US Healthcare - unbelievable!

Lockstep · 16-05-2010 11:56pm

Manic Moran wrote: »

As the preface to that table points out, it's pretty raw data which cannot really lead to any conclusions. For example, factors like immigration and birth rates will affect the death rate per 1,000 of population. The US's population growth rate is almost twice that of France, three times higher than the UK's and Norway's population growth rate, and over ten times that of Spain. As a result, as the population increases faster in the US, an equal 'real' death rate would show up as lower as a percentage of population.

NTM

I completely agree; it is very raw data. As is the amounts that die from things like road accidents and bear attacks.
However, I'm not sure that the fact Americans die more from things like road accidents and bear attacks can explain their lower life expectancy.
Death rates aren't correlated against birth rates; they're counted per 1000 of the population, regardless of birth rate.

At it's heart, life expectancy is the best way of determining the health and longevity of a nation. THe US' is surprisingly low for such a wealthy nation.

DeVore · 17-05-2010 12:02am

The US makes it mandatory to have car insurance but optional to have health insurance.

Because cars are important.

DeV.

Manic Moran · 17-05-2010 12:09am

kickoutthejams wrote: »

I completely agree; it is very raw data. As is the amounts that die from things like road accidents and bear attacks.
However, I'm not sure that the fact Americans die more from things like road accidents and bear attacks can explain their lower life expectancy.
Death rates aren't correlated against birth rates; they're counted per 1000 of the population, regardless of birth rate.

At it's heart, life expectancy is the best way of determining the health and longevity of a nation. THe US' is surprisingly low for such a wealthy nation.

For the record you'll note I've edited my post you quoted. I've not sat down to figure out if the logic was entirely correct, but I'm fairly sure the age discrimination comment is accurate.

NTM

Overheal · 17-05-2010 5:21am

Also bear in mind the unfortunate gun violence and greater homocide rate, which would (should?) be factored into averaging life expectancy. There is also the obesity rate but Ireland is no lean brisket herself these days.

DeVore wrote: »

The US makes it mandatory to have car insurance but optional to have health insurance.

Because cars are important.

DeV.

We got hung up on that in US Pol a few months ago.

Arguably, nobody forces you to drive a car. Its a choice. Mandatory Cover is tied in with that choice. As is licensing, and in most states, the Right to Keep and Bear Arms is also tied to licensing requirements. But its also a purely optional endeavor: you do not need to own a firearm. You don't need to drive a car.

Funnily enough most Americans don't like the idea of Government telling them what to buy. Much less making it mandatory on penalty of fines or jail time for failing to comply with new Healthcare law which is to come into effect, which demands every living breathing American spend money on some form of Insurance with only few exceptions. And only because they are living and breathing.

When you get right down to it you don't have to do anything. You can't be taxed if you choose to earn no income, for instance. Or pay Sales Tax if you don't buy anything.

Laminations · 17-05-2010 11:33am

rightwingdub wrote: »

I do believe that health insurance should be provided in cases of catostrophic illness, i don't have a problem with that, Milton Friedman believed that health insurance should be provided in cases of actostophic, however, you are letting emotional sentiment get in the way of hard nosed financial reality.

and when your granny starts costing you too much you'll put a pillow over her face. Private health care is a far better system only for those that can afford it. Yes currently people may only be able to get an xray during weekday working hours and under a private system you may get one at weekends but under such a system a poor person could never get one, any day of the week. And insurance companies would cherry pick the healthier customers, something they are already trying to do.

Frankly i'd rather have a heart than a hard nose

Lockstep · 17-05-2010 2:39pm

Manic Moran wrote: »

For the record you'll note I've edited my post you quoted. I've not sat down to figure out if the logic was entirely correct, but I'm fairly sure the age discrimination comment is accurate.

NTM

Could you expand on this? Having a higher population growth or a birth rate does not change the predicted life expectancy of the average citizen.

Manic Moran · 17-05-2010 4:19pm

kickoutthejams wrote: »

Could you expand on this? Having a higher population growth or a birth rate does not change the predicted life expectancy of the average citizen.

Distribution, not discrimination, sorry.

Age distribution is absolutely relevant to the death rate all other things being equal. To take an exteme example, let's say that some African country has a life expectancy of 40 years, but each adult is quite prolific and has seven kids. The average age of the country is going to be very young, and the population is going to be increasing, by and large. Because you have three kids being born for every 40-year-old dying, the percentage of people dying as a proportion of population as a whole is artificially low.

On the other hand, a nation full of nothing but WWI veterans, who had almost no kids at all is going to have a death rate as a percentage of population artificially very high, simply because so much of the population is dying off. And will likely be having a decrease in population overall. Yet the life expectancy would be about 110. You simply cannot correlate death rate with life expectancy absent context.

