US health system ranks last compared with peer nations

Re: US health system ranks last compared with peer nations – report

#161

Post by pjc50 » Thu, Sep 19, 2024, 9:38 AM UTC

Propelloni wrote: post #138

l5870uoo9y wrote: post #93

The UK performs better (third place) than, for example, Germany (second last place). The UK's healthcare system is often heavily criticized as being on the brink of collapse - any explanation for this?

The actual report [1] says it took five domains into account: a) access to care, b) care process, c) administrative efficiency, d) equity, and e) health outcomes. Read the linked summary. To summarize the summary: from 10 investigated countries, 9 are in the same ballpark. The US is an extreme outlier, bad in almost anything and expensive to boot. The NHS being in trouble is apparently orthogonal to these domains. It…

The NHS manages demand by rationing with queues rather than prices. That seems not to be accounted for. You get great care once they get round to you, but people routinely wait months or years in pain for fairly routine treatments.

I don't really know what the answer is because eroding "free at the point of use" will also push a load of people out of healthcare.

Re: US health system ranks last compared with peer nations – report

#162

Post by inglor_cz » Thu, Sep 19, 2024, 9:43 AM UTC

benterix wrote: post #140

inglor_cz wrote: post #128

Earlier quoted context omitted.

Well, they are engaged in constant low-level conflict with Russia, so their systems must be pretty hardened against hostile incursions already. If there is one EU region where digital security must be taken as a life-and-death matter, it is the Baltics. In case of weakening of NATO, they are the foremost candidates for the next Special Military Operation.

> In case of weakening of NATO, they are the foremost candidates for the next Special Military Operation. I guess the odds of Trump winning are much lower than a couple of months ago. And even if he wins, if he follows with his stupid plan of giving Ukraine to Putin, he will be criticized by all sides. So losing a Baltic state would be another bitter blow and he probably would want to avoid that as he wants to appear…

It is not really just about Trump. It is quite obvious at least since Obama that US strategic interests are reorienting towards Southeast Asia, which is understandable as half of humanity lives there.

And even with a friendly administration, it can feasibly happen that there will be more crises unfolding at the same time than the US is capable of efficiently addressing. (Say, Ukraine and Israel and Taiwan.)

I wonder how much of a choice the other countries have. Being a European and observing European political patterns, I am very sure that Finland, Sweden, Denmark and most of the former Soviet satellites will continue to support Ukraine because they know what is at stake for them. The UK may as well, given that the dislike between England and Russia goes a long way back.

But there are influential people in Germany (and I am not talking about the AfD here, but about the industrial lobby) constantly pushing in the back rooms for reconciliation with Russia at any cost, because high energy costs have made a mess of the German economy, and I can see something like a repeat of the Munich betrayal of 1938 in the future. At this phase of the war, Putin would be open to such an agreement with Germany. Not even his wildest plans foresee a re-subjugation of the former GDR, so Germany risks "nothing" (well, a lot of goodwill east of the Oder, but that may be an acceptable tradeoff for the businesspeople).

And the more distant countries such as Spain or the Netherlands or Belgium aren't really that much interested in Eastern European affairs, all the verbal proclamations notwithstanding. Although NL has some unsettled business against Russia with regards to that shot down airliner.

Re: US health system ranks last compared with peer nations – report

#163

Post by evnix » Thu, Sep 19, 2024, 9:55 AM UTC

jorvi wrote: post #145

evnix wrote: post #88

Earlier quoted context omitted.

Condition is if "your doctor orders it" and how long does it take to get to that doctor if it isn't an emergency. I don't about Switzerland but it is quite bad in majority of EU countries. And Why can't you just walk in to a clinic to get x-rays and tests done like it is in done elsewhere. Have clinics compete for price. The other part no one mentions is the utter cheating that goes on in statistics to show that the…

> And Why can't you just walk in to a clinic to get x-rays and tests done like it is in done elsewhere. Have clinics compete for price. Because false negatives are a massive problem. People get biopsies or treatments for things that never needed it, which is ultimately worse for their health (on average) than catching the rare time it is something.

There is no stats to what you are speaking. General People not being able to get to doctor in months is a bigger problem than a rare false negative.

This also reduces burden on doctors. If the only thing your doctor does is prescribe antibiotics and orders scans. Why not do it yourself and get treated early.

