European healthcare
Aug 24th, 2007, 04:06 AM
#541
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Keep in mind that costs in the USA are partly driven by service expectations. I expect that if my doctor thinks it would be a good idea for me to have an MRI for my sinus condition that I'll be having that MRI within a couple of hours. Doesn't bother me to pay more for that service. Because I'm willing to pay more for it, there are more MRI sites available for everyone, even those on Government medical programs.
Aug 24th, 2007, 04:47 AM
#542
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>>>We don't know if the cancer would have developed or not.<<<
No, we don´t. I was just trying to figure out why there is no significant difference in women´s cancer survival rates in the US and Europe, but there is a difference in men´s survival rates.
is it now like this: an European and an American man on 60 developes a prostate cancer. The American one is screened, and operated accordingly. They both trot on, and the American man´s cancer does not come back. They both get a heart attack at the age of 80, and die. The American man goes to cancer survival statistics, his European counterpart is nowhere in the statistics, except in the heart attack ones.
No, we don´t. I was just trying to figure out why there is no significant difference in women´s cancer survival rates in the US and Europe, but there is a difference in men´s survival rates.
is it now like this: an European and an American man on 60 developes a prostate cancer. The American one is screened, and operated accordingly. They both trot on, and the American man´s cancer does not come back. They both get a heart attack at the age of 80, and die. The American man goes to cancer survival statistics, his European counterpart is nowhere in the statistics, except in the heart attack ones.
Aug 24th, 2007, 05:05 AM
#543
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...but prostate cancer is just one cancer, and the claim is that US male recovery rates are higher for all cancers, taken together.
There is of course a completely different explanation, because the male/female discrepancy seems to rule out the system as an explanation.
It's a commonplace among British doctors that men won't go to the doctor for anything, and that cancer symptoms in particular come to light far too late among British men. Though we tend not to value macho-ness much, we really do regard visiting a doctor as seriously wimpish. My experience is American men are very different from us in this (to the point of striking us as downright cissy), while British and American women seem about the same as each other in their propensity to seek a doctor's help.
Can't speak for the chaps across the Channel - but could this be the real explanation?
There is of course a completely different explanation, because the male/female discrepancy seems to rule out the system as an explanation.
It's a commonplace among British doctors that men won't go to the doctor for anything, and that cancer symptoms in particular come to light far too late among British men. Though we tend not to value macho-ness much, we really do regard visiting a doctor as seriously wimpish. My experience is American men are very different from us in this (to the point of striking us as downright cissy), while British and American women seem about the same as each other in their propensity to seek a doctor's help.
Can't speak for the chaps across the Channel - but could this be the real explanation?
Aug 24th, 2007, 05:08 AM
#544
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I'll ask again.
Would the Wyden proposals get more attention if they were proposed by Teddy, Hillary, Nancy, Joe(Biden) or others who seem less interested in solutions than their own reelection?
Has anyone here read any of Wyden's proposals?
Would the Wyden proposals get more attention if they were proposed by Teddy, Hillary, Nancy, Joe(Biden) or others who seem less interested in solutions than their own reelection?
Has anyone here read any of Wyden's proposals?
Aug 24th, 2007, 05:20 AM
#545
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"A family of 4 living in NYC (median income about $60,000) making the US median income can't afford health insurance if it isn't offered by the employer."
Ira - According the AMA proposal (pg. 21), premiums for privately purchased family health coverage average considerably less than employment-based family coverage ($3972 vs $10,456). The reason, according the the AMA, is that private purchases typically don't include a lot of extras (e.g., mental health, Viagra, etc.).
Aug 24th, 2007, 05:31 AM
#546
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>>>
...but prostate cancer is just one cancer, and the claim is that US male recovery rates are higher for all cancers, taken together.<<<
I know, but like Ira already said, US prostate cancer figures are the highest in the world. But I don´t believe for a second that there would be more prostate cancers there, in Europe and elsewhere they just go unnoticed, so there is not even a chance to end up in cancer survival statistics.
