Best Health Care System in the World?

[George Ray]

Does the USA have the world's best Health Care System?

500 word minimum, compare and contrast, cite sources.

[elf]

Well, what are the criteria?

[shamus]

The Japanese live the longest, so you might look there.
Australia isn't far behind, so maybe we do something right.

[perldog007]

The Japanese live the longest, so you might look there.
Australia isn't far behind, so maybe we do something right.

Brings up an interesting question to my mind. Do you define the "best" by how long life lasts, by how often people get sick, or by what happens when they do get sick?

Presumably, most folks would rather be well and have long lives than to have fantastic medical solutions in response to frequent illness and reduced life span.

We really do have to discount Oz though, I mean they talk funny ( j/k DON"T KILL ME!!! )

looking at the situation in America, would that then suggest that our focus on health care reform is somewhat myopic?

Does meaningful reform of the system have to go beyond how we practice and pay for medical treatment?

[Nicholas Scheuer]

This has gotta be a troll.

The USA ranks well down the list in general health of its population, and we all know, "if we can put a man on the moon, we can do anything".

A adult might disregard his or her own health with booze and/or cigarettes, or obesety, but when USA infant mortality raks well below many other nations, something is clearly wrong.

Are Repubs practicing some sort of genocide by opposing a public option for "certain folks" kwho cannot agfford health insurance, and annot get a jpb in Repub-controlled business?

(That's no more exagerated than Boehner's babble about Dems.).

Moby Nick

[WX]

My criteria would be availability of services, access to services by those on the lowest incomes and cost to the patient, this includes end user cost of prescription drugs.
Australia rates very well, despite the media claims of a health system in crisis.

[capt jake]

The US system has to be the best...that is of course, if you are one of the upper level executives!

[Pugwash]

http://news.bbc.co.uk/2/hi/americas/8325685.stm

[StevenBauer]

No. We were ranked 37th, though we spend more than twice what the top ranked counties do. I recently heard that we had moved up to 30th. Still pretty lame.





Steven

[Stan D]

It certainly is the best if the criteria is how much money we spend.

[George Roberts]

No. We were ranked 37th, though we spend more than twice what the top ranked counties do. I recently heard that we had moved up to 30th. Still pretty lame.

Steven

As I recall the scoring criteria, two of the issues scored almost required a single payer system. Without a single payer system one is relegated to the second tier.

Bias is clear.

Yes, there are a lot of things the US health care system could do better, but bringing up biased measures to force unnecessary and perhaps wrong change seems improper.

Make up a list of what you want in a health care system and compare what you want with what is proposed.

[Pugwash]

As I recall the scoring criteria, two of the issues scored almost required a single payer system. Without a single payer system one is relegated to the second tier.

Bias is clear.

Yes, there are a lot of things the US health care system could do better, but bringing up biased measures to force unnecessary and perhaps wrong change seems improper.

Make up a list of what you want in a health care system and compare what you want with what is proposed.

I wonder if America has the best veterinary care in the world?

[Hwyl]

I wonder if America has the best veterinary care in the world?

Well they call vets "Dr".

[TimH]

Vets have more schooling to go through than regular doctors - or so I have heard.

[oznabrag]

I wonder if America has the best veterinary care in the world?

They say they're amongst the top tier, but those losers still have trouble with tracheal trauma and related oxygen deprivation. Even assuming the pet in question receives treatment!

Slackers.

[Flying Orca]

I see what you did there.

[StevenBauer]

As I recall the scoring criteria, two of the issues scored almost required a single payer system. Without a single payer system one is relegated to the second tier.

Bias is clear.

No. This is not true.

"WHO’s assessment system was based on five indicators: overall level of population health; health inequalities (or disparities) within the population; overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts); distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system); and the distribution of the health system’s financial burden within the population (who pays the costs)."

