
1. It's all socialized medicine out there.
Not so. Some countries, such as Britain, New Zealand and Cuba, do provide health care in government hospitals, with the government paying the bills. Others -- for instance, Canada and Taiwan -- rely on private-sector providers, paid for by government-run insurance. But many wealthy countries -- including Germany, the Netherlands, Japan and Switzerland -- provide universal coverage using private doctors, private hospitals and private insurance plans.
In some ways, health care is less "socialized" overseas than in the United States. Almost all Americans sign up for government insurance (Medicare) at age 65. In Germany, Switzerland and the Netherlands, seniors stick with private insurance plans for life. Meanwhile, the U.S. Department of Veterans Affairs is one of the planet's purest examples of government-run health care.
2. Overseas, care is rationed through limited choices or long lines.
Generally, no. Germans can sign up for any of the nation's 200 private health insurance plans -- a broader choice than any American has. If a German doesn't like her insurance company, she can switch to another, with no increase in premium. The Swiss, too, can choose any insurance plan in the country.
In France and Japan, you don't get a choice of insurance provider; you have to use the one designated for your company or your industry. But patients can go to any doctor, any hospital, any traditional healer. There are no U.S.-style limits such as "in-network" lists of doctors or "pre-authorization" for surgery. You pick any doctor, you get treatment -- and insurance has to pay.
Canadians have their choice of providers. In Austria and Germany, if a doctor diagnoses a person as "stressed," medical insurance pays for weekends at a health spa.
As for those notorious waiting lists, some countries are indeed plagued by them. Canada makes patients wait weeks or months for nonemergency care, as a way to keep costs down. But studies by the Commonwealth Fund and others report that many nations -- Germany, Britain, Austria -- outperform the United States on measures such as waiting times for appointments and for elective surgeries.
In Japan, waiting times are so short that most patients don't bother to make an appointment. One Thursday morning in Tokyo, I called the prestigious orthopedic clinic at Keio University Hospital to schedule a consultation about my aching shoulder. "Why don't you just drop by?" the receptionist said. That same afternoon, I was in the surgeon's office. Dr. Nakamichi recommended an operation. "When could we do it?" I asked. The doctor checked his computer and said, "Tomorrow would be pretty difficult. Perhaps some day next week?"
3. Foreign health-care systems are inefficient, bloated bureaucracies.
Much less so than here. It may seem to Americans that U.S.-style free enterprise -- private-sector, for-profit health insurance -- is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours.
U.S. health insurance companies have the highest administrative costs in the world; they spend roughly 20 cents of every dollar for nonmedical costs, such as paperwork, reviewing claims and marketing. France's health insurance industry, in contrast, covers everybody and spends about 4 percent on administration. Canada's universal insurance system, run by government bureaucrats, spends 6 percent on administration. In Taiwan, a leaner version of the Canadian model has administrative costs of 1.5 percent; one year, this figure ballooned to 2 percent, and the opposition parties savaged the government for wasting money.
The world champion at controlling medical costs is Japan, even though its aging population is a profligate consumer of medical care. On average, the Japanese go to the doctor 15 times a year, three times the U.S. rate. They have twice as many MRI scans and X-rays. Quality is high; life expectancy and recovery rates for major diseases are better than in the United States. And yet Japan spends about $3,400 per person annually on health care; the United States spends more than $7,000.
4. Cost controls stifle innovation.
False. The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who's had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs.
Overseas, strict cost controls actually drive innovation. In the United States, an MRI scan of the neck region costs about $1,500. In Japan, the identical scan costs $98. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one-fifteenth the American price. (And Japanese labs still make a profit.)
5. Health insurance has to be cruel.
Not really. American health insurance companies routinely reject applicants with a "preexisting condition" -- precisely the people most likely to need the insurers' service. They employ armies of adjusters to deny claims. If a customer is hit by a truck and faces big medical bills, the insurer's "rescission department" digs through the records looking for grounds to cancel the policy, often while the victim is still in the hospital. The companies say they have to do this stuff to survive in a tough business.
Foreign health insurance companies, in contrast, must accept all applicants, and they can't cancel as long as you pay your premiums. The plans are required to pay any claim submitted by a doctor or hospital (or health spa), usually within tight time limits. The big Swiss insurer Groupe Mutuel promises to pay all claims within five days. "Our customers love it," the group's chief executive told me. The corollary is that everyone is mandated to buy insurance, to give the plans an adequate pool of rate-payers.
The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.
In many ways, foreign health-care models are not really "foreign" to America, because our crazy-quilt health-care system uses elements of all of them. For Native Americans or veterans, we're Britain: The government provides health care, funding it through general taxes, and patients get no bills. For people who get insurance through their jobs, we're Germany: Premiums are split between workers and employers, and private insurance plans pay private doctors and hospitals. For people over 65, we're Canada: Everyone pays premiums for an insurance plan run by the government, and the public plan pays private doctors and hospitals according to a set fee schedule. And for the tens of millions without insurance coverage, we're Burundi or Burma: In the world's poor nations, sick people pay out of pocket for medical care; those who can't pay stay sick or die.
This fragmentation is another reason that we spend more than anybody else and still leave millions without coverage. All the other developed countries have settled on one model for health-care delivery and finance; we've blended them all into a costly, confusing bureaucratic mess.