My husband was diagnosed with one just last year. He acted as a guinea pig for an American/Finnish research team, and the cancer finding was a total accident. He was healthy as a horse, so it was a surprise. He was treated, and the doctors said that a cancer that small would never have been found in a routine screening, so he would just have marched on, and propably died of old age without even knowing that he has cancer.
So now he is a in cancer survival statistics, a man who has never even seen a sick day, and who just went through a routine surgery.
...but prostate cancer is just one cancer, and the claim is that US male recovery rates are higher for all cancers, taken together.<<<
I know, but like Ira already said, US prostate cancer figures are the highest in the world. But I don´t believe for a second that there would be more prostate cancers there, in Europe and elsewhere they just go unnoticed, so there is not even a chance to end up in cancer survival statistics.
My husband was diagnosed with one just last year. He acted as a guinea pig for an American/Finnish research team, and the cancer finding was a total accident. He was healthy as a horse, so it was a surprise. He was treated, and the doctors said that a cancer that small would never have been found in a routine screening, so he would just have marched on, and propably died of old age without even knowing that he has cancer.
So now he is a in cancer survival statistics, a man who has never even seen a sick day, and who just went through a routine surgery.
Aug 24th, 2007, 05:37 AM
#547
"Has anyone here read any of Wyden's proposals? " Yes. I have the same objections as with the AMA proposal.
An anecdote for those who favor private insurance. I was recently in a car accident and taken to hospital by ambulance. The EMS outfit sent me a bill for the ambulance ($425 for a 10 minute ride). My medical insurance co. rejected it on the grounds that the provider was not part of the company's network of preferred providers. I called up and pointed out that no EMS company was listed as preferred, and the claim was resubmitted. Subsequently the EMS company was paid 80% by my insurance co. and 20% by me. I will soon have the fun job of getting the other party's auto insurance to pay all the bills associated with the accident, and will then have to reimburse my medical insurance company.
None of this totally unproductive activity would be necessary with a single payer system.
An anecdote for those who favor private insurance. I was recently in a car accident and taken to hospital by ambulance. The EMS outfit sent me a bill for the ambulance ($425 for a 10 minute ride). My medical insurance co. rejected it on the grounds that the provider was not part of the company's network of preferred providers. I called up and pointed out that no EMS company was listed as preferred, and the claim was resubmitted. Subsequently the EMS company was paid 80% by my insurance co. and 20% by me. I will soon have the fun job of getting the other party's auto insurance to pay all the bills associated with the accident, and will then have to reimburse my medical insurance company.
None of this totally unproductive activity would be necessary with a single payer system.
Aug 24th, 2007, 06:17 AM
#548
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Interesting argument raised by Elina.
According to the Cancer Research UK website (http://tinyurl.com/yfw49b - overview section), 23 out of 100 cancers diagnosed in UK men involve the prostate. You may also find the figure 12% of all cancers cited in places- I believe that refers to the total with respect to men and women combined.
In the US, the equivalent statistic is 30 out of 100 (http://tinyurl.com/38738p). A significant, but not dramatic, difference in the relative incidence of diagnosis.
US healthcare has a cancer-survival edge over western
Europe in more deadly cancers (http://tinyurl.com/2c83rg)
- prostate (81 percent vs. 56 percent)
- melanoma (86 percent vs. 76 percent)
- colon (60 percent vs. 47 percent)
- rectum (57 percent vs. 43 percent)
- breast (82 percent vs. 73 percent)
- uterine cancer (83 percent vs. 73 percent)
A minimum of a ten-percentage point survival advantage is indicated for all of these cancers.
According to the Cancer Research UK website (http://tinyurl.com/yfw49b - overview section), 23 out of 100 cancers diagnosed in UK men involve the prostate. You may also find the figure 12% of all cancers cited in places- I believe that refers to the total with respect to men and women combined.
In the US, the equivalent statistic is 30 out of 100 (http://tinyurl.com/38738p). A significant, but not dramatic, difference in the relative incidence of diagnosis.