Re: US health system ranks last compared with peer nations – report

#164

Post by tester89 » Thu, Sep 19, 2024, 9:59 AM UTC

arjie wrote: post #36

One thing that's surprised me about the US is the general slowness of most things. In India, you can get MRIs and CT Scans same day. Or you could the last time I was there. And it didn't cost very much in comparison. My doctors have all been good (attested to by my parents who are surgeons themselves) but the healthcare system is wonky. One thing I didn't expect is that the Indian system where you just drag your heal…

Can the median income Indian citizen get such service? Chances are no. This report is about the average case. Extremely rich Americans, just like extremely rich Indians can probably get faster service.

Re: US health system ranks last compared with peer nations – report

#165

Post by vkazanov » Thu, Sep 19, 2024, 10:02 AM UTC

vidarh wrote: post #33

naming_the_user wrote: post #2

What does the ranking look like if you compare percentiles? Naively I would assume as a non-American that if you're in the top 20% by income in the US you end up much better off than the top 20% income Brit, for example. Or is it just actually worse for everyone? It feels intuitively obvious that the average will be worse because, well, the average person is skint and the US is less socialist.

As someone in the UK with income in the top 1%, I have never bothered with private insurance because I genuinely don't feel I need it. I occasionally pay for private GP services, and I've paid for some private services for my son, but for the most part the NHS works. It has waiting times for non-essential things, and if you don't want that, you can pay for insurance that gets you seen faster and it costs a pittance.…

As someone in the same income range, and many friends in comparable spot, I have to say that NHS is sometimes ok.

Here's an NHS case.

Case 1. My friend's wife had her body going numb, like, completely senseless. They didn't have a private insurance back then. It was maddening hard to get past the GP. And then there were numerous tests, and queues, and... She had a viral brain infection that was, luckily, easy to fix. Could go horribly wrong should they wait for a couple more months.

The problem is that GPs are afraid to assign tests other than the most simple blood tests (unless it's an obviously broken bone).

Case 2. My wife fainted in the middle of a family dinner. It looked serious, and I recognized the sympthoms thanks to dr. ChatGPT. Our car was at service that day. I was trying to get an ambulance but calling all the publicly available NHS numbers but all we got were endless questioneers. We had to force the situation by taking a taxi right to the hospital door. She had an urgent surgery the same evening, quite serious.

Again, there's just TOO MUCH backpressure from NHS at the entrance. Once you get past these filters, it actually it decent.

OTOH, with my highest tier private insurance I had an MRI scans, kidney checks, blood tests all done within a week or two, mostly because of how I had to coordinate things between various private clinics. Not fast, sure, but acceptable.

Re: US health system ranks last compared with peer nations – report

#166

Post by Yizahi » Thu, Sep 19, 2024, 10:04 AM UTC

benterix wrote: post #129

evnix wrote: post #71

Earlier quoted context omitted.

The general slowness extends to simple things like x-rays and blood tests too. This is not just US but whole of the west seems to have the exact same attitude. Most of Asia has same day or next day medical tests. In India you can order something like UberEats where in a technician comes home collects your blood samples and the results are emailed within the next 24 hours or so. Medicine seems to be commoditzed in the…

I live in Europe and if I take a blood test at 7 am I can usually check the results online by 1 pm.

Blood test yes, MRI - no. In the Ukraine I can go to the M24 center, and yes, 24 means it is literally working 24/7/365. And I don't need doctor's referral to do it. In EU I had to wait 2 months and have doctors referral, and that was lucky window I caught by chance. Other people report waiting much longer.

To get to the specialist doctors is also hard in EU, compared to the Ukraine. Here I had to wait between 1 to 3 months to a lot of specialists. And if any mistake in the referral is made, then wait need to be repeated.

Example - I got a referral for the retinal diag. But to do it 15 mins before the test eye drops are administered (atropine) to dilate pupils. Apparently I have needed to have two referrals - one for the drops, and another for the diag itself, and I got only the second one (made by an eye doctor in the same clinic, so regular staff). So I have waited months, and was denied the procedure, then a spend a week on a phone and visiting clinics in person to sort this out. Then I got proper referral (haha, actually not even then, they simply caved and allowed me to do it with what I had) and had to wait a month again to do a simple check which would take me a hour at any arbitrary day in Ukraine.

Re: US health system ranks last compared with peer nations – report

#167

Post by foldr » Thu, Sep 19, 2024, 10:09 AM UTC

armitron wrote: post #144

Propelloni wrote: post #138

Earlier quoted context omitted.