So in hindsight, my initial post was probably somewhat correct. Although you cannot automatically correlate population growth with a decrease in average age (Things like immigration will also factor), it is pretty much an indicator that the nation is one where kids are being born faster than old geezers are dying off.

NTM

Lockstep · 17-05-2010 4:37pm

Manic Moran wrote: »

Distribution, not discrimination, sorry.

Age distribution is absolutely relevant to the death rate all other things being equal. To take an exteme example, let's say that some African country has a life expectancy of 40 years, but each adult is quite prolific and has seven kids. The average age of the country is going to be very young, and the population is going to be increasing, by and large. Because you have three kids being born for every 40-year-old dying, the percentage of people dying as a proportion of population as a whole is artificially low.

On the other hand, a nation full of nothing but WWI veterans, who had almost no kids at all is going to have a death rate as a percentage of population artificially very high, simply because so much of the population is dying off. And will likely be having a decrease in population overall. Yet the life expectancy would be about 110. You simply cannot correlate death rate with life expectancy absent context.

So in hindsight, my initial post was probably somewhat correct. Although you cannot automatically correlate population growth with a decrease in average age (Things like immigration will also factor), it is pretty much an indicator that the nation is one where kids are being born faster than old geezers are dying off.

NTM

Your logic relies on there being life expectancy having a correlation between birth and death rates. It's not deaths as a proportion of the population it's deaths per thousand. Thus the death rates in a small country like Ireland can be correlated with the death rates of a large country by India.

We are discussing death rates, not growth rates.

rovert · 17-05-2010 5:40pm

rightwingdub doesnt like socialised heathcare....shocking

oppenheimer1 · 17-05-2010 8:23pm

PeakOutput wrote: »

or because private hospitals need to make money and cant jsut decide to go home on fridays cause their unions wont let them work the weekend with triple pay or some such ridicolous demand

or because the unions have inflated the prices so much that we simply cant afford to pay for the two extra days care?

so no link to show ireland is one of the best healthcare systems in the world?

http://www.photius.com/rankings/healthranks.html

19th in the World, not bad. Granted the survey was 10 years ago as WHO no longer rank nations healthcare. I would expect we have improved since then, as mortality rates have dropped.

rubensni · 17-05-2010 9:09pm

Manic Moran wrote: »

Though an interesting statistic, depending on how it's calculated, you can't assume it's automatically a function of the healthcare system. For example, the death rate from traffic accidents is 50% higher in the US than it is in Ireland: Americans are dependant on the automobile, and, frankly, drive like idiots. Not the fault of the healthcare system, and I don't care how good your system is, breathing Los Angeles smog cannot be good for your long term prospects. Similarly, as a nation with lots of swimming pools and nice warm beaches, the death rate from drowning is seven times higher than that of the UK. The death rate from wild animals in the US is, I believe, pretty near to infinitely higher than that of Ireland: When's the last time an Irish five-month-old was taken by a bear? We're even fighting more wars, with more people killed in military training accidents. When you have people living in the Nebraska countryside where an ambulance will take nearly an hour just to get to you, people will be dying who might otherwise be saved in Ireland where most ambulances aren't more than a half-hour away.

If the infant mortality rate is simply 'Number of kids who make it to age 3 divided by number of kids born', or the life expectancy is simply 'sum of all ages of people when they died divided by the number of people in the sample', then even if the healthcare systems were identical, the US would come out the worse for the comparison.

NTM

Jaysus, MM, I'm not living at all

I accept your point that no comparison is exact, but the leading causes of death are the same: cardiovascular and cancer.

Dob74 · 17-05-2010 9:30pm

I have to say I found healthcare in the states for superior to this country.
I must state I had private health insurance through employer.

Personally its this simple if we want a good health system we have to pay for it.
Private health care in the states is extermly expensive, you cant afford it unless you are very rich or your empolyer provides it.(Any employer with more than 10 workers must have some kind of health cover)
Peresonally I would go for the continental model, but in this country forgot it.
It will never happen.

Manic Moran · 17-05-2010 10:24pm

kickoutthejams wrote: »

It's not deaths as a proportion of the population it's deaths per thousand.

Per thousand whats? Per thousand seconds? Diagnoses of obesity? Anteaters in the wild in the nation? It's per thousand people, which by definition is a proportion of the population. If a large portion of the population is young, the proportion of people dying, all else being the same, is going to be smaller. Hell, the CIA web page you linked to says as much:

This indicator is significantly affected by age distribution, and most countries will eventually show a rise in the overall death rate, in spite of continued decline in mortality at all ages, as declining fertility results in an aging population.

but the leading causes of death are the same: cardiovascular and cancer.

