Posted on 09/13/2009 8:43:46 AM PDT by Kaslin
Obamacare threatens what's right with American health care.
This is the poll number that drives supporters of Obamacare crazy: Eighty-nine percent of Americans in a June 2008 ABC News/USA Today/Kaiser Family Foundation survey said they were satisfied with their health care. Put another way, more than 270 million Americans (I'm including kids) are reasonably happy with the system of medical care in this country. Other polls have found the same level of satisfaction.
One reason is the availability of first-rate care almost everywhere, day or night. But there's a more important reason: If you have a serious ailment, your chances of survival are better when treated in America than anywhere else in the world. Sure, the system has flaws, shortcomings, and inefficiencies. It probably costs too much. But if your goal is to live longer, then American doctors and American hospitals are your best bet.
Americans appear to understand this. So do the 400,000 foreign patients who come here every year for medical care. "Not too many people get on a plane and fly to Cuba or to France" to see a doctor, says Dr. Stanley Goldfarb, associate dean of clinical education at the University of Pennsylvania School of Medicine and an expert on worldwide health care systems.
Why would they go anywhere but here? America provides timely access--and not just for the wealthy--to the latest and most innovative technology, a full array of breakthrough drugs, and the top medical specialists. "If you have an acute illness, this is the country to get your care," Goldfarb says. "If you're not that ill, other countries are great."
Even if you're not seriously ill, American doctors have more to offer. The two most significant innovations for patient care in the past decade are magnetic resonance imaging (MRI) and computerized tomography (CT), according to Dr. Scott Atlas, chief of neuroradiology at Stanford University Medical School. The United States has 27 MRI machines per million Americans. Canada and Britain have 6 per million. The United States has 34 CT scanners per million. Canada has 12 per million, Britain 8.
And utilization of MRI and CT technology has become routine in America. My wife had an X-ray after injuring her ankle last spring and the diagnosis was she'd broken a bone. When it was slow to heal, she had an MRI, which revealed she'd actually torn a tendon. Now her ankle is healing.
Our share of the cost was minimal. Health insurance pays for tests, and you don't need a Cadillac policy to be covered. A little-known fact: Out-of-pocket expenses by American patients amounted to 12.6 percent of total national health spending ($2.24 trillion) in 2007.
That's one of the lowest percentages of private out-of-pocket spending among the world's advanced countries--lower than Germany, Japan, Canada, and most countries in Europe, including those with government-run health care systems. Why do Americans get more and pay less? Because their insurance policies provide broader coverage than most government plans, says Tom Miller of the American Enterprise Institute.
Private insurance, Medicare, and Medicaid cover most of the high cost of treating critical illnesses such as cancer and heart disease. And those are the ones in which the survival rates in the United States are significantly higher than in Europe or other countries. There are clinical data substantiating this. Two major studies (EUROCARE-4 and a study by the National Center for Epidemiology, Health Surveillance, and Promotion, in Rome, both published in the September 2007 issue of Lancet Oncology) were used to compare five-year survival rates for Americans and Europeans diagnosed with cancer.
For all cancers, 66.3 percent of American men and 63.9 percent of women survived. In Europe, 47.3 percent of men and 55.8 percent of women survived five years. Those are statistically important gaps.
And the survival rates were higher in the United States for the most common cancers as well. More than 99 percent of men with prostate cancer had survived in the United States after five years, 77.5 percent in Europe. Those with colon or rectal cancer survived at a 65.5 percent rate here and 56.2 percent in Europe. The rates for breast cancer showed a similar difference, 90.1 percent for Americans, 79 percent for Europeans.
Dr. Atlas cites a different set of results that underscore the same point: Your chances of living longer are better with treatment here. "Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom," he reports (see "Here's a Second Opinion," Hoover Digest online). "Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher."
Canada, whose single-payer health system is admired by many liberals, fared better but still trailed the United States. "Breast cancer mortality in Canada is 9 percent higher than in the United States, prostate cancer is 184 percent higher, and colon cancer among men is about 10 percent higher," according to Dr. Atlas.
Gary Becker, the Nobel Prize-winning economics professor at the University of Chicago, has cited still another study, this one on the mortality rates for the second leading cause of male cancer deaths (prostate) and the deadliest cancer for women (breast). This study, by Samuel Preston and Jessica Ho of the University of Pennsylvania, Becker wrote in his blog, found that "death rates from breast and prostate cancer declined during the past 20 years by much more in the U.S. than in 15 comparison countries of Europe and Japan."
Becker draws the obvious conclusion: "These results suggest that the U.S. health care system does deliver better control over serious diseases than systems in other advanced countries."
What gives American medicine its advantage? Success in treating cancer is largely determined by early detection and treatment and the use of the best drugs. "The United States does very well on all three criteria," Becker wrote. It helps that medical care for cancer and other deadly disease is more intensive here.
