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Q: Tryint to make sense of the healthcare debate
asked by: satellitebeach on August 28th, 2009
New User
I am 30 years old, not extremely politically active, but interested in the future of our healthcare system. I found the article below, which basically states that the prognosis for patients diagnosed with various cancers typically have a higher rate of surviving in the U.S. than in countries with a national health system. If that is true then why is the life expectancy of U.S. residents typically lower than that of all the countries mentioned? If our current healthcare system is so great then why are we not living longer than those with national healthcare? If you have any insight I would definitely be interested as I am trying to figure out where I stand on this very important issue. I know it is probably pretty difficult to be objective but please try because if I wanted to hear a bunch of people talk about everything but the raw data and facts then I would listen to politicians Smile


This Wiki article says that we have a lower "crude death rate" than most of the countries mentioned: http://en.wikipedia.org/wiki/List_of_count ries_by_death_rate

And this Wiki article says that we have a lower life expectancy that most of the countries mentioned in the article:
http://en.wikipedia.org/wiki/List_of_count ries_by_life_expectancy


Article I read:
Cancer Society's Deadly Medicine
by Michael D. Tanner


Michael Tanner is director of health and welfare studies at the Cato Institute and coauthor of Healthy Competition: What's Holding Back Health Care and How to Free It (2005).

This article appeared in the New York Post on September 10, 2007.

The American Cancer Society announced recently that it will spend its entire advertising budget next year not on urging Americans to stop smoking or get mammograms, but on campaigning for a government takeover of the U.S. health-care system. This is perverse: It's hard to imagine anything worse for cancer patients than government-run health care.

For all its faults and all the criticism that it has received, the United States' free-market health-care system has made America the place you want to be if you have a serious illness.

Cancer patients understand this. The overall five-year survival rate for all types of cancer for men in America is 66.3 percent, and 62.9 percent for women, the best outcome in the world.

We shouldn't be surprised. The one common characteristic of all national health-care systems is that they ration care.

Sometimes they ration it explicitly, denying certain types of treatment altogether. More often, they ration more indirectly - imposing global budgets or other cost constraints that limit the availability of high-tech medical equipment or imposing long waits on patients seeking treatment.

In the United States, there are no such government-set limits, meaning that the most advanced treatment options are far more available. This translates directly into saved lives.

Take prostate cancer, for example. Even though American men are more likely to be diagnosed with prostate cancer than their counterparts in other countries, we are less likely to die from the disease. Fewer than 20 percent of American men with prostate cancer will die from it, against 57 percent of British men and nearly half of French and German men. Even in Canada, prostate cancer kills a quarter of men diagnosed with the disease.

A big part of the reason is that, in most countries with national health insurance, the preferred treatment for prostate cancer is . . . nothing.

Prostate cancer is a slow-moving disease. Most patients are older and will live for several years after diagnosis. Therefore it is not cost-effective in a world of socialized medicine to treat the disease too aggressively. The approach saves money - but at a high human cost.

Similar results can be found for other forms of cancer. For instance, only 30 percent of U.S. citizens diagnosed with colon cancer die from it, compared to fully 74 percent in Britain, 62 percent in New Zealand, 58 percent in France, 57 percent in Germany, 53 percent in Australia and 36 percent in Canada.

And less than 25 percent of U.S. women die from breast cancer. In Britain, it's 46 percent; France, 35 percent; Germany, 31 percent; Canada, 28 percent; Australia, 28 percent, and New Zealand, 46 percent.

Even when there is a desire to offer treatment, national health-care systems often lack the resources to provide it. In Britain, for example, roughly 40 percent of cancer patients never get to see an oncology specialist. Delays in receiving treatment under Britain's national health service are often so long that nearly 20 percent of colon cancer cases considered treatable when first diagnosed are incurable by the time treatment is finally offered.