I'm sure they are. but how many causes of un-natural death does the US have that Ireland doesn't? They all count in the grand total. (And besides, if cardiovascular is correlated to obesity rates, the problem isn't the US's healthcare system, it's the US's very extensive network of junk food sales points).

NTM

northwest100 · 17-05-2010 10:28pm

Manic Moran.

What are your views on TRICARE?

Is it a good system in the US?

Manic Moran · 18-05-2010 2:27am

I have not had any issues with quality of care. If it's efficient or not, though, I have no idea.

NTM

Dude111 · 19-05-2010 8:48pm

DeVore wrote:

When I couldn't produce a credit card, they took me out of the ambulance and left me on a stretcher in the ski resort car park, high off my head on morpheine.

In canada this happend??

Im so sorry...... I thought this country (USA) was the only place stuff like that occured.....

The GOVT here wants full control it seems and they keep working deeper and deeper into people's lives.... ITS SAD THERE ARENT ENOUGH PEOPLE TO "WAKE UP" AND SEE WHATS HAPPENING HERE!

fontanalis · 19-05-2010 8:56pm

Dude111 wrote: »

In canada this happend??

Im so sorry...... I thought this country (USA) was the only place stuff like that occured.....

The GOVT here wants full control it seems and they keep working deeper and deeper into people's lives.... ITS SAD THERE ARENT ENOUGH PEOPLE TO "WAKE UP" AND SEE WHATS HAPPENING HERE!

Stop watching Gllen Beck and Michelle Bachman, funny no-one got worked up when Bush expanded medicare to be funded from the deficit.

Dude111 · 19-05-2010 9:26pm

Not to worry mate,I DONT WATCH THOSE CLOWNS

Lockstep · 19-05-2010 9:52pm

Manic Moran wrote: »

Per thousand whats? Per thousand seconds? Diagnoses of obesity? Anteaters in the wild in the nation? It's per thousand people, which by definition is a proportion of the population. If a large portion of the population is young, the proportion of people dying, all else being the same, is going to be smaller. Hell, the CIA web page you linked to says as much:

And Ireland has a younger population than the US.

It also has a lower median age

Manic Moran wrote: »

I'm sure they are. but how many causes of un-natural death does the US have that Ireland doesn't? They all count in the grand total. (And besides, if cardiovascular is correlated to obesity rates, the problem isn't the US's healthcare system, it's the US's very extensive network of junk food sales points).

NTM

PAul Krugman goes into this in the Healthcare Imperative. I lent my friend my copy but I'll try and dig it out for here. He calls it the BUt We Eat More Cheeseburgers doctrine which doesn't actually account for that much difference in the US.

PeakOutput · 19-05-2010 10:22pm

oppenheimer1 wrote: »

http://www.photius.com/rankings/healthranks.html

19th in the World, not bad. Granted the survey was 10 years ago as WHO no longer rank nations healthcare. I would expect we have improved since then, as mortality rates have dropped.

i agree our healthcare system isnt bad

but for how much we pay for it its terrible and mortality rates do not a good system make

life expectancies infant mortality rates etc etc from what iv read have more to do with the wealth of a society then its health care system

danman · 19-05-2010 10:22pm

I've told my story a few times on this forum with regards to healthcare.

I was diagnosed with a chronic illness over 20 years ago.
I was diagnosed here. My care was nonexistant. Inwas given a few tablets and sent on my way.

I moved to NI, I thought my care would be better. It was the exact same.

I moved to London, I thought the care would be better, unbelieveably, it was worse. I couldn't get a consultant appointment for love nor money.

I moved back here 12 years ago, and I was quite appriensive about my care, but to my surprise, things had gotten a lot better.
I can phone my consultant any time and arrange a meeting with his team within 6 days, usually less.

I have been on cutting edge drugs, that aren't available in the UK because of cost.
(I know a consultant in the UK, who has told me that he cannot prescribe the drugs unless in very extreme circumstances.)

I have regular hospitalisations, 3 times so far this year, and I cannot fault them, apart maybe for the food. But then again, in my case, I don't usually worrry about eating.
The only complaint I could have, is the wait I usually have between A&E and getting a bed.
But, believe me, When you're feeling extremly ill and when your getting the necessary treatment, you don't worry about a bed.

My fellow sufferers are quite an active online. There are various websites and forums dedicated to my disease.
Most of the members on these forums are in the US.

They cannot believe how I get my treatment. They have to fight tooth and nail to get theirs. The vast majority of them would be middle income and have health insurance.

The ones without medical insurance have no hope. They will get basic treatment, but not the advanced/expensive meds.
This is a problem for them. Without these meds, they cannot work. If they cannot work, they can't get the meds.

We actually have a decent healthcare system, take it from someone who deals with it every day of his life.

I don't have medical insurance, I'm a public patient.