Which, in turn, punctures the most persistent myth of all: that America has "the finest health care" in the world. We don't. In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero.
Given our remarkable medical assets -- the best-educated doctors and nurses, the most advanced hospitals, world-class research -- the United States could be, and should be, the best in the world. To get there, though, we have to be willing to learn some lessons about health-care administration from the other industrialized democracies.
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I just do not understand the vehement arguing against any sort of public option. We have had government healthcare in this country now for decades in the form of Medicare and Tricare, both of which have the dreaded end of life counseling- otherwise known as hospice. I have to laugh that some of the people at these town hall meetings arguing against any public option and supposedly terrifed of *death panels* are obviously Medicare beneficaries- they already have what they are foaming at the mouth to prevent anyone else from receiving.
The plain truth of the matter is that the only entities that stand to lose if the public is offered even the option of going with some sort of government plan- are insurance companies. If the future of insurance companies is important to you, things are going well about now.
Canada's health care system has its problems, but there are a few advantages to being in Canada, according to OECD statistics:
You're more likely to outlive James Stenbeck: life expectancy is 78.1 years in the U.S.A. and 80.7 years in Canada (data from 2006).
Gwen's baby Billy would have a fighting chance against Jean Passanante: infant mortality is 6.7 deaths per 1000 live births in the U.S.A., and only 5.0 deaths per 1000 live births in Canada (data from 2006).
You and your neighbours look like the population of Oakdale: 34.3% of people in the U.S.A. were obese in 2006, according to actual measurements, but only 15% of people in Canada were obese in 2007, according to self-reported measurements.
Canada has 2.2 practising physicians and 9.0 nurses per 1000 people, which means long waiting times for those who cannot afford to hop over and pay for their own treatment in the U.S.A., where there are 2.4 practising physicians and 10.6 nurses per 1000 people (many of whom are left to suffer and die). The averages across OECD countries are 3.1 physicians and 9.6 nurses per 1000 people.
Canada spends 10.1% of its GDP on health care (3895 US dollars per person in 2007), with 70% of this amount coming from tax dollars.
The U.S.A. spends 16.0% of its GDP on health care (7290 US dollars per person in 2007), more than any other country. Only 45% of this amount comes from taxpayer dollars, tied with Mexico for the lowest government share in health care costs among OECD countries. The cost of private insurance accounts for another 35% of health care costs, and the largest insurance companies spend only 76.9-83.9% of revenue from your premiums on medical bills, with about 12% going to the cost of insurance paperwork at the hospital (http://www.pnhp.org/news/2006/march/medicalloss_ratios_.php). The remaining 16.1-23.1% of your premiums go to paperwork and lobbying expenses for the insurance companies.
A recent study found that medical bills accounted for 62% of American bankruptcies in 2007, and nearly 80% of those who filed for bankruptcy had health insurance (Himmelstein, D, E., et al, “Medical Bankruptcy in the United States, 2007: Results of a National Study, American Journal of Medicine, May 2009).
If you do the math, your government spends $3280.5 per capita, but only provides health insurance to some people. Another 46 million Americans (27% of the population under age 65) were without health insurance in 2007, according to the U.S. Census Bureau. Everyone else has to call Bangalore from his/her sickbed to argue with the outsourced spectre of a private health insurance provider. The Canadian government spends only $2726.5 per capita, and provides health care to everybody.
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My post is related more to health care than BO. As someone who has been a health care provider for nearly 50 years, I do believe that we need a better health care system in our country. I look at it this way. Education is in the public domain. Isn't health care just as important as education? Again I speak as a nurse educator so I think I know what I'm talking about. Both are equally important, IMO.
However, this health care bill is just about the most ridiculous thing I have ever seen! Eleven hundred pages that most who are voting on it haven't read let alone understand. Trying to shove it down our throats by the end of August is laughable.
I truly do not believe BO has the experience or the depth of knowledge to be the president but he is so I support him and pray for him to do well for our country almost every day. Having said that, I wonder if McCain or anyone else could have done any better. The problems we face at this time are almost overwhelming and I wonder who could better solve them.
I used to have a plaque in my office that said: 'All the people who know how to run this country are busy teaching school.' Just a little humor to lighten the day.
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Coming up with a good health care plan is a tremendous challenge for any president. Hillary Clinton couldn't get it done in 1993/1994 when William Jefferson Clinton was President. It doesn't matter who voted for Obama and who didn't. That is irrelevant. Obama is our President and he is tackling one of the hardest, most difficult, tasks any president could have. It also doesn't help that the Republicans doesn't want the health care plan to pass when the Democrats are in office. George Bush was too busy with the Iraq war to care anything about health care. The Democrats are in office now and it is a good chance they will be there in 2013-2017. It is not a good thing to wait many more years for the republicans to help pass a health care bill, or to work on an answer to our health care problems. IMO, this country would run a lot better if they eliminated the party system. It was organized around 1792. It might have worked then but it doesn't work very well now. The republicans and democrats have fought for years. However, the republicans should not let the bill pass if they honestly feel that it is not good for the country. I cannot honestly say if the bill is good or bad because I don't know, or understand, everything that is in the bill. If anyone can find the Health Care Reform bill, and can understand it, please let me know. Unless you know, and can understand, what is in the bill, how can you honestly say whether it is good or bad???
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