Quote: (01-12-2011 10:58 PM)Entropy4 Wrote:
Spending more does not equal higher quality care.
I am comparing the quality of care first-hand, based on my own experience with several "free" and one "non-free" healthcare. And I pointed out exactly where spending indeed provides higher quality care.
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In fact, the US health care system is incredibly inefficient when compared to just about any other developed country. We pay far more and receive far less for fewer people.
Indeed. An "efficient system" in a development country would not treat a 80yo with an expensive surgery - they'll spend those money on younger people. The old fart doesn't pay taxes anymore, so he isn't worth spending any money. Barbaric? Indeed. But extremely efficient!
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In 2000, The World Health Organization rated the US health care system 37th in the world in terms of quality and efficiency, coming in behind such powerhouses as Morocco, Chile and Costa Rica.
When you read such a report, it is important to understand criteria they use. Let's see them, and see how they apply to "quality and efficiency of healthcare":
1. Overall Level of Health. This is a very useless parameter, because it takes into account a lot of influential factors, quality of healthcare being very miniscule here. WHO considers that the healthier the population is, the better must the healthcare be. However, those two things are not really relevant. Look on US, for example - an obesity is a major problem here, so it would score very low. Now think of it: does really the fact a lot of people are stuffing themselves with crappy foods and are too lazy to go to gym, indicates problems in the healthcare system?
2. Responsiveness, how fast could one get treatment. WHO measures availability and accessibility, and the better they are, the better the system is. This is probably the most important factor for me, which determines healthcare quality. And USA scored high on this one.
3. Distribution of Health in the Populations or "fairness" of healthcare system towards those who have the worst health. WHO considers that the most sick people should get most healthcare money (regardless of their ability to pay for it). Meaning, if I am poor, obese, abuse alcohol and drugs, and have no insurance but more sick than you, I should get more healthcare than you, even if you are rich, have insurance and take care of your health. In short, this parameter measures how socialistic the healthcare system is. And of course USA scores low here, its healthcare system is not socialistic. However, if you think about it, it has nothing to do with healthcare quality or efficiency.
4. Distribution of Financing. Item 3 measures money spent, and this item measures money collected. Same as with 3, it measures how "socially fair" the healthcare system is toward the poorest. Meaning, to score high the country must charge rich a lot, middle class a little, and poor nothing, providing them all with the same level of healthcare. Same as 3, it measures the socialistic aspect of the system, which has nothing to do with healthcare quality.
Considering that 2 out of 4 factors measure just how "socialistic" the healthcare system is, it is not surprise that US came 37. If they removed the item 2 (which is the only item relevant to healthcare), US would be on the bottom of that list. What would it mean? It would mean that US has a significant unhealthy population, and that its healthcare system is not socialistic. Now, do you really needed to read a report to get that?
And now about what this report is helpful for. It is helpful to answering the following question: "if I am poor and have no money, which country would provide the best healthcare for me"?
Now, about the rest:
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* Canada had the highest percentage of patients (36%) who had to wait six days or more for an appointment with a doctor, but the United States had the second highest percentage (23%) who reported that they had to wait at least this long.
This is based on (wrong) assumption that all Americans have the same, equal access to doctors. This, of course, is not the case. The cheaper/crappier is your insurance, the less doctors are available for you, and the more you have to wait. The correct answer would be that in US the waiting time depends on what kind of health insurance you got.
Another problem here is that in US, unlike Canada or Russia, you can go to any doctor, not only the doctor "assigned" to you. Of course your insurance might not cover it, but if you're in hurry, even $150 is not a very big deal. This, of course, is not measured in this response.
I've explained this one in such details so you can see how hard is to make a reliable comparison. And how easy is to introduce any bias.
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Statistically speaking, the US only out-performs other developed countries in extreme situations. We have the most cancer survivors, for instance.
This is not an extreme case, this is a real indicator of how advanced the medicine really is. Everyone can treat common cold, but things like cancer, AIDS, brain tumors are significantly more difficult. And cancer is definitely not an extreme case.
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As far as me being bankrupted by a judge... yes, but considering a 10k deductible would bankrupt me anyway, then it's a moot point.
Hospitals typically let you to pay in installments if you don't have money, so you could pay off those 10K in two years paying $416 a month. But if your financial situation is so dire that a 10K debt would force you into bankruptcy, you might consider working here and putting some money into your rainy day fund. If shit happens when you're abroad and you don't have insurance there, they may not even care to say your life until you pay or at least post a deposit.
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Breaking my leg, yes, that's basically the worst case scenario. But Mexico is only a $300 flight and six hours away, and they can take care of it for less than $1k.
How you imagine it, you gonna walk around carrying a broken piece of your leg to the plane? What about a broken hip? You may not even be able to sit in the airplane seat.