In Canada, the Society of Surgical Oncology recommends that cancer surgery take place within two weeks of preoperative tests. Yet one study indicates that median waiting time for cancer surgery in Canada ranged from 29 days for colorectal cancer to more than two months for urinary cancers. Radiation treatment and new therapies, such as brachytherapy, are also far less available than they are in the United States. Consider this: seven out of 10 Canadian provinces report sending prostate-cancer patients to the United States for radiation treatment.

But the advantages of free-market health care go far beyond an absence of rationing. With no price controls, free-market U.S. medicine provides the incentives that lead to innovative breakthroughs in new drugs and other medical technologies. U.S. companies have developed half of all the major new medicines introduced worldwide over the last 20 years.

In fact, Americans played a key role in 80 percent of the most important medical advances of the last 30 years. Eighteen of the last 25 winners of the Nobel Prize in Medicine either are U.S. citizens or work here.

If the American Cancer Society got the government-run national health-care system it wants, we would eliminate consumer choice and put a stop to the innovations we count on to improve our health. It would condemn thousands of cancer sufferers to waiting lists and denied care. In the end, it would cost lives.

If the Cancer Society truly wants to help Americans suffering from that complex array of diseases called cancer, it will get back to campaigning for mammograms and quitting smoking, and keep the government out of the picture.
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motherofhighspiritedones
replied on August 30th, 2009
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In my opinion, our life expectancy is lower than other places due to our diets, our lack of adequate exercise, our overpowering need for nicotine and other harmful substances, and our accident/homicide rates. Putting all of these together, sure our cancer SURVIVAL rate is higher, however, with all of our lifestyle choices, our life expectancy is lower than other countries' national averages. Sure, other countries have their issues, but if you combine the deaths from diabetes, heart disease, and other medical issues related to our need for fast, fried food, add in our drug problems, our nicotine problems, our accidental death problems (think car wrecks and those persons who do things that would surely qualify them for a Darwin Award), homicides, and then of course our immense need to work more and sleep less (this can cause our life expectancy to shorten as well), then you see why we don't live as long as those in other countries, who may have less than adequate health care systems, yet who take better care of themselves. In short, while our health care system is able to cure our cancers and help us survive longer with cancer, we as citizens, are not helping ourselves by insuring a healthy diet, exercise, healthy sleeping habits, and avoiding unhealthy recreational festivities (think again back to the Darwin Award contender, everybody knows one)and unhealthy drugs/nicotine/alcohol. Genes may have a play, too. And I am thinking that there may be more gene diversity in, say, Europe, than in the US, for example, we often marry within our country, and then our children marry within our country, etc...every once in awhile, new genes from another area are introduced, but abroad, I think the diversity is much greater. I am not saying we ALL do this, just quite a few of us. I am also not saying others in different countries DON'T do it...they very well may, I just don't know it. That is just my thought/theory though...no scientific evidence (that I know of) to back it up...just thinking.
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SSN0616
replied on October 27th, 2009
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genetic diversity?
I think you need to rethink the idea of less genetic diversity in the US than in Europe. Considering that americas backbone has been the tens of millions of immigrants from around the world who all now live here, the idea that you can find any country in europe where blacks marry whites, indians wed muslims and an italian/irish man can marry a brazilian woman, I think thats simply wrong.
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deteragram
replied on October 28th, 2009
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I don't put much stock in someone saying that we should not have national health care because numbers show that those with national healthcare have lower success rates in a few areas. No health plan is perfect or is on top in every single area of health care.
To be honest, after the initial burst of information on national health care, I tuned out the rest of the debate. But a recent class assignment has stirred up my interest once more.
There is a 2008 PBS video (Sick Around the World) in which a man visits 5 different countries that have national health care systems: Japan, Germany, Great Britain, Switzerland, and Taiwan. The correspondent interviews officials, citizens, and physicians in each country to find out what each system's good and bad points are. For those who are interested, here is the link.
