Yup–those end-of-life oldsters are out there shopping for new insurance companies! And the companies are eager to sign them up…
I am happy with the FAA, CDC, our Interstate Highway system, and our local fire and police departments.
Are you trying to claim that if a new treatment cures Grandma’s cancer and she lives a healthy life of weightlifting and triathlons for the next ten years until she trips on a hole in the stair carpet and the piano she’s carrying crushes her to death, her cancer treatment costs would still be counted in with the “last year of life” statistics?
Because if so, AFAICT, that’s complete bullshit. “Last year of life” medical costs are computed, AFAICT (as in this study), by looking at medical records of dead people and seeing what medical costs they actually incurred in the twelve months before they died. You know, in the last year of their life.
Now, if what you’re rather awkwardly trying to get at is the fact that some treatments used on dying people are also sometimes successful in keeping people from dying, then sure, that’s quite true. But in such successful cases, the costs of those treatments are not counted as “last year of life” medical costs. Because they weren’t incurred in, you know, the last year of the patient’s life.
Or it could be that the U.S has a lot more fat people.
Scandinavian obesity numbers.
U.S. obesity numbers.
You’ll note that the Scandinavian countries is obesity rate is about 1/3rd of that of the U.S. Interestingly, the number of C-sections for Scandinavian countries is also about 1/3rd.
Hmmm, how is socialized medicine going to fix that?
Slee
Dutch people have a totally different attitude toward these things.
I recall when I was working in a hotel, I was a salaried employee and Petra, the Dutch intern, she was from the Netherlands, were talking how they changed it, so that salaried people no longer got sick leave. The hourly people did.
And I was complaining because first of all I never got sick, so I could use the sick days as vacation time, and in effect I was getting docked 5 days of vacation. And I was complaining to Petra and she looks at me totally dumbfounded and says “Mark, you should stop complaining about having to earn a living and just be thankful that you are HEALTHY ENOUGH to go to work every day. Not everyone is so lucky.”
And you know in her way she did have a point. So the Dutch people look at things differently.
Social Security is a pretty well run organization, with amazingly low adminiastrative costs given the scope of their activities.
If the OP accurately reflected what was said on CSPAN, I believe it may be a different stat than what many folk are discussing here.
27% of ALL medicare costs are spent of the last 12 months of life.
This doesn’t simply refer to terminally ill elderly. It would also include all medicare costs for infants who do not attain their 1st birthday, all accident victims who die within 12 months, and even the routine check-up of a guy less than 12 months before he gets hit by a bus.
I’m often surprised that Medicare has no means testing, and such generous limits on covered treatment. Was just talking to a relatively well-off 75 year-old guy who recently ran up $1/4 million in cardiac treatment, paying $0 out of pocket. Doesn’t impress me as a sustainable system.
And I also would support limits on the types of care covered, especially with strict limits on heroic efforts to prolong the lives of terminal patients. Basically establish that EVERYONE will receive a certain base level of treatment, emphasizing prevention, palliative treatment, and hospice for the terminal. If you are wealthy enough to afford more costly measures, more power to you. And if you are poor, and happent to have some horrible condition - well, that’s just your bad luck. I see no reason why society ought to consider itself obligated to provide organ transplants and such at no cost.
A big part of the reason for so many C-sections in the US is that doctors are afraid of being sued if they do nothing and complications ensue.
This is in fact a general problem with US healthcare, in that nervous doctors order all sorts of test and procedures “just to be sure”, which costs a lot of money but does not increase health overall, and probably decreases it.
I can name four.
Michigan Secretary of State (before the budget crunch, still an okay operation considering the operating funds now available). It’s our version of the DMV. I’ve found people there are usually helpful and it to be fairly quick, even after the budget crunch. The only argument against it was when the federal government stuck their nose* in our ID systems and imposed it’s hurdles and nonsense making getting state ID near impossible in some cases causing a lot of tears. Not the SOS’s fault though. Despite the troubles from fedland they do go out of their way to help you when they can.
Community public schools. They taught me how to read, and write. They taught me math, science and history too. Essential skills we all need. I couldn’t finish high school because I had to watch my sister so my mom could work. We were too poor to afford a baby sitter. The public school system also provided adult education so I could take my GED tests for free. I scored 800 (perfect score) on social studies, 780 on science, 780 (IIRC) on reading, 640 (IIRC) on math, and embarrassingly low on writing. Never had much interest in grammar so that was my own fault. I scored high on these tests because…
Of libraries. At the library I was able to take the literacy I learned at school and leverage it to read books on so many things. I gave my self a crash course in physics in the 3rd grade, and built up from there. I read all the books in the school libaray on physics, then the public library. Then I moved on to geology, nature, sociology, history, mythology, scifi, comedy etc. I really built a love for reading there. It was that love of reading that made the internet so appealing, and prompted me to get a webtv, and finally a computer. Not cheap easy things to get for someone ghetto poor in rural Michigan. The computer was a learning experience in it’s self. I learned so much about how they work, how they’re put together, configured, troubleshooting, etc. This lead to…
FAFSA. Applying for federal student financial aid is really easy. Surprisingly easy. The site is straight forward to use. The main problem anyone has with it is the EFC (excepted family contribution) if they’re under 25. But that’s an argument to vote more people into government who will nurture the program and expand it. I’m studying for a high paying job in computers. This will elevate me from a none net-payer of taxes to a tax paying bracket, lowering the tax burden on the rest of you.
I’ll happily pay taxes on schools, libraries, financial aid, infrastructure improvements and the like because without them I’d be illiterate, highly ignorant, and stuck being poor. I’d like to see the next generation have even better support and opportunities.