Tests for colon, breast, cervical, and prostate cancer have become an integral part of American health care, far more than in other countries. Nine out of 10 middle-aged women have had a mammogram, 96 percent of all women a Pap smear. As for men, 54 percent have had the PSA test for prostate cancer, 30 percent a colonoscopy for detecting colon cancer.
Since most advances in medical care are developed here, Americans benefit from them sooner, often many years sooner. Senator Edward Kennedy received proton beam therapy, which spares other tissue while attacking cancer. It may have prolonged his life. "You don't have a chance of being exposed to that in other countries," Dr. Goldfarb says.
In treating heart disease, Americans have far more access to statin drugs that reduce cholesterol. "Some 56 percent of Americans who could benefit from statin drugs . . . are taking them," Dr. Atlas wrote. "By comparison . . . only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians receive them."
But breakthroughs and discoveries are enormously expensive, so much so that America spends far more on health care (now 17 percent of GDP) than any other country. Incremental advances have driven up the cost of treating heart patients especially, but their effect in saving lives is indisputable.
"Wildly successful" is the way David Brown of the Washington Post has characterized the transformation of heart treatment. "Today, someone having a heart attack who gets to a hospital in time is likely to get cardiac catheterization, angioplasty, the placement of a medicated stent, therapy with four anticoagulant drugs and, on discharge, a handful of lifetime prescriptions," he wrote. These are innovations over the past half-century.
The results are in. "In the 1960s, the chance of dying in the days immediately after a heart attack was 30 to 40 percent," Brown wrote. "In 1975, it was 27 percent. In 1984, it was 19 percent. In 1994, it was about 10 percent. Today, it's about 6 percent."
These results are matched by the success in dealing with all heart disease. "In 1970, the death rate from coronary heart disease was 448 per 100,000 people," according to Brown. "In 1980, it was 345. In 1990, it was 250. In 2000, it was 187. In 2006, it was 135."
Cold numbers don't capture the breathtaking drama of what's happened. The transformation of heart care "has saved the lives of millions of Americans," Brown wrote. ". . . It is safe to say that almost everybody who has a heart attack wants the best treatment available. Nobody wants to turn back the clock." Nor should they, despite higher costs.
Critics of American health care, including advocates of overhauling the system and enlarging the government's role, harp on the rankings by the World Health Organization and other health organizations. These rankings are out of date, discredited, or misleading.
The WHO rated U.S. health care 37th in the world in 2000, behind Andorra, Malta, Colombia, Cyprus, and Morocco and just ahead of Slovenia and Cuba. This is not credible. To reach this ranking, the WHO used ideological assumptions--about such things as "financial fairness" and "responsiveness distribution"--heavily biased in favor of socialist countries or those with government-run health systems and against those relying on market incentives.
"It is entirely possible to have a health care system characterized by both extensive inequality and good care for everyone," Glen Whitman, an economics professor at California State University at Northridge, concluded. Indeed, that comes close to describing the U.S. system and explains why it gets a low WHO ranking.
America's relatively high rate of infant mortality is more complicated. In 2004, the United States ranked 29th in the world, based on government reports (not the WHO) from the countries ranked. Some of these statistics may be unreliable, and the standards for measuring infant deaths vary.
All babies that show signs of life at birth are counted as alive in the United States, even if they die within hours. Some countries don't count infants who die within 24 hours, others register babies below a certain weight as stillborn. So comparisons among countries are unreliable.
But we do have an infant mortality problem. The chief source is preterm births, babies born at 6 or 7 months. Non-health care factors play a role. "Lower infant mortality tracks with fewer teen pregnancies, married as opposed to single mothers, less obesity and smoking, more education, and moms pregnant with babies that they are utterly intent on having," Dr. Bernadine Healey explained in U.S. News & World Report. But biological reasons for so many preterm births remain something of a mystery.
The average life expectancy of Americans (78 years) is affected by infant mortality. The WHO ranked the United States 24th in life expectancy a decade ago. But "it's not about health care," Dr. Goldfarb says. "The mortality statistics are a social phenomenon, not a health care phenomenon." Diet, lifestyle, obesity, lack of exercise, a relatively high crime rate--all play a part.
But here's the good news. If you reach 80 in America, when most people are highly dependent on health care, your chances of reaching 90 are at least as good and probably better than anyone else's in the world. And of getting to 100 as well. The older you get in America, the better your prospects for living longer--thanks to American health care. Let's hope it stays that way.
I don’t understand why we need insurance, other than catastrophic. Doesn’t it drive costs up? Why isn’t it pay as you go? Why do I need insurance for every last thing? It seems that means an extra layer of admin, overhead, and profits. Why can’t doctor’s simply charge what the market will bear?
It all boils down to control of the people. If the government can control health care, they can control everything in your lives. This is the socialist way of controlling people. It doesn’t work in other countries and it can’t work here.