US healthcare has a cancer-survival edge over western
Europe in more deadly cancers (http://tinyurl.com/2c83rg)
- prostate (81 percent vs. 56 percent)
- melanoma (86 percent vs. 76 percent)
- colon (60 percent vs. 47 percent)
- rectum (57 percent vs. 43 percent)
- breast (82 percent vs. 73 percent)
- uterine cancer (83 percent vs. 73 percent)
A minimum of a ten-percentage point survival advantage is indicated for all of these cancers.
Aug 24th, 2007, 06:27 AM
#549
Interesting paragraph in smueeler's last cite:
"If two of the patients had cancers that could not be effectively treated and caused their deaths in five years, both would have died in 1995. If the American’s cancer was detected by a screening test in 1991, the survival time since diagnosis would have been four years. If the European’s cancer was found in 1993 at a late stage, when it started to cause symptoms, the survival time would have been only two years. Although the American’s survival time after diagnosis was longer than the European’s, both lived the same time after their cancer developed. This apparent increase in survival time is called lead time bias."
That article also notes that only 10% of the US population was involved in the US study, does not cite the figure for Europe, which might well be 100%.
"If two of the patients had cancers that could not be effectively treated and caused their deaths in five years, both would have died in 1995. If the American’s cancer was detected by a screening test in 1991, the survival time since diagnosis would have been four years. If the European’s cancer was found in 1993 at a late stage, when it started to cause symptoms, the survival time would have been only two years. Although the American’s survival time after diagnosis was longer than the European’s, both lived the same time after their cancer developed. This apparent increase in survival time is called lead time bias."
That article also notes that only 10% of the US population was involved in the US study, does not cite the figure for Europe, which might well be 100%.
Aug 24th, 2007, 06:35 AM
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Aug 24th, 2007, 06:51 AM
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"Real clear politics":
"Even with all that, it strains credulity to hear that the U.S. ranks far from the top. Sick people come to the United States for treatment."
Ok, rarely has somebody been so far off the point.
"When was the last time you heard of someone leaving this country to get medical care?
Somebody who can´t afford the medical care in USA usually can´t afford to leave the country, too. But please...
>The WHO judged a country's quality of health on life expectancy. But that's a lousy measure of a health-care system. Many things that cause premature death have nothing do with medical care. We have far more fatal transportation accidents than other countries.
And why is that?
>Similarly, our homicide rate is 10 times higher than in the U.K., eight times higher than in France, and five times greater than in Canada.
When you adjust for these "fatal injury" rates, U.S. life expectancy is actually higher than in nearly every other industrialized nation.
The authors carefully avoided showing the numbers, because even the high homicide rates are actually tiny compared with the natural deaths.
It sounds so much "USA can´t be anything but the top".
>Another reason the U.S. didn't score high in the WHO rankings is that we are less _socialistic_ than other nations.
By using the S-word the authors get the sympathy of the conservatives. Nice to increase popularity, but it hardly does anything for the credibility of their theses... Although the artificial restrictions they listed do sound quite ridiculous - is it really true?
"Even with all that, it strains credulity to hear that the U.S. ranks far from the top. Sick people come to the United States for treatment."
Ok, rarely has somebody been so far off the point.
"When was the last time you heard of someone leaving this country to get medical care?
Somebody who can´t afford the medical care in USA usually can´t afford to leave the country, too. But please...
>The WHO judged a country's quality of health on life expectancy. But that's a lousy measure of a health-care system. Many things that cause premature death have nothing do with medical care. We have far more fatal transportation accidents than other countries.
And why is that?
>Similarly, our homicide rate is 10 times higher than in the U.K., eight times higher than in France, and five times greater than in Canada.
When you adjust for these "fatal injury" rates, U.S. life expectancy is actually higher than in nearly every other industrialized nation.
The authors carefully avoided showing the numbers, because even the high homicide rates are actually tiny compared with the natural deaths.
It sounds so much "USA can´t be anything but the top".
>Another reason the U.S. didn't score high in the WHO rankings is that we are less _socialistic_ than other nations.
