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US health system ranks last compared with peer nations – report

theguardian.com

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

#171

Post by anal_reactor »

inglor_cz wrote: post #162
benterix wrote: post #140

Earlier quoted context omitted.

> 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…

While I can see populist parties pushing for an agreement with Russia, it would be a ridiculous move because it would completely split EU into two parts: Russia-lovers (countries that don't border Russia) and Russia-haters (countries that do border Russia).

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

#172

Post by mytailorisrich »

pjc50 wrote: post #161
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…

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.

The issue with the debate over "free at the point of use" is that it is often framed as two extremes: It's either free or we'll have the same as the US where people are pushed out of healthcare on price (ignoring the counter-examples of most other developed countries).

But in reality there is a vast continuum between "free" and prohibitively expensive. There is also of course the option that some categories get "free" care in any case (like prescriptions now, which in England are £9.90 in general but 0 for children and people on specific benefits).

"Free at the point of use" is totemic of the NHS and any suggestions of change are rejected as a matter of quasi-religion (which can be seen in a few comments here to some extent)

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

#173

Post by inglor_cz »

anal_reactor wrote: post #171
inglor_cz wrote: post #162

Earlier quoted context omitted.

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…

While I can see populist parties pushing for an agreement with Russia, it would be a ridiculous move because it would completely split EU into two parts: Russia-lovers (countries that don't border Russia) and Russia-haters (countries that do border Russia).

I agree that it would be a ridiculous move that would split the EU, but people have done such things in the past anyway.

The French discarded all the credibility gained through their extremely bloody victory in WWI by not helping Czechoslovakia and Poland in 1938-9. Prior to that, France was admired and followed by a dozen countries in Central and Eastern Europe which sought to emulate it. Nowadays, meh. It has been almost 90 years since the moment of French weakness and the trust is still not repaired.

Putin himself started a major land war with barely 200 000 soldiers against the second largest country in Europe. Any serious military planner would say that it is not nearly enough to ensure victory, and many people including me in fact considered the whole thing a bluff just by looking at the inadequate numbers. Yet here we are, in precisely the sort of unwinnable war of attrition that is the result of such a bad decision. It may yet end Russia as a power, not directly through the force of arms, but through later destabilization.

People are experts on stupid decisions, especially if they feel in a Zugzwang. I am not sure what German social democrats are going to do if their labor unions start to seriously push them. The threat of losing important factory jobs is potentially very destabilizing for the established left wing of the German political spectrum.

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

#174

Post by CaptainZapp »

evnix wrote: post #163
jorvi wrote: post #145

Earlier quoted context omitted.

> 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.

You can absolutely walk in an have an MRI made at any time.

It's just not paid for by your health insurance.

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

#175

Post by tmaly »

evnix wrote: post #71
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…

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 had to visit the ER in Philippines.

In US we sit there for 5-7 hours and see a nurse practitioner.

In Philippines we were in an out in 2 hours and saw two doctors.

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

#176

Post by archagon »

vkazanov wrote: post #165
vidarh wrote: post #33

Earlier quoted context omitted.

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…

How much do you pay for your private insurance?

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

#177

Post by attendant3446 »

evnix wrote: post #99
calgoo wrote: post #89

Earlier quoted context omitted.

I had some pain in my lungs and they gave me an xray in about 30 minutes here in Spain to confirm that i had pneumonia. I waited 45 min to see the doctor in the emergency room and then another 10min waiting for the doc to check the xrays.

Yeah you need to know the keywords in EU, "pain in chest", "seizures". After which the emergency treatment is quite good. But for the majority, it isn't great. You go with pain in stomach and it happens to be cancer, you die waiting. I personally have seen so many of these and it's heartbreaking.

That is true, but it also varies from country to country. In Sweden I haven't been able to see a doctor in 1.5 years. In Germany, the waiting time is ridiculous, usually 1-3 months, but if you choose your doctors (Google Maps is the best catalogue for almost everything) - you get the results and 99% of it is covered by statutory insurance.

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

#178

Post by JeremyNT »

pjc50 wrote: post #161
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…

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.

> 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.

For what it's worth (don't let the politicians tell you otherwise) the US is the exact same way.

Here, because it's all about profit and margins are so thin, there's no slack in the system. It takes literally months to book an appointment with my primary care doctor. If you aren't already "established" it might take even longer.

Tests for not-immediately-life-threatening things are the same way. You get the next available slot which could be weeks or months out.

There aren't free slots floating around because they want all the staff busy all the time.

And you might think "well can't you pay extra to get to the front of the line?" The answer is well... I can't. Maybe there's some income level that this is possible or secret handshake, but it's not accessible to middle class people.

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

#179

Post by betaby »

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…

> One thing that's surprised me about the US is the general slowness of most things.

... and there is Canada

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

#180

Post by triceratops »

shiroiushi wrote: post #70
netsharc wrote: post #59

Earlier quoted context omitted.

Obama himself has said to that Obamacare (well ACA) is like (to use my own analogy) a "patch" on a a system that can't just be reimplemented (most of it due to political reasons). It's not terrific but it's what was able to be done. Whereas e.g. single payer was an unachievable pipe dream from where they were standing in 2008/09. And he'd rather have something a bit better rather than go for the excellent system and…

And why was it "an unachievable pipe dream"? As I remember it, the Democrats had control of both houses of Congress, as well as the White House, for about 2 years. They could have passed anything they wanted.

You're remembering wrong. They had a super-majority for only about 6 months. After that Republicans could hold up legislation via filibustering.

https://en.wikipedia.org/wiki/2010_United_States_Senate_spec...

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