Now let me pose this question. The unnamed factor in my story is persistent good health. I had an appendix go when I was a kid but it was covered by a state program to make sure all kids have health care (darn that evil government wasting money prevent kids from dieing in the streets). How might my story been different if I had a serious medical condition in adulthood?
Bullshit. for two reasons.
My own posts show government programs at community (library, and some of the school system), state (more of the school, Secretary of State), and federal (FAFSA and further educational assistance) levels that have very positive results.
If you feel Pure Capitalism ™ is so much better for everything you should work in it, and live by your own words.
Yep, both very probable contributing causes. And both indications that US healthcare is not the best in the world.
Dunno. How do they do it in Scandanavian countries? Education? Making healthier food choices available in schools? Something else? I really don’t know. But they’re obviously doing something right.
If an insurance company is facing a major expenditure for a procedure, especially for an older patient, they will come out ahead by denying the procedure even if the patient switches coverage.
And many times, because the patient’s choices are restricted by their employer, finding another insurer is not an option whether a procedure is denied or not.
Let me explain a little better:
Take a group of people dying of cancer. In one country, they are given palliative care, and 100% of them die. But end-of-life costs are low.
In the second country, terminal cancer patients are given expensive treatments and surgeries to attempt to cure them or lengthen their lives. Let’s say 5% of those people survive. Their statistics aren’t counted in ‘last year of life’ costs, but the 95% who die sure are, and the money was spent on them as well. So the overall ‘end of life’ costs go up, but if that’s all you’re looking at, what you’re missing is that the number is really reporting “the cost of saving 5% of terminally ill people.”
Now, you can argue that it’s not worth the cost to try to save x% of people with radical treatments, but my point is that this is where a lot of innovation occurs. The Jarvik artificials hearts were hellishly expensive, and everyone who had one implanted died. I doubt such a treatment would ever be attempted in a country with socialized medicine. And yet, extreme measures like that sometimes turn into routine measures. Kidney Dialysis was once extremely risky and only worked for a short time. It was also hellishly expensive. Today, people can be kept alive on dialysis indefinitely.
Industries need ‘early adopters’ to create innovation and fund expensive and risky things. In a socialized health care system under strict cost controls and an egalitarian mindset, I fear that research and innovation will suffer. It will all fall into the hands of the government.
I’m pretty certain those 5% are going to die as well! 
OTOH, the employer (in the form of the HR people) has leverage with the insurance co. that no individual has, and that nobody has with the government.
Perhaps, but having a corporate HR go up against an insurer on behalf of a single employee is outside of my experience or knowledge. I’m not saying it’s never happened, but I’ve never heard of it.
I believe it happens all the time.
I deal with a lot of HR people, and they’ll talk about whether their carrier is responsive or not to this type of thing.
Would a summary of a peer reviewed article in a journal do?
So here is a government program that seems to deliver better health outcomes at a lower cost.
For those who continually say “but it simply can’t be done in the United States”, I say:
You guys can do most anything you set your minds to. I don’t expect an attitude of “oh well, it’s too hard, can’t be done” and other excuses from Americans. Get in there and FIX IT.
This. “It can’t be done” is the words of a defeatest. America was born fighting. We don’t give up. We didn’t give up to the British, we didn’t give up to the Confederates, we didn’t give up when the industrial revolution reduced many Americans to grueling lives of continual unsafe labor and the government was ripe wirh corruption from political bosses and the like, we didn’t give up when women couldn’t vote, nor did we cede the fight so that all Americans regardless of race were treated equal under the law, we didn’t give up to Imperial Japan nor Hitler.
We fought. We won our independence, then we kept the country together and emancipated the slaves, we fought for labor laws and dismantled the political machines, we faught that women would gain sufferance, Americans stood strong in the south and broke the notion that they weren’t equal. We and the allied forces ended the pure evils of Nazi Germany and equally barbaric Imperial Japan. It was American industrial might that got supplies to Britain building Liberty ships faster then Germany could sink them. Though we were isolationists when Pearl Harbor awoke our fury we were a force to be reckoned with. We went to the moon just to one-up the USSR.
We’re a fighting people. We’re strong. It takes the combined economic might of Western Europe to rival us.
You’re gonna tell me we can’t do whatever virtually every other industrial country did just fine?
Bullshit. You must be profoundly ignorant.
That’s the attitude. We should keep fighting!
No matter how many other countries have enacted this socialized medicine system, and no matter how much we are pressured to adopt it ourselves, we should resist! Keep fighting it! Never give up! Remember the Alamo!
Another thing to fight is the total bullshit of “do you trust a bureaucrats for your medical care” meme, as well as the scary “socialist medicine” meme.
There are ways of creating government efficiency that work, and don’t have to have the above problems.
A single payer system, where the government acts as the single insurer but DOES NOT make medical decisions for individual patients seems to work pretty well.
A federal law, such as the Canada Health Act, can see to it that there are uniform standards of care between smaller jurisdictions (provinces, states) that actually pay the salaries of the medical professionals.
Think about it another way: let’s say my city police department has top-notch detectives, state of the art DNA testing equipment, and labs full of crazy NCIS-style shit. But they do a lousy job of keeping drug dealers off the streets, they take three hours to show up and fill out an accident report for a fender-bender, and they generally don’t do anything to make people feel safe.
Meanwhile, your city doesn’t have as much technology and talent at the top, but they have plenty of cops on the streets and they’ve put tons of thought into using them effectively to prevent crime. People feel safer and crime is objectively decreased.
If there’s an eccentric serial killer on the loose, it might be better to be in my city. But in just about every other respect, it would be better to be in yours.
This is kind of where we are in the US. If you have some obscure cancer, you’re probably better off here than anywhere, but if you’re an old man with pneumonia, not so much.
If that’s true, then it’s a lousy thing to leave to the free market.