By using the S-word the authors get the sympathy of the conservatives. Nice to increase popularity, but it hardly does anything for the credibility of their theses... Although the artificial restrictions they listed do sound quite ridiculous - is it really true?
Aug 24th, 2007, 07:16 AM
#552
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Hi sm,
>According the AMA proposal.., premiums for privately purchased family health coverage average considerably less than employment-based family coverage...The reason, according the the AMA, is that private purchases typically don't include a lot of extras ...<
That's why a Ford focus is less expensive than a Lincoln - doesn't include a lot of "extras".
My sister has the "basic" Blue Cross/Blue Shield plan for which she pays about $3000. Mine is the fancy one - about $10,000 for self and spouse.
I shall compare them without medicare. She has a $3000 deductible for medical and $1400 for RX. Min is $700 for Rx.
Her plan doesn't pay for vision care, mental health/substance abuse care, yearly physicals, as mine does. Her lifetime limit is $1M, mine is $2M.
Her yearly cost, insurance and out-of-pocket, is equal to or greater than mine, and she has less protection in case of major illness or injury.
This is because she is not part of a Group and has to pay retail prices.
>According the AMA proposal.., premiums for privately purchased family health coverage average considerably less than employment-based family coverage...The reason, according the the AMA, is that private purchases typically don't include a lot of extras ...<
That's why a Ford focus is less expensive than a Lincoln - doesn't include a lot of "extras".
My sister has the "basic" Blue Cross/Blue Shield plan for which she pays about $3000. Mine is the fancy one - about $10,000 for self and spouse.
I shall compare them without medicare. She has a $3000 deductible for medical and $1400 for RX. Min is $700 for Rx.
Her plan doesn't pay for vision care, mental health/substance abuse care, yearly physicals, as mine does. Her lifetime limit is $1M, mine is $2M.
Her yearly cost, insurance and out-of-pocket, is equal to or greater than mine, and she has less protection in case of major illness or injury.
This is because she is not part of a Group and has to pay retail prices.
Aug 24th, 2007, 08:25 AM
#554
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Sorry smueller... I couldn't let you away with it
Let’s forget that this study is from 2000.
Sm says “US healthcare has a cancer-survival edge over western Europe”
Western Europe???
Does it say that? No. The article says the “Eurocare countries”. Now these include Poland, Lithuania, Turkey, Romania, Estonia, Czeck Republic, Bulagaria, Cyprus, Poland, Latvia,”(Eastern Europe)
Hardly bastions of healthcare…some of these, you may remember, ranked even worse than the US 37th in the world placing.
“[Those most] affected bymalignant neoplasms of the larynx, trachea, bronchus and lung with 106 deaths per 100 000 inhabitants [are] …Lithuania (151 per 100 000), Estonia (152), Poland (162), Latvia (167), Slovakia (174), the Czech Republic (187) and Hungary (236).”
The lowest rates are in Sweden (39) and Finland (51).
The second term sm uses is:
“more deadly cancers”
Where did you get the term “more deadly”?
So what is the most deadly? #1 lung #2 stomach
Let’s forget that this study is from 2000.
Sm says “US healthcare has a cancer-survival edge over western Europe”
Western Europe???
Does it say that? No. The article says the “Eurocare countries”. Now these include Poland, Lithuania, Turkey, Romania, Estonia, Czeck Republic, Bulagaria, Cyprus, Poland, Latvia,”(Eastern Europe)
Hardly bastions of healthcare…some of these, you may remember, ranked even worse than the US 37th in the world placing.
“[Those most] affected bymalignant neoplasms of the larynx, trachea, bronchus and lung with 106 deaths per 100 000 inhabitants [are] …Lithuania (151 per 100 000), Estonia (152), Poland (162), Latvia (167), Slovakia (174), the Czech Republic (187) and Hungary (236).”
The lowest rates are in Sweden (39) and Finland (51).
The second term sm uses is:
“more deadly cancers”
Where did you get the term “more deadly”?