The WHOs top 50:

1 France
2 Italy
3 San Marino
4 Andorra
5 Malta
6 Singapore
7 Spain
8 Oman
9 Austria
10 Japan
11 Norway
12 Portugal
13 Monaco
14 Greece
15 Iceland
16 Luxembourg
17 Netherlands
18 United Kingdom
19 Ireland
20 Switzerland
21 Belgium
22 Colombia
23 Sweden
24 Cyprus
25 Germany
26 Saudi Arabia
27 United Arab Emirates
28 Israel
29 Morocco
30 Canada
31 Finland
32 Australia
33 Chile
34 Denmark
35 Dominica
36 Costa Rica
37 United States of America
38 Slovenia
39 Cuba
40 Brunei
41 New Zealand
42 Bahrain
43 Croatia
44 Qatar
45 Kuwait
46 Barbados
47 Thailand
48 Czech Republic
49 Malaysia
50 Poland

[TimH]

The only people in the US who dont have insurance are the slackers who dont deserve to be healthy or live very long.

Those 36 countries above us are commie bastards who dont believe in Darwin.

[Nanoose]

No.

(Source: the 40plus million that have no medical coverage)

[Pugwash]

No.

Duh.

[TimH]

Why should those of with good jobs or who simply inherited wealth from our hard working ancestors have to pay for health coverage from the slackers who dont make or have as much?

[Norman Bernstein]

Does the USA have the world's best Health Care System?

500 word minimum, compare and contrast, cite sources.

Yes... for two segments of our society.

The first segment: members of Congress, who have superb health care, a wide range of choices, and who pay next to nothing for it.

The other segment: the very wealthy, who can easily afford to pay for the very best.

For the rest of society: some get excellent health care, but are at constant risk of losing it. Others get inadequate health care, or none at all, and die earlier as a consequence.

[Stan D]

Why should those of with good jobs or who simply inherited wealth from our hard working ancestors have to pay for health coverage from the slackers who dont make or have as much?

Because it's the right thing to do? And because those two groups you mentioned can afford it? Where's your Patriotism? Don't you want the U.S. at the top of that list?


I'm thinking now how Republicans won't like the word "Patriotism" used against 'em like this, but it sure was fun!

[perldog007]

Well the bill just passed the house, i reckon that means we get to find out......

[TimH]

Because it's the right thing to do? And because those two groups you mentioned can afford it? Where's your Patriotism? Don't you want the U.S. at the top of that list?


I'm thinking now how Republicans won't like the word "Patriotism" used against 'em like this, but it sure was fun!

Sometimes its fun to be facetious.

[Stan D]

You are so right. But I wasn't.

[TimH]

You are so right. But I wasn't.

But I was.

[George Roberts]

No. This is not true.

"WHO’s assessment system was based on five indicators: overall level of population health; health inequalities (or disparities) within the population; overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts); distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system); and the distribution of the health system’s financial burden within the population (who pays the costs)."

So how does the US rate on the last factor listed? I suspect systems where the wealthy pay for the care (single payer systems supported by taxes on the rich) gets high scores.

I suspect the second indicator is also biased, but I am not going to examine the assessment that closely.

I appear to be more or less correct.

[George Roberts]

The only people in the US who dont have insurance are the slackers who dont deserve to be healthy or live very long.

I admit that I am a slacker, but I have told everyone here how to have their health insurance paid for by the US government - other taxpayers. Perhaps not in full, but at least for the most part. Perhaps not for all people, but for most.

Most people deserve to healthy and to live for a reasonable length of time.

[John P Lebens]

The USA health care system is clearly not the best in the world. It costs more per capita than an other country (on average twice as much) and our health outcomes are 37 out of 50 according to the WHO. With all the smoke, mirrors and noise about the current health care proposals, I have to ask - can we wake up and smell the coffee? We are America - why can't we put together a system that is affordable and effective? Most of the other countries have sorted this out already - what are we waiting for?

[AussieBarney]

I just had an experience with our health care system. even though they are saying it is a dying basket case, I was through the system so fast my head spun. As i said in another thread. I presented to emergency and said " I need to see someone about these chest pains" Within three minutes I was on a gurney with an angel hooking me up to the machines. Thirty hours later I had a a stent installed in my coronary artery. this was done with professionalism and care of the highest order. being a pensioner I did not have to pay a zac for it. As I said thank the great spirit I am Australian.

[purri]

For OZ rating ranters, please note the criteria.

[downthecreek]

Superb health care is undoubtedly available in the USA. The system of health care is a different matter.

[Rapelapente]

I suspect systems where the wealthy pay for the care (single payer systems supported by taxes on the rich) gets high scores.

In France, rated N°1(, didn't know that ...), the global care system's cost is supported by social taxes and income taxes for the deficits...