The actual report [1] says it took five domains into account: a) access to care, b) care process, c) administrative efficiency, d) equity, and e) health outcomes. Read the linked summary. To summarize the summary: from 10 investigated countries, 9 are in the same ballpark. The US is an extreme outlier, bad in almost anything and expensive to boot. The NHS being in trouble is apparently orthogonal to these domains. It…

Are you living in the UK or just making baseless assumptions? For an ever-inceasing number of serious health issues, the NHS has been essentially non-functional for many years. I have friends with chronic conditions that are looking to emigrate becase they're dreading their health getting worse in a system that's doing nothing to help them. "NHS would be great except for the bad politicians" is not a serious argument…

It's underfunded. I'm willing to bet that the countries they're thinking of moving to either spend more on healthcare as a proportion of GDP than the UK does or don't have healthcare that's free at the point of use (or both).

Re: US health system ranks last compared with peer nations – report

#168

Post by piva00 » Thu, Sep 19, 2024, 10:21 AM UTC

evnix wrote: post #88

CaptainZapp wrote: post #76

Earlier quoted context omitted.

> The general slowness extends to simple things like x-rays and blood tests too. This is not just US but whole of the west seems to have the exact same attitude. In Switzerland I get an MRI within 48 hours if my doctor orders it. Mind you, healthcare is also very expensive comparatively but the quality is very high and coverage is extensive.

Condition is if "your doctor orders it" and how long does it take to get to that doctor if it isn't an emergency. I don't about Switzerland but it is quite bad in majority of EU countries. And Why can't you just walk in to a clinic to get x-rays and tests done like it is in done elsewhere. Have clinics compete for price. The other part no one mentions is the utter cheating that goes on in statistics to show that the…

> And Why can't you just walk in to a clinic to get x-rays and tests done like it is in done elsewhere. Have clinics compete for price.

I hope you are aware that these also exist in many EU countries, private clinics aren't banned because of public healthcare, you can purchase private health insurance in many countries, I can't say all because I don't know the intricacies of every country's system since this is a national policy and each member-state is free to run their own systems.

Here in Sweden I have private health insurance through my employer, I cannot go directly to a clinic for imaging, etc. since it needs a referral from a doctor but it's quite simple and when I needed I had many choices of private clinics to do a MRI. If you don't have insurance you can definitely pay out of your own pocket, both for a private doctor as for exams.

Re: US health system ranks last compared with peer nations – report

#169

Post by jq-r » Thu, Sep 19, 2024, 10:25 AM UTC

A_D_E_P_T wrote: post #146

benterix wrote: post #129

Earlier quoted context omitted.

I live in Europe and if I take a blood test at 7 am I can usually check the results online by 1 pm.

Same. But in Croatia where things are a little bit... well... different. For instance, I don't need a prescription to buy (almost) any drug in the pharmacy. And I don't need a prescription or referral for any medical exams or blood tests; I can order them myself. Asia is like this, but Europe to the north and west of Croatia really isn't. I believe that things in the UK and Germany might be a lot slower and much more…

Well some relatively common things are easy to get in Croatia (bloodwork and meds - GPs like to prescribe those to get rid of you), more serious like exams, treatments, surgeries are absolutely terrible with waiting lists which are years long. People are dying, and/or their condition worsens before they even see a specialist. This is common knowledge for many years now.

Private clinics are opening left and right with the same(!) doctors working in both public and private clinics. Also corruption is rampant allowing doctor's friends to jump lines and that also happens for money/favors. So if you're not rich enough to go to a private clinic your second best option is bribes/corruption/nepotism. And if you don't have the latter, you're frankly fucked.

Re: US health system ranks last compared with peer nations – report

#170

Post by iteria » Thu, Sep 19, 2024, 10:29 AM UTC

mattclarkdotnet wrote: post #152

arjie wrote: post #36

One thing that's surprised me about the US is the general slowness of most things. In India, you can get MRIs and CT Scans same day. Or you could the last time I was there. And it didn't cost very much in comparison. My doctors have all been good (attested to by my parents who are surgeons themselves) but the healthcare system is wonky. One thing I didn't expect is that the Indian system where you just drag your heal…

Australia checking in and agreeing, usually same day or even within a few hours for MRI, x-ray and ultrasound. Next day for CAT. Centralised records so each practitioner can see the full history. Oh and blood tests done with max 30 minute wait and then results in 48h

Same and I'm American.

Although as an American, I always struggle with blanket statements because we have wildly different standards for literally everything depending on where you are. I live in a major city that isn't LA or NYC or something like that. all of my medical records are digitized too. All my doctors can look at everything an urgent care, hospital, regular doctor did. But also my sister who lives in nowhere, USA has to deal with paper everything and long delays. The US is both 1st and 3rd world depending on what area you're talking about.