Ignoring any potential effects other than the cost burden, and if that burden is roughly equal to that of the current system, (the editorial apparently cannot conclusively demonstrate that overall costs will be higher), then for me it’s something of a wash. OTOH, I am concerned if the overall quality of care drops significantly, as the editorial claims will happen. Is this true, however? Amongst the unattributed claims made in the editorial are these:
breast cancer mortality is 88% higher in the UK than the US (presumably there is some way of showing that the health care system itself is at fault)
1.8 million people in the UK are waiting to get into a hospital (how does that compare, on a percentage of population basis, to the number of people waiting to get into a US hospital?)
More than 70% of Germans, Australians, Britons, Canadians and New Zealanders think their systems need “complete rebuilding” or “fundamental change.”
I don’t have the means to do any deep research on these. Are these claims correct? If not, there seems little reason to credit any of the other assertions in the cited editorial.
The point is that the vast majority of people are not being prevented from getting an illness by the preventive care. Either because the preventive care doesn’t actually prevent all instances of the illness - just a portion of them (and a pretty small portion in the case of some, like mammograms for women under 50) - or because the vast majority wouldn’t have gotten these illnesses even without preventive care.
So you’re not comparing the amount of preventive care against the illness in the case of the one person who doesn’t get sick (or is cured) as a result of the program - you’re comparing the amount of preventive care that is expended to all people to the savings for that minute percentage that are actually saved from a more serious illness.
This is where your math (& whack-a-mole’s) breaks down.
In addition to the above, there are arguments that preventive care sometimes not only doesn’t save money but is also bad for health. The reason is that a lot of screenings (in particular some types of cancer screenings, e.g. prostate & thyroid) find things that would have been better off left untreated, but once they are found can’t be ignored because no one can really distinguish which cancers will be dormant and which ones will be aggressive. So the patient is “forced” into a cycle of more tests, treatments and interventions, some of which save his/her life but some or even most of which are unnecessary medical intrusions.
Possibly this will be alleviated in the future as doctors learn to assess the risks in a more precise manner. (Or possibly it will get even worse, as doctors come up with more imprecise tests that raise early alarms about even more conditions.) But today that is the state of affairs WRT many early interventions and preventive measures.
Number 1 is a cherry picked statistic, if it is true at all. The USA has the highest survival rate for breast cancer, but France has the highest survival rate for colon and rectal cancer. If someone wants to prove the US healthcare system is better than socialized medicine, the most honest way is NOT to pick the USA’s best indicator against the worst indicator among all the countries you’re comparing against. If you shift your focus away from these types of cancers toward stuff that can be prevented, like lung cancer, adult onset diabetes, and obesity-related diseases, the USA looks like a third world country compared to some places with socialized medicine.
That’s not the whole story, though. The main problem with American health care is that it costs too much. Americans have more preventable diseases than other countries because it costs too fucking much to see a doctor.
Do you really think that making everyone go to the doctor every year (as if you could really do that) would cut down on those issues? Those are the (mostly) 100% preventable diseases and costs that are due strictly to the patient.
How is it correct that I must pool resources with people who clearly aren’t going to take care of themselves? Those people are not unlucky, they are stupid. I should npt be penalized for that.
It’s not just pooling resources. It’s also making it more efficient, by removing roughly one-third of the people who have their hand in the healthcare cookie jar for profit. If nobody has to pay the insurance company, the only people directly collecting a profit for your doctor visits would be hospitals and doctors, which is the way I think it should be.
Americans aren’t any “stupider” than countries with socialized medicine, but Americans sure do get more preventable diseases. What do YOU think the connection is?
I had no math - I was just setting up the equations. As I said, the actual numbers for the benefits are hard to find. Yes, the majority of people will get sick in ways that cannot be prevented - vast majority, I’m not sure. On the other hand, the cost of preventative care is a tiny fraction of the cost of being sick, both in terms of treatment and lost earnings opportunities.
It costs about $100 a month (total, not just co-pay) for Warfarin and to get my blood checked to keep me from having a stroke. If I had one, it would be $50K or $100K in hospital bills easily, or, if I died, about $1 million in lost earnings. That’s a pretty big multiplier.
Some of my papers deal with this very issue, for the computer business not for medicine, so I’m quite up on the pros and cons.
False positives are inevitable. We do throw away good chips all the time. But I suspect most people will agree that the cost of a false negative far outweighs that of a false positive. Much of what you are saying concerns how to diagnose the problem. Is it really better to ignore a problem than to possibly have problems diagnosing it, which requires more tests?