So what is the most deadly? #1 lung #2 stomach
Aug 24th, 2007, 08:54 AM
#555
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Elina's point was that Americans suffer disproportionately from prostate cancer, which is less deadly than lung or stomach cancer. The last two are "more deadly" cancers.
The qualifier "western" was inaccurate. Yet it is wrong to assume that less developed countries such as Poland are basket cases when it comes to healthcare.
The following is from a TimesOnline article from earlier this week titled "UK cancer survival rates are among the worst in Europe" (http://tinyurl.com/28qfr8) - "In general, five-year survival (generally a proxy for “cure”) is highest in Nordic Countries and Central Europe, intermediate in southern Europe, lower in the UK and Ireland, and lowest of all in Eastern Europe."
So, apparently, of the countries you listed, only the eastern European nations would bring down the average survival rates. What is the population of Bulgaria, Romania, Latvia and Estonia compared to the rest of the Eurocare nations? That would be measure of how likely poor healthcare in eastern Europe will affect overall European performance statistics.
The qualifier "western" was inaccurate. Yet it is wrong to assume that less developed countries such as Poland are basket cases when it comes to healthcare.
The following is from a TimesOnline article from earlier this week titled "UK cancer survival rates are among the worst in Europe" (http://tinyurl.com/28qfr8) - "In general, five-year survival (generally a proxy for “cure”) is highest in Nordic Countries and Central Europe, intermediate in southern Europe, lower in the UK and Ireland, and lowest of all in Eastern Europe."
So, apparently, of the countries you listed, only the eastern European nations would bring down the average survival rates. What is the population of Bulgaria, Romania, Latvia and Estonia compared to the rest of the Eurocare nations? That would be measure of how likely poor healthcare in eastern Europe will affect overall European performance statistics.
Aug 24th, 2007, 10:40 AM
#556
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Did a little fact checking at lunch and found another article, this one in the Daily Telegraph titled "UC cancer survival rate lowest in Europe" (http://tinyurl.com/2o55a8).
It describes a bleak picture of healthcare outcomes in the UK.
For example, "Britain was the exception. Despite spending up to £1,500 on health per person per year, it recorded similar survival rates for Hodgkin's disease and lung cancer as Poland, which spends a third of that amount."
It also quotes an article from the medical journal The Lancet Oncology - "We have good evidence that survival for lung cancer has been compromised by long waiting lists for radiotherapy treatment."
Apparently, the British healthcare system is overburdened (an argument against single-payer coverage), at least with regard to cancer care.
Aug 24th, 2007, 10:52 AM
#557
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"Apparently, the British healthcare system is overburdened (an argument against single-payer coverage), at least with regard to cancer care."
Yes, the British NHS system is overburdened. The statistics you quote are several years old, and may not reflect the increased spending recently. There is no reason to think that there will not be improvements in the next few years, as capacity is further increased.
How is the United States going to deal with the substantial number of its citizens who do not have access to any healthcare except the charitable provisions of the emergency room, or whose health insurance is now paying for a reduced level of treatment? Do you have a plan?
Yes, the British NHS system is overburdened. The statistics you quote are several years old, and may not reflect the increased spending recently. There is no reason to think that there will not be improvements in the next few years, as capacity is further increased.
How is the United States going to deal with the substantial number of its citizens who do not have access to any healthcare except the charitable provisions of the emergency room, or whose health insurance is now paying for a reduced level of treatment? Do you have a plan?
Aug 24th, 2007, 11:32 AM
#558
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How is the cancer survival rate for those 45 million Americans (about 15%) who are uninsured? I bet it is great because they are never diagnosed.
This 45,000,000 (larger than the population of Canada) includes a higher proportion of the poorer, non-white populace who are never screened but are at higher risk for all types of cancer.
Until there is universal healthcare, US lags behind nearly every other civilized country. Face it. Most agree.
End of story.
If you want more insult - you pay more for healthcare and people are getting rich because of the US insurance monopolies. (You didn't think it was non-profit did you?)
Rather be treated for cancer in the UK than not treated because of being unisured in the US.