The social taxes are calculated differently according to the origin of your earnings:

On salaries: about 8 %
On Pensions: 7,1 %
On financial income (stocks, buildings rents, etc... ): 12,1 %
These contributions are partially non deductible ( for 30 to 70 %, according on the origin) of your global income, so you'll pay taxes on taxes....

So ALL the incomes are taxed. Two times for a part, since you pay taxes on the non-deductible social taxes...

Of course the deficits (20 billions this year...) are paid on the National budget.
The National budget is mainly alimented by, the income taxes,(paid by 50% of the families only, which can goes up to 40 % of the income), the V.A.T, (19,6 % of quite all purchases, and about 5% on food purchases), by the fuel taxes ,we currently pay 1,15 € a gas liter(4,37 € a gallon,6,5 $ at the current rate...) , and a lot, lot more taxes on about all you can do, buy, inherit, donate...
A little confusing I agree, and I made it much more simpler than it actually is...
In fact we may be rated N°1 about global care system, but we are also rated N°1 about taxes (we even passed Sweden...).
Beside that, our system works, so far.
My job is to be part of it. I can see "inside" of it.
And even if I belong to the Full tax payer category, I want to keep it.
The poorest part of our population has about the same care than the wealthiest.
Whatever medical care needed is provided to all of us, whatever the cost , whatever your income.
I don't want to see that changing.

[John Smith]

One facet of this that is seldom discussed is the impact of stress on our health.

Our system of healthcare actually adds to that stress.

Imagine for a moment, if you can, living without concern of health care. Knowing that if you need medical attention, you don't have to worry about how to pay for it. Or knowing that if you lose your job, you still have health insurance without having to do anything to get it.

[TimH]

We are America - why can't we put together a system that is affordable and effective? Most of the other countries have sorted this out already - what are we waiting for?

Especially when we have 36 better systems to base ours on.

Too many profit takers in the health care industry. I say get a complately new system in place and wipe out the old one entirely. Including its execs.

[George Roberts]

Rapelapente ---

I am glad you like your health care system. When you treat food and shelter with the same type of system, you will be enlightened.

You don't treat food and shelter like health care, because you feel you have the ability to obtain sufficient food and shelter on your own. And you feel you are unable to obtain sufficient health care on your own.

You don't want health care for others. You want health care for yourself. And you are willing to force the rich to pay for it.

So how should we feel about forcing the rich to pay for our needs? It seems like theft to me.

[Stan D]

Especially when we have 36 better systems to base ours on.

Too many profit takers in the health care industry. I say get a complately new system in place and wipe out the old one entirely. Including its execs.

Just the insurance companies. They suck up about 30% of the money that passes through them. Medicare and Medicaid do the same job for only 2%.

[oznabrag]

...
So how should we feel about forcing the rich to pay for our needs? It seems like theft to me.

Our present system is DEFINITELY theft.

It's really weird how you object to re-distribution of wealth ONLY when it flows from rich to poor. Poor to rich you got no problem with. In fact, you seem to take it as the God-given RIGHT, nay, DUTY of the rich to rob the poor blind.

[Cuyahoga Chuck]

It depends on what are you mean by "health care system".
If you're talking about the smarts and the technology that is the basis of our system we have a lot of it and much of it is at the frontiers of medicine.
If you are talking about how all this good stuff is supplied to the populace the answer is much less satisfying.

[TimH]

Just the insurance companies. They suck up about 30% of the money that passes through them. Medicare and Medicaid do the same job for only 2%.

Well there ya have it. Thats the answer.

[Rapelapente]

Medicare and Medicaid do the same job for only 2%.

That's why I'm rather optimistic for your changes.
The French public system's management costs 6.5 %. This over cost comes mainly from the incredible advantages public workers have, and their subsequent inefficiency...
The respect of public money seems much bigger in US and we DO have lessons to get from you on that point !

To Georges:
About the "theft": one forumite stated on an other thread that 60 % of personal bankruptcies in US came from Medical bills... When this happens to somebody who just lost his insurance by losing his job, and paid previously regularly his insurance's fees ,is'nt it theft ????

About the food and shelter : Yes ,we do have a similar protection system for that, and paid on the same budget. But it was'nt the subject of the thread.

As I said previously, the "poors" are paying too for their protection, through their salaries and all their purchases, V.A.T, fuel taxes etc...