I do support evidence based medicine, which might improve this situation, and I hope reduce costs. But evidence based medicine is appropriate for both the rich with insurance now and the poor without it.
Good point. I’m also old enough to remember commercials where the usual suspects were ranting and raving about how Medicare was socialized medicine.
Question for all: proponents of UHC can point to a lot of countries where it is in operation (in a variety of ways) with good results. Are there any countries around with even less government support for healthcare than ours (i.e., pay most of the bills yourself) and what are the outcomes in terms of life expectancies? I’d think that only developed world nations would be a good comparison, because underdeveloped nations would have low life expectancies for other reasons.
Lack of healthcare isn’t the cause of these illnesses and diseases, it’s a sedentary lifestyle and diet. sounds like what we need is an education program.
I think they are saying we can spend the $100/month to protect you and you will almost certainly live longer as a result. Yet inevitably you will end up the the hospital for something that will be the end of you and we are on the hook to try and save you then.
So, by that cold calculation, why spend the $100/month to keep you alive since we will all share in paying for your death?
Of course this is true for everybody so why should we bother at all?
I think from Fotheringay-Phipps that is the first time I have ever seen someone argue against preventative medicine making us all less healthy.
I guess we should all stay at home, ignore those nagging pains and wait till we collapse to go to the hospital. That is clearly a better strategy. :rolleyes:
But what’s the likelihood that you are being prevented from having a stroke by these measures? Or, looked at differently, for every 1,000 people who have these preventive measures, how many fewer people will suffer strokes than a similar population that does not have these measures? In order to break even at the $100K per stroke cost level, you would have to prevent 12 out of 1,000 per year. Any less and you’re losing money.
[Your lost earnings are not a valid comparison for purposes of this discussion.]
I was not talking about false positives. I was talking about correct positives, which produce information that is hard to ignore but hard to deal with constructively.
I once read that something like 75% of men aged 75 (or some numbers in these ranges) test positive for cancer of the thyroid, if tested. Very few men die of thyroid cancer. These are not false positives, but are valid tests - these guys do have thyroid cancer. But most thyroid cancer is slow growing. A minority is fast growing. It’s difficult or impossible to tell them apart. And it’s hard to resist the urge to treat the condition, once it’s known that the guy has cancer.
I’m not the guy who made up these arguments, and if this is the first time you’ve ever heard them then you are simply uneducated about these matters and should consider more reading and less posting on the subject.
So 47 million people are dying every year because they don’t have health insurance?
Look, this kind of stupid-ass shit doesn’t add anything to the debate. Every fucking time someone points out the undoubted fact that Obama’s scheme involves spending a trillion dollars we haven’t got, all the lefties can do is come back with meaningless crap about how asking “how the hell are we going to pay for all this?” means you want poor people to die.
And at the end would still leave 15 million people without health insurance (cite). Aren’t they going to die too? Don’t you care about them?
So now what - we spend another trillion we haven’t got?
I realize ‘cost-benefit analysis’ is a dirty word to Democrats, but this bill is going to bankrupt us all. Let’s try to overcome the taboo, shall we?
As noted running to the doctor just to find “something” is an issue and for whatever reason doctors tend to find things they need to treat. Additionally they noted changing definitions of when there is a problem.
That is for the medical community to decide and sort out. They need to determine how to appropriately diagnose various issues. Part of the problem is probably a litigious environment where if the doctor misses anything or worse, spots it and ignores it, they will get crucified.
None of that argues against going to see a doctor if you notice unusual pains or symptoms that are not normal. Sitting at home hopping whatever it is goes away is not healthy. Far better to see a doctor sooner rather than later when your little issue might be a big issue.
Hey, how about you find something that I said in this thread (or anywhere else, if you prefer) which “argue[d] against going to see a doctor if you notice unusual pains or symptoms that are not normal”.
The straightforward thing for you to do would be to admit that what I said was pretty much what the various experts said or were quoted as saying in the linked articles, and are what is directly relevant in the context of this debate. (And, for a more complete picture, that you were uninformed on the subject.)
Whether you’re up to that, I don’t know. (Just kidding, actually I do.)
Yes yes, do the populist posturing if you must. Feel better? Okay.
The Democrats are claiming that healthcare reform will save money by making people use preventative care, lowering costs. The record so far shows that preventative care costs more money. Is it worthwhile to spend more money to possibly improve health? Sure, sometimes: that’s what doctor’s visits are all about. But it is false to pretend that healthcare reform will be cheap, because preventative care costs **more **money. Got that?