This 45,000,000 (larger than the population of Canada) includes a higher proportion of the poorer, non-white populace who are never screened but are at higher risk for all types of cancer.
Until there is universal healthcare, US lags behind nearly every other civilized country. Face it. Most agree.
End of story.
If you want more insult - you pay more for healthcare and people are getting rich because of the US insurance monopolies. (You didn't think it was non-profit did you?)
Rather be treated for cancer in the UK than not treated because of being unisured in the US.
Aug 24th, 2007, 12:58 PM
#559
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RobJame - Yes, nearly 46 million Americans are uninsured, we already covered that. But, you are one of the posters that changed the subject to the question of whether or not those Americans that are covered are getting their money's worth. Thus the cancer statistics, etc. Now that you are faltering on this front, you want to regress back to the subject of universal coverage.
I've already offered US Census Bureau statistics indicating that nearly one-third of the uninsured in the US can likely afford it. That leaves 30 million, probably about 10 million or so are likely here illegally. Even illegals will receive emergency care (including disease treatment), they are not simply left to die.
Of course, that leaves 20 million legal Americans many of whom truly cannot afford coverage and are not eligible under Medicaid (qualifications vary from state to state). I agree that something should be done to address these individuals. They deserve coverage, especially those that are trying to hold jobs, etc. They are the truly deserving. An incremental approach, as opposed to a "universal" approach, will more effectively target these individuals.
On the other hand, I feel little sympathy for those that can afford health insurance and accept a "calculated" risk not to obtain it. Would you feel much sympathy for a single male in his twenties earning $60,000 per year that incurred financial difficulties because he simply didn't want to spend money on healthcare?
If such individuals become seriously ill or injured, they will be treated, but they will incur a financial penalty. Of course, they should be treated, but they foolishly took a risk and should accept the financial consequences. While I would likely have sympathy for their medical problems, I have no more sympathy for their financial situation than for the person that chooses not to purchase car insurance and then has to pay up when he has an accident.
By the way, American minorities are not "at higher risk for all types of cancer." Some, yes. All, no.
I've already offered US Census Bureau statistics indicating that nearly one-third of the uninsured in the US can likely afford it. That leaves 30 million, probably about 10 million or so are likely here illegally. Even illegals will receive emergency care (including disease treatment), they are not simply left to die.
Of course, that leaves 20 million legal Americans many of whom truly cannot afford coverage and are not eligible under Medicaid (qualifications vary from state to state). I agree that something should be done to address these individuals. They deserve coverage, especially those that are trying to hold jobs, etc. They are the truly deserving. An incremental approach, as opposed to a "universal" approach, will more effectively target these individuals.
On the other hand, I feel little sympathy for those that can afford health insurance and accept a "calculated" risk not to obtain it. Would you feel much sympathy for a single male in his twenties earning $60,000 per year that incurred financial difficulties because he simply didn't want to spend money on healthcare?
If such individuals become seriously ill or injured, they will be treated, but they will incur a financial penalty. Of course, they should be treated, but they foolishly took a risk and should accept the financial consequences. While I would likely have sympathy for their medical problems, I have no more sympathy for their financial situation than for the person that chooses not to purchase car insurance and then has to pay up when he has an accident.
By the way, American minorities are not "at higher risk for all types of cancer." Some, yes. All, no.
Aug 24th, 2007, 01:19 PM
#560
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>On the other hand, I feel little sympathy for those that can afford health insurance and accept a "calculated" risk not to obtain it.
That's why a compulsory insurance would make sense.
I know the Americans have a psychologic problem with anything compulsory. But you pay the taxes after all too, and close the seat belts while driving and motorbike helmets...
Btw., is it compulsory in US to insure your car against third party damage? Just curious.
That's why a compulsory insurance would make sense.
I know the Americans have a psychologic problem with anything compulsory. But you pay the taxes after all too, and close the seat belts while driving and motorbike helmets...
Btw., is it compulsory in US to insure your car against third party damage? Just curious.
