Conservatives and health care rationing

[Voyager]

@Starving_Artist

Disagree. It’s an attempt to save money by cutting back on mammograms.

You have any evidence that the people doing and reporting on the study have anything to do with allocating health care dollars or setting policy? Do you think that any attempt at measuring the effectiveness of tests is just an effort to save money?

Not really. The idea is that the government will give everyone all the treatments they want – until it starts to run out of money. It is then that rationing and what has been referred to as “death panels” (or what certain of our liberal brethren will undoubtedly refer to as ‘just an attempt to allocate government funds more effectively’) will likely come into existence.

You of course realize that the thing referred to by Her Mooseness as a “death panel” had absolutely nothing to do with not paying for end of life care. Are you coming out against allocating government funds most efficiently, or do you think that the current system of allowing those without enough money to go without care is most efficient? Do you think that leaving things alone is going to do anything but drive us to the brink of bankruptcy?

[Voyager]

@Euphonious_Polemic

There can be an argument that the US has TOO MANY MRI machines. They may just sit around uselessly, waiting for someone to make use of them or MRI’s could be used far too often (when they do not return a positive benefit to the patient) The same could be said of doctors salaries - there can be an argument that they are paid TOO MUCH in the United States, due to the structure of the “money buys what you want” health system.

This may be partly the cause of the US paying much more per capita for health care (with inferior outcomes) as compared with other countries.

The problem isn’t them sitting around unused. The bigger problem is that patients who do not need an MRI get one anyway (recommended by some doctors) in order to pay the machine off.

I assume that for you anyone who really needs one goes to the front of the line, right?

[Voyager]

@Starving_Artist

There’s no comparison. Medicare covers a relatively small percentage of the population that is in the latter stage of life (i.e., people who only need coverage for a decade or so, if that). It’s a horse of a completely different color entirely than a program that would seek to cover the entire population from cradle to grave.

Just want to point out that if the average life expectancy is 75, this does not mean that you can expect to live an average of 10 years when you hit 65. This is a fairly common fallacy that drives my friend who writes statistics books crazy. You need to look at expect life given you have hit 65. (Which is quite a bit longer.)

[Euphonious_Polemic]

@Voyager

The problem isn’t them sitting around unused. The bigger problem is that patients who do not need an MRI get one anyway (recommended by some doctors) in order to pay the machine off.

I assume that for you anyone who really needs one goes to the front of the line, right?

Pretty much. My wife needed an MRI to confirm a diagnosis of a brain tumor. No waiting- we got in very quickly. Wait times for MRI are dependent on medical diagnosis and severity. Of course there are always problems and anomolies that come to the attention of the press - no system is perfect.

But… I was quite pleased that nobody pushed in line ahead of her just because they had more money than us. Or that nobody got in line ahead of her because their doctor had to pay a machine off.

[yorick73]

@villa

So that means a significant percentage of the uncovered like their health care? I can see if it was 89% of the covered, but 89% is more than the covered percentage…

And my health care and coverage sucks donkey balls.

Hey…I didn’t pull the numbers out of my ass

Here’s a link with the actual survey linked.

http://www.foxnews.com/politics/2009/06/24/obama-pushes-national-health-care-americans-happy-coverage/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%253A+foxnews%252Fpolitics+%2528FOXNews.com+-+Politics%2529

[villa]

@yorick73

Hey…I didn’t pull the numbers out of my ass

Here’s a link with the actual survey linked.

http://www.foxnews.com/politics/2009/06/24/obama-pushes-national-health-care-americans-happy-coverage/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%253A+foxnews%252Fpolitics+%2528FOXNews.com+-+Politics%2529

Well, given the web site, it appears you pulled them out of someone else’s ass… And the analyst they choose to comment is from the AEI, which is hardly the most friendly organization towards health care reform.

I’d have to look more into the questions, but my guess would have to be that people are happy with the quality of health care when they get it. That strikes me as a reasonable position. You get good quality care in a public hospital emergency room. That you have to wait for hours and you have no real access to preventative care doesn’t stop you being satisfied with the care you get.

I think few people deny that America has some of the absolute best health care in the world. It’s the method of allocating that care that people think is bat shit crazy.