http://www.pbs.org/video/video/1050712790
I need to warn you, though, that this video is one hour long. I found that it was well worth the time and gained some insight into the possiblities of national health care in the United States.
For those who don't have the time or the desire to watch the video, here are some of the highlights.
Great Britain-
Through the NHS, they pay half what we pay in the United States, have longer life expectancies, and lower infant mortality rates.
Primary and emergency care are great. Elective care (e.g. hip replacement surgery) is not so great because of the waiting lists.
Citizens cannot go directly to a specialist but must have a referral from their general practitioner first.
GB is a world leader in preventative health and preventative medicine.
Japan
The Japanese spend slightly less than the British on healthcare. The country has the longest healthy life and the lowest infant mortality.
The Japanese go to the doctor three times as often as Americans, can see specialists on demand, and do not have doctor appointments. However, the average doctor visit is 3-5 minutes.
The Health Care Ministry tightly controls the price of procedures and drugs to keep them affordable. In fact, they set the price for all medical procedures. The more procedures done, the lower the government makes the cost of it (e.g MRIs).
However, the low cost has not stifled the use or invention of new medical testing or machines. It simply forced manufacturers to find a way to make the machines/ tests more cheaply.
On the downside, 50% of hospitals are in financial deficit so Japan may have to raise prices a little so hospitals do not go broke.
Germany
The rich can opt out of this system and pay for private care.
If a patient has a serious problem, they can usually be seen in the same day. If the problem is not serious, they will probably have to wait about two weeks.
Germans pay premiums based on income and receive health care for about 2/3 of America's cost.
Health insurance continues whether a person is employed or not.
Standard medical procedure/ doctor visit costs are set and drugs are a bargain.
On the downside, some doctors feel undervalued and underpaid. The average Dr. salary is $80,000 and the average Family doctor makes about $120,000 a year. Medical school is free and the average malpractice insurance premium is $1,400 a year, 1/10 the cost of malpractice insurance in the United States.
Taiwan
This country examined other government healthcare systems to come up with their own version in 1995. They combined features from 12 different countries with national health care.
Everyone has equal access, free choice of doctor, no waiting. Competition among doctors is encouraged.
No one, even the wealthiest, can opt out of the system.
Clinics are open on weekends.
No referrals are needed.
They have a credit card- sized Smart Card which contains medical history, a record of doctor visits, and medications. This card is scanned at every visit and billing is sent directly to the governmnet health system. Because of this card, there is a very low administration fee.
Though there is no limit to the number of times you can go to the doctor, if a patient goes to the doctor over twenty times in a short period of time, they get a visit from a government official for a 'discuassion.'
Taiwan spends 6% of the GDP (Gross Domestic Product- The total market value of all the goods and services produced within the borders of a nation during a specified period) on health care. (The USA spends about 16%). Although needed, officials are afraid to raise that cost to 8% for fear of voter backlash.
Switzerland
It is mandated that everyone buy insurance with the state paying for the poor. There are no profits for basic care. Many Swiss insurers were already not for profit.
Hospitals can profit from supplemental coverage for things such as private hospital rooms.
Some argue that low prices or profits will kill technology or research but this is not true in Switzerland's case. In addition, they make 1/3 of their profits from US consumers of drugs.
There is a fixed benefit cost.
Their administration cost is 5% as opposed to the US cost of 22%.
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ServiceU
replied on October 29th, 2009
Supporter
Oprah Winfrey had a women from the United Arab Emirates state that her country dont pay for electricity, they provide for the poor and they have health care for everyone. i am very much impressed by this. They dont have any homeless people!!!
I really think that we should evaluate other countries that has universal health care coverage and mimic what they are doing.
For example the countries that has health care for all doesnt do the same thing that Canada does.
Something has to be done because the uninsured are going to the hospital and not paying the bill.
It breaks my heart to hear about people who have pre-existing health issues and is bills thousands of dollars they cant pay for.
i think if the important people was in their shoes some kind of bill would be passed.
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