Manic Moran · 19-05-2010 10:31pm

And Ireland has a younger population than the US.

https://www.cia.gov/library/publicat...wer median age

Again, doesn't mean too much. The US has a bit of a 'pulse' of deaths coming up, the Baby Boomers who started hitting retirement age about a year ago. A bunch of old people, but not old enough yet to be dying off. I'm sure you'll see a bit of an increase in the death rate there.

We also still have the issue of the US population growth rate somehow being a few times higher than that of Ireland. I don't think you can claim it's just due to immigration, kids are being born. The problem with your comparisons is that they presume fairly similar age distributions.

He calls it the BUt We Eat More Cheeseburgers doctrine which doesn't actually account for that much difference in the US.

I take your word for it, but as they say, a billion here, a billion there, and soon you're talking some real money. Higher US obesity rates may have a fairly small, but identifiable effect on life expectancy. Not -too- many people in raw number will drown in swimming pools or on the beach, but add the higher rate to the mix. Not a huge portion of the population are killed in car crashes, but add that higher US ratio to the mix. Not too many people will die simply because it takes over an hour between when an ambulance is called and they're able to get to the Kansas farmhouse in which they live and then to a hospital, but a few. Add them in. the 30% higher suicide rate in the US than Ireland may not be huge in terms of raw numbers, but again, another difference in the average for early deaths.

And so on, and so forth.

NTM

Lockstep · 20-05-2010 7:46pm

Manic Moran wrote: »

Again, doesn't mean too much. The US has a bit of a 'pulse' of deaths coming up, the Baby Boomers who started hitting retirement age about a year ago. A bunch of old people, but not old enough yet to be dying off. I'm sure you'll see a bit of an increase in the death rate there.

We also still have the issue of the US population growth rate somehow being a few times higher than that of Ireland. I don't think you can claim it's just due to immigration, kids are being born. The problem with your comparisons is that they presume fairly similar age distributions.

I take your word for it, but as they say, a billion here, a billion there, and soon you're talking some real money. Higher US obesity rates may have a fairly small, but identifiable effect on life expectancy. Not -too- many people in raw number will drown in swimming pools or on the beach, but add the higher rate to the mix. Not a huge portion of the population are killed in car crashes, but add that higher US ratio to the mix. Not too many people will die simply because it takes over an hour between when an ambulance is called and they're able to get to the Kansas farmhouse in which they live and then to a hospital, but a few. Add them in. the 30% higher suicide rate in the US than Ireland may not be huge in terms of raw numbers, but again, another difference in the average for early deaths.

And so on, and so forth.

NTM

Actually the age distribution is close enough.
The CIA World Factbook lists the median age; Ireland's and the US are fairly similar (Ireland's median age being slightly younger)

Mad_Max · 21-05-2010 1:30pm

danman wrote: »

We actually have a decent healthcare system, take it from someone who deals with it every day of his life.

I don't have medical insurance, I'm a public patient.

I would somewhat go along with this. If you have a serious problem, you'll get seen to rather sharpish and will get great care.

If you have a non-emergency problem though, it can be a nightmare of a wait.

I've found the care to be excellent in both cases though, and all as a public patient.

danman · 21-05-2010 2:09pm

Mad_Max wrote: »

I would somewhat go along with this. If you have a serious problem, you'll get seen to rather sharpish and will get great care.

If you have a non-emergency problem though, it can be a nightmare of a wait.

I've found the care to be excellent in both cases though, and all as a public patient.

There does seem to be a problem getting into the system, but once you're in, the service is very good.

That doesn't mean that the admin staff doesn't need to be cut.

One of my hospitalisations happened in NI.
There is a scheme, whereby Irish residents get hospital care paid for by the HSE in the case of emergencies.

I got the bill for my minor surgery (£3,000), and passed it on to the HSE.
They refused to pay untill I proved that I didn't just walk into the hospital, by my own choice.
I had to get statements from the out of hours doctors that I attended and sent me to hospital.

It whole process took months.
Meanwhile, I was getting phonecalls every day from the hospital admin staff looking for their money.

Surely, they could have investigated this themselves (HSE) and liased with the hospital admin staff. But they refused to contact them until I could prove it was an emergency!

It's a small complaint, and reflects more on the admin staff than the service as a whole.

Nijmegen · 21-05-2010 3:42pm

Our hospitals could do an awful lot better in an awful lot of areas if they were simply managed better, and for the same money if not less.

This is not in dispute by anyone, I think... And could be said about a lot of arms of the state.

In the main however, the quality of care is quite good in general areas, but my experience would be that in specific areas there can be massive failings.

In all, our healthcare system is of average quality for what we put in, good by worldwide standards, but not what it could be.

US Healthcare - unbelievable!

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