And may be I misunderstood (..my so poor english ) your answer about my ability to pay my own health care, but be reassured, I do can afford it. I said I'm on the full tax payer side. I could even afford a top of the line health care in the US...

[Chris Coose]

You only hear this quote from people who have actively stood by and done nothing to correct the problem.

the dubbya, for example, had all the information at hand, he ignored the millions without insurance, knew of the corruptions by big pharmacy the corruptions of the insurance pukes and did nothing, while simply exclaiming, "the US has the best health care system in the world."

The neoshitbirds fall in line and say it over and over.
It is simply not true and this topic question should never be a part of the discussion in the forward motion to fix the thing that is in a fatal state.

[Antonio Majer]

3 San Marino

this is quite comic...a little village, specialized in laundering money coming from tax-dodge in Italy...put there just to make the following others sink...

the French system is a model, just like UK was before Thacher's reign. I don't understand how it may be possible that Germany is 25, it's a nonsense.

And about my dear country: the quality of the Italian medical system is very different among the country, changing from very good to very bad, according to the area; but to live longer and longer, I guess we count more on the beauty and lightness of the Italian style of living then on the average quality of our health care system, especially in South Italy...

[George Roberts]

That's why I'm rather optimistic for your changes.
The French public system's management costs 6.5 %. This over cost comes mainly from the incredible advantages public workers have, and their subsequent inefficiency...
The respect of public money seems much bigger in US and we DO have lessons to get from you on that point !

Your misunderstanding of Medicare is amazing. The benefit of Medicare is the discount that Medicare demands. You need to compare what Medicare pays for a procedure to the list price of the procedure. Let's say it is much more than 2%.

Insurers also get a similar discount. Do insurers increase health care cost by 30%? No. It might be proper to say that the insured pay a 30% premium above their risk for the insurer to accept the risk, but that happens on all forms of insurance. If you want to play that type of game, you need to oppose all forms of insurance and need to want the government to handle all insurance.

To Georges:
About the "theft": one forumite stated on an other thread that 60 % of personal bankruptcies in US came from Medical bills... When this happens to somebody who just lost his insurance by losing his job, and paid previously regularly his insurance's fees ,is'nt it theft ????

The employee also lost his wages and other benefits that came with having a job. Perhaps we sould have the rich pay for those benefits thorough a government program.

Health care insurance is available to almost all. A nice high deductible policy would have removed the health care cost component of the bankruptcy proceedings. And for most at very little cost. The employee made a poor choice. (Much like all the people who got sub-prime home loans and then defaulted.) Don't blame the system because people make poor decisions.

And may be I misunderstood (..my so poor english ) your answer about my ability to pay my own health care, but be reassured, I do can afford it. I said I'm on the full tax payer side. I could even afford a top of the line health care in the US...

I am glad you can afford your health care. I prefer to pay an insurance company to accept my risk and pay for my care. (I pay less than $6K/year for insurance. I had over $200K in claims this year. I will be 90 or so before I pay enough premiums to cover my claims. I appear to be a winner, if that is the proper word for one who needs that much health care.)

[Rapelapente]

the French system is a model, just like UK was before Thacher's reign. I don't understand how it may be possible that Germany is 25, it's a nonsense.

The French system might appear like a model, but is still much improvable, specially on the financial efficiency.
To keep it, we must reduce the waste of money coming from the poor management.
We also have to cope with quite a lot of abusers, not only from immigrants, but also from native French people, profiting of the system, and making "Black money" in undeclared jobs.

I agree, Antonio, the German 25th rank seems weird !

[Nicholas Carey]

To Georges:
About the "theft": one forumite stated on an other thread that 60 % of personal bankruptcies in US came from Medical bills... When this happens to somebody who just lost his insurance by losing his job, and paid previously regularly his insurance's fees ,is'nt it theft ????

The 60% bankruptcy figure (it's actually 54.5%, but what's a few percentage points among friends) comes from the article, "Illness And Injury As Contributors To Bankruptcy" (Himmelstein et al.), published in 2001 in Health Affairs: the Policy Journal of the Health Sphere. You can download the article in PDF form here.