[yorick73]

@Euphonious_Polemic

There is certainly some truth in your argument - but the fact there are fewer MRI machines does not mean that we do not have enough, nor does it mean that the wait for an MIR is necessarily deleterious to the health of the population.

There can be an argument that the US has TOO MANY MRI machines. They may just sit around uselessly, waiting for someone to make use of them or MRI’s could be used far too often (when they do not return a positive benefit to the patient) The same could be said of doctors salaries - there can be an argument that they are paid TOO MUCH in the United States, due to the structure of the “money buys what you want” health system.

This may be partly the cause of the US paying much more per capita for health care (with inferior outcomes) as compared with other countries.

Do you have any evidence of this or are you just theorizing? The fact that many Canadian doctors choose to practice in the US and that many people with money choose to come to the US to avoid waits that could cost them their lives suggests otherwise.

[yorick73]

@villa

Well, given the web site, it appears you pulled them out of someone else’s ass… And the analyst they choose to comment is from the AEI, which is hardly the most friendly organization towards health care reform.

I’d have to look more into the questions, but my guess would have to be that people are happy with the quality of health care when they get it. That strikes me as a reasonable position. You get good quality care in a public hospital emergency room. That you have to wait for hours and you have no real access to preventative care doesn’t stop you being satisfied with the care you get.

I think few people deny that America has some of the absolute best health care in the world. It’s the method of allocating that care that people think is bat shit crazy.

LOL…I figured you would love that cite. Here is the Poll.

http://www.usatoday.com/news/health/2006-10-15-health-poll1.htm

[villa]

Yes - 89% of all people are somewhat or very satisfied with the health care they receive, but a significantly smaller percentage (7 percentage points less) are somewhat or very satisfied with their ability to get appointments etc. I will say, the drop off is much less than I would have expected it to be.

I hope the poll has been looked at by someone much better at stats than me - I’m surprised by its results.

[sqweels]

@yorick73

You are forgetting that, unlike a private company, a government run plan can operate at a significant loss for quite some time…effectively putting private companies out of business. Also, once you reach single payer it is probably impossible to go back.

But we’re not talking a single-payer system; health care rationing is a red-hot issue wrt the issue as it’s being debated right now. I have a very hard time believing that the private health care system will be put entirely out of business.

You are also forgetting about the taxpayers. Eventually, if taxes need to be increased to keep supporting the system, there will be a movement toward cutting taxes or at least not raising taxes.

But isn’t that what conservatives would want? If there are significant saving from not having to do business with private insurers and signifcant saving from tax cuts then there are… significant savings. Ergo, rationing good.

[yorick73]

@villa

Yes - 89% of all people are somewhat or very satisfied with the health care they receive, but a significantly smaller percentage (7 percentage points less) are somewhat or very satisfied with their ability to get appointments etc. I will say, the drop off is much less than I would have expected it to be.

I hope the poll has been looked at by someone much better at stats than me - I’m surprised by its results.

I think that’s normal. I get pissed if I can’t see a doctor the day I call. I would have answered the question the same way.

[Euphonious_Polemic]

@yorick73

Do you have any evidence of this or are you just theorizing? The fact that many Canadian doctors choose to practice in the US and that many people with money choose to come to the US to avoid waits that could cost them their lives suggests otherwise.

Your costs are higher per capita, and your population health outcomes are poorer than many countries with UHC. Don’t have the stats to hand, but I’m sure someone can look them up.

You do have top tier healthcare for those who can afford it though - no question about that.

I’d like to see any stats about those who travel to the US to avoid waits - are these waits of inconvenience or waits that “would cost them their lives”?

[villa]

@yorick73

I think that’s normal. I get pissed if I can’t see a doctor the day I call. I would have answered the question the same way.

But isn’t it a matter of expectations too? I can answer I am reasonably satisfied with the ability to see a doctor if I know I have no insurance, and I spend 8 hours waiting in an ER, because the alternative is not seeing a doctor.

That doesn’t mean I wouldn’t be happier with a system where I had insurance and I could make an appointment for a check up and prevent the disease ever hitting me.

My problem isn’t so much with the numbers, it is that Fox News and the AEI (surprise, surprise) present them as meaning there is a level of happiness with the health system out there that may not actually be the case.