Do you have the money to buy another new car and pay the other person's bill if the accident is your fault? I sure wouldn't
Actually, the same survey showed that even though a large majority were happy with their own care, only 44 percent were satasfied with the overall system of health care in the country.
I agree with you regarding why can’t the doctor simly charge what the market will bear, but it goes farther then that
The focus must be on the underlying principle of whether liberty can co-exist with government gaining total control of that segment of the American economy. It is about allowing more power to Washington politicians and bureaucrats to eat up the citizens' hard-earned income under the guise of something everyone cares about.
So what I want to know is if 83 to 89% of the people like their health care and are satisfied with it, why does Rasmussen say that support/non support of Obamacare is 50/50? That is down from 47/53, either way it doesn’t jibe with the polls that say more than 80 percent of the people are satisfied with their health care. Now, I know Rasmussen is accurate, at least he has been, but there is something going on here that smells funny. I have idea, and I see no problem with it, let’s put this puppy to a vote, put it on a national ballot, fail we never hear about Nationalized health care again, pass we are stuck with it. I don’t think they dare do that, it would go down flaming into history if they did.
Obama's new health care would take away many of the cost containment options in the private sector such as eliminating pre-existing illness exclusions. It would also likely change the medical care available by rationing access, standardizing procedures available to best practices and eliminating the most costly treatments available. It would also dictate the price that could be charged for procedures. However, it would not tackle tort reform which is a big contributor to costs.
This is the problem with Obama care. It would not just change the cost/affordability factor - which is the problem for many Americans, it would change the quality and nature of the care itself for all Americans in an effort to control costs.
I think Americans are satisfied with the care they receive -just not the affordability and the funding system that makes that good care available to Americans. In my opinion, the private group insurance system is sound, but it needs a wrap-around for people who cannot afford the large out of pockets for a surgery or for those who have an extraordinary expensive medical treatment such as heart surgery or a premature infant.
Didn't understand Huck's question? He said why not just catastrophic health insurance, that would cover operations. I news for you also. Before the 1960s, early 70s, when medicare was adopted and started driving medical costs sky high, people paid for most of their health care and didn't have insurance.
That included operations, they paid for it. At 4 years old I had my tonsils out(they don't do that any more)because I almost died from an infection of them. My mother was divorced(not her fault)and working at a water paints factory, making about 1.25 an hour. She didn't have insurance but paid for my operation, it was a strain but still she did it.
Insurance itself has driven the costs of medical up, medicare being the main reason.
We need tort reform, we don't need government run health care, we need competition across state lines, something every other business in the US has but not health insurance. We need to overhaul medicare with an eye on eventually phasing it out altogether and that goes for SS also.
As for Auto insurance, if we weren't required to have it the cost would be much lower, I remember in CA when the law first went into effect, it drove prices up almost immediately.
In some countries, pharmacists can prescribe medication. Saves a $75 doctor visit. If the pharmacist thinks the patient needs more care, they are referred to a doctor.
If a large majority are satisfied with their own care, yet only 44% are happy with the overall system, all that tells me is they are buying the constant drone from the liberal media that the overall system is bad. They have no personal knowledge of it. They are only repeating what they hear on the alphabet networks.
This list shows a characteristically short-sighted perspective. First, chiropractors routinely return people to work sooner and at lower cost than do physicians, with fewer long-term complications. It's why professional sports teams now routinely employ them. Second, it seems you look at drug and alcohol treatment as a cost, while discounting the cost of the consequences of continued abuse, including divorces, incarceration, and catastrophic treatment; it would seem you are looking at a budget and not a system. I'll give you one when it comes to "mental health" treatment, which is never ending with few realized benefits.
When it comes to deductibles, there should be a threshold where they become applicable. I don't want people with infectious diseases avoiding triage because of the cost of a deductible, but I do want a deductible for anything beyond that. Keeping the cost of prevention cheap is only rational, particularly for prenatal care.
I have been taking the same B/P meds for 25 years but every 6 months I have to pay that $75 to see the doc to get the prescription renewed. He takes my B/P and calls in the prescription for another 6 months.
My son is a cop and he doesn’t pay social security. They have their own plan and it’s better than s.s. Some people are exempt. It should be optional for everybody if it is going to exist at all.
#16 posted to wrong thread.
How could it not? It's a middle man. Giant bureaucracies that require overhead, equipment, office space, supplies, and profits. Why? Why do we need them for everything? It makes no sense.
It seems to me it's as if we had food insurance to cover our grocery bill. Why not just cut out the middle man and buy direct?
I was speaking of the industry’s typical cost containment measures in policies. (I used to be a group policy underwriter.) Not that I agree with all of them.
Once upon a time, I also paid claims. Chiropractors were an issue. They ate up benefits like candy.
I had an endoscopic surgery. No big deal. The hospital bill alone was $25,000. I sure as heck couldn’t just pay for it. My out of pocket alone was in excess of $5,000.
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