Abstract
In 2001, 1.458 million American families filed for bankruptcy. To investigate medical contributors to bankruptcy, we surveyed 1,771 personal bankruptcy filers in five federal courts and subsequently completed in-depth interviews with 931 of them. About half cited medical causes, which indicates that 1.9-2.2 million Americans (filers plus dependents) experienced medical bankruptcy. Among those whose illnesses led to bankruptcy, out-of-pocket costs average $11,854 since the start of illness; 75.7 percent had insurance at the onset of illness. Medical debtors were 42 percent more likely than other debtors to experience lapses in coverage. Even middle-class insured families often fall prey to financial catastrophe when sick.

Here's the nutshell table:


The authors are:

David Himmelstein is an associate professor of medicine at Harvard Medical School and a primary care physician at Cambridge Hospital in Cambridge, Massachusetts.

Elizabeth Warren is the Leo Gottlieb Professor of Law at Harvard Law School in Boston. She was chief adviser to the National Bankruptcy Review Commission.

Deborah Thorne is an assistant professor in the Department of Sociology and Anthropology at Ohio University in Athens.

Steffie Woolhandler is an associate professor of medicine at Harvard, where she codirects the General Medicine Faculty Development Fellowship Program. She practices primary care internal medicine at Cambridge Hospital.

But wait...there's more!

Since 2001, things have changed, health care costs and insurance premiums have skyrocketed, economy in the tank and bankruptcy rules tightened due to the Congress' passage of the Credit Card Company Protection Act of 2005. The same team has published a new study, "Medical Bankruptcy in the United States, 2007: Results of a National Study", in the August 2009 issue of The American Journal of Medicine.

Abstract

Background
Our 2001 study in 5 states found that medical problems contributed to at least 46.2% of all bankruptcies. Since then, health costs and the numbers of un- and underinsured have increased, and bankruptcy laws have tightened.

Methods
We surveyed a random national sample of 2314 bankruptcy filers in 2007, abstracted their court records, and interviewed 1032 of them. We designated bankruptcies as “medical” based on debtors' stated reasons for filing, income loss due to illness, and the magnitude of their medical debts.

Results
Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income. The rest met criteria for medical bankruptcy because they had lost significant income due to illness or mortgaged a home to pay medical bills. Most medical debtors were well educated, owned homes, and had middle-class occupations. Three quarters had health insurance. Using identical definitions in 2001 and 2007, the share of bankruptcies attributable to medical problems rose by 49.6%. In logistic regression analysis controlling for demographic factors, the odds that a bankruptcy had a medical cause was 2.38-fold higher in 2007 than in 2001.

Conclusions
Illness and medical bills contribute to a large and increasing share of US bankruptcies.

You can get the PDF at http://download.journals.elsevierhea...4309004045.pdf

[George Roberts]

Nicholas Carey ---

Look very carefully at the threshold used - $1000 of medical expense.

Certainly $1000 of medical expense in the past 2 years is important for poor people, but it is certainly not sufficient to declare bankruptcy. I expect those owed the $1000 will not even try to collect from the poor. And those who are not poor enough have the ability to pay the $1000. (Of course, there are those lawyers who make a large profit by having the near poor declare bankruptcy.)

The average medical expense, $11K, is not enough to cause many working to declare bankruptcy.

I suspect the loss of 2 or more weeks of work is a more important cause of the bankruptcies. After that time period many employers need to replace the worker. But that has nothing to do with medical expenses.

---

Perhaps you should do a poll:

How much in medical expense would cause you to declare bankruptcy:

$1-10K
$10-50K
$50-100K
$100-200K
Over $200K

[Nicholas Carey]

Nicholas Carey ---

Look very carefully at the threshold used - $1000 of medical expense.

Certainly $1000 of medical expense in the past 2 years is important for poor people, but it is certainly not sufficient to declare bankruptcy.

I believe if you actually read the study, you'll discover that the median unexpected medical expense that pushed people into bankruptcy was about $4,500 US.

It isn't much, but if you are in a precarious position to start with, it doesn't take much to push you over the precipice.

One thing to note as well: 3/4 of those declaring medical bankruptcies had health insurance at the start of bankrupting illnesss. 40% of those lost their insurance at least temporarily by the time they declared bankruptcy.

[capt jake]

One thing to note as well: 3/4 of those declaring medical bankruptcies had health insurance at the start of bankrupting illnesss. 40% of those lost their insurance at least temporarily by the time they declared bankruptcy.

Get sick, lose job, lose insurance.....No income...simple and very sad...