[sqweels]

@yorick73

How many surgeons are there in canada per million people? I don’t know but I DO know that many Canadian doctors come to the US to make more money.

Well then if health care in Canada is poor, it’s not because doctors are taking too large a share of the pie.

[yorick73]

@villa

But isn’t it a matter of expectations too? I can answer I am reasonably satisfied with the ability to see a doctor if I know I have no insurance, and I spend 8 hours waiting in an ER, because the alternative is not seeing a doctor.

That doesn’t mean I wouldn’t be happier with a system where I had insurance and I could make an appointment for a check up and prevent the disease ever hitting me.

My problem isn’t so much with the numbers, it is that Fox News and the AEI (surprise, surprise) present them as meaning there is a level of happiness with the health system out there that may not actually be the case.

Your points are valid and, of course, I cannot answer those questions. Forget the Fox link…I just did that for fun. Concentrate more on the ABC/Kaiser poll.

[villa]

I was concentrating on that poll. As I said, the numbers are higher than I expected them to be, but I am not sure it actually shows anything of significance, other than that the US has very good health care. Which I think nobody denies.

Also, as an aside, from talking to doctor friends, we actually to a degree want people to think they are getting bad health care, or not to think it is quite so good. People like to think a doctor has done something for them. Sending them home, telling them to wrap up warm, drink a lot of fluids and sleep a lot is often seen as worse health care than writing a prescription for anitbiotics that will do nothing but raise the resistance out there. Wellness programs also don’t seem to count highly in people’s minds as good health care. Much better to improve people’s diets than give them the best treatment for cardiac arrest anywhere in the world.

[yorick73]

[quote=“Euphonious_Polemic, post:52, topic:520686”]

Your costs are higher per capita, and your population health outcomes are poorer than many countries with UHC. Don’t have the stats to hand, but I’m sure someone can look them up.

You do have top tier healthcare for those who can afford it though - no question about that.
What are the health outcomes based on? I don’t think you can draw a straight line between quality of health care and overall health of the country. Americans have significantly higher rates of obesity than Canadians, and we smoke and drink more as well. All the medical access in the world can’t save some people.

@Euphonious_Polemic

I’d like to see any stats about those who travel to the US to avoid waits - are these waits of inconvenience or waits that “would cost them their lives”?

Yeah…I haven’t found anything that is not slanted one way or the other. I’ve seen stories on news programs concerning people whose lives were saved by coming to the US for treatment but, of course, these are anecdotal.

[Euphonious_Polemic]

In a quick search, I did come up with this from 2007:

Health outcomes often better in Canada than U.S.: review

• This was a meta-study that looked at the results of 38 different studies that compared the two countries

The money quote:

“Overall, Canada did better, and in fact we found a statistically significant five per cent mortality advantage [of survival] to people with diagnoses in Canada compared to their counterparts in the United States,” Devereaux said.

and

" that is important because in the United States, they’re currently spending a little over $7,100 per individual on health care annually, whereas in Canada we’re spending a little over $2,900 per individual annually,"

Note, I don’t know where he gets the dollar figures from; I’ve seen others that say Canada is US$3,678; in the U.S., US$6,714.

[yorick73]

@Euphonious_Polemic

In a quick search, I did come up with this from 2007:

Health outcomes often better in Canada than U.S.: review

• This was a meta-study that looked at the results of 38 different studies that compared the two countries

The money quote:
and

Note, I don’t know where he gets the dollar figures from; I’ve seen others that say Canada is US$3,678; in the U.S., US$6,714.

But this still doesn’t get to the root of the disparity. Here is a link to one abstract of interest.

Health Status, Health Care and Inequality: Canada vs. the U.S.

Note that mortality for certain cancers are higher in Canada. Also, the health-income gradient is steeper in Canada than in the US which suggests that there is a stronger link between SES and health than availability to health care

Note: I’m not familiar with this publication and cannot access the article. I just post the abstract link for consideration.

[Euphonious_Polemic]

NBER is very reputable, but it is still only ONE cite. Mine was a meta-study that looked at 38 different papers.

I think we’re safe to say AT LEAST though that the health of Canada’s population is as good as the US population, even though we spend significantly less money.