That’s proof enough for me.
Not sure what the implication of that is other than we use more assets for a given illness. I just dealt with kidney stones and it involved 2 CT scans, with 2 sets of follow-up X-rays. Did I need the CT scan? Couldn’t tell you. I can tell you the stones were much more obvious on the CT scan by many a factor of many. I couldn’t pass the stones in a week so I went to a Urologist who pencilled me in that day for their removal. 3 hrs later I was stone free (OK, they put a stint in for 5 days). I’m sure the whole ordeal could have been done for a fraction of the cost with no difference in overall health care. We probably waste a lot of money on diagnosis with little return on health dollars invested. But I’m going to have to vote for the extra money in this case.
And to add to the girth of Americans vs our better-schooled cousins is the transportation factor. GB is a more centralized society with an excellent transportation infrastructure. The closest store I go to is 10 miles away. Virtually everything I do involves a car including bike rides.
Spending twice the money for no increase in health? Why would you vote for that? If the extra expenditure where making us more healthy it would make sense, but obviously if it’s not having a very large effect if whatever subtle factor is making the British more healthy outweighs by far any benefit we’re getting by paying twice as much for our healthcare.
OK, but again the study controlled for the greater amounts of exercise that Brits get, and even taking out that difference they have better health.
“Vote” was a poor choice of words, as I didn’t mean it in the political sense. I was in a lot of pain and the response was instantaneous. I want access to the best equipment and medical procedures. Or put another way, the ability to throw my own money at a problem if I think its necessary. If you’ve ever had a stint removed from a ureter you’ll understand why it’s important to have a good doctor (I checked before I chose him).
Using my kidney stones as an example what would have happened in single payer countries: From the Boston Globe
Around 25 percent of patients undergoing elective surgery in Canada, Australia, and New Zealand – and around 36 percent in Britain – have to wait more than four months for a turn in the OR (The figure in the United States: 5 percent). According to the Fraser Institute, a Vancouver think tank, the average Canadian patient waited 8.3 weeks for an appointment with a specialist in 2003 – and another 9.5 weeks before getting treated.
My experience with kidney stones was as follows: I drove to the hospital with what I thought was a slipped disk. They found me on the ground in front of the emergency room. In 20 minutes they had me full of morphine and on my way to a CT scanner. Diagnosis was made in 1 hr and I was sent home with pain medication and a prescription. 24 hrs later I called my family doctor and got a different prescription. 48 hrs after that I was back in the hospital where they prescribed something that worked. 7 days from the start I made an appointment with a Urologist (of my choice) for the following day. I then got a 2nd CT scan which confirmed the kidney stone hadn’t moved. I had surgery and was out the door in 4 hours. 5 days later the stint was removed.
Well, I didn’t live in the UK for an extended period of time, but I did live there for a cumulative year (6 months in London, 2 years back in the US, then 6 months in Edinburgh) so I may have some room for comparison.
Both times I was in the UK I lost significant amounts of weight (40-50 lbs), without consciously exercising or dieting at all. Both times I came back to the US I gained the weight back immediately. The reason? Giles hit it square on the head:
I can’t say what a huge difference having to walk most places made for my health. That is the only thing that made me lose weight in the UK – and I think it made me healthier in other ways as well. I was outdoors more, in the fresh air, interacting with people more often, getting some sun. Even though the study says the gap persists once the weight difference is calculated in, I still think the fact that the Brits walk more makes a difference even for people of the same weight. You can be skinny but unhealthy if all you do is sit inside all day watching TV.
Because of all that, I blame the car culture for a lot of the US’ health problems. You have to drive EVERYWHERE in this country. In most places, you don’t even have the option of walking – and it’s getting worse all the time. The car culture leads to isolation, and as someone mentioned above, social factors such as this can effect one’s health. (My social life was always a lot better in the UK – it was easy to bump into people you knew on the street; get together’s were fairly simple to plan, etc.)
On the flip side, the Brits I knew smoked a lot more than your average American. Another factor at play might be the different climates of the two countries. Most Americans live in the South of the country, the heat of which might discourage people from getting out of the house and moving around. And when they do get out and move around, the relentless sun leads to a higher risk of cancer. Maybe Britain’s rainy climate is simply healthier.
The British apparently do have access to health equipment that is at least as good or better then our own, for half the price. If their equipment and procedures were measuably worse, then presumably they’d have measurably worse health.
You spent your own money on medical expenses? Most Americans, anyways, are insured and aren’t spending thier own money, at least not directly. And in anycase, I think in Britian one can still spend their own money to pay a doctor directly if you really think you get something out of paying someone out of pocket. (also nitpick: doesn’t a nurse usually remove stints? they did when I was in the hospital, agree that a soft touch is appriciated down there though)
So far as I can tell, that isn’t using kidney stone surgery as an example. It’s just all elective surgeries. Presumably there is some sort of triage system in place in Britian, so if you are crippled with pain from kidney stones or the like, you get in quicker while others whose surgery can be put off without ill effects are made to wait longer. Of course it still sucks to have to wait longer as no one likes drawing these things out, but if there aren’t any ill effects (and again the article reference in the OP shows that there aren’t any measurably large effects on Britain’s health), but if it halves the price of health care (which in this country is 2 trillion dollars a year, or about the total size of the US gov’ts spending in a year!) then I’d say it is worth it. Not to mention that the other advantages that come along with a single payer system.
Also I enjoyed the part in that Globe article where the author criticized a bumper sticker for not presenting an in depth enough argument to support it’s position on single payer healthcare 
That is true. A lot of Americans who deride the UK system seem not to be aware that you can pay for healthcare if you want, and you can also have private medical insurance. Insurance is cheap as most people still use the NHS for routine doctor’s appointments or for urgent treatment - the insurance is mostly for non-urgent treatments such as elective surgeries.
Since graduating, I have spent about 12 years in each of the US and UK.
The last time I had health insurance in the UK (admittedly 10 years ago) it cost £452/year (call it $850) for the family. Here in the US it costs my company more than that per month, and I still pay $2,000 or so per year for things not covered by insurance. (And that excludes orthodontics, which is a whole other story…).
I think that cost is a factor even for well-off people in the US. I can easily afford the treatment, yet I canceled an MRI because I didn’t want to pay $500 for a minor twinge in my knee. I suspect some people take the same approach for ailments that turn out to be more serious. Let’s face it, many guys look for an excuse not to see the doctor, so if you throw in a hefty bill also, that’s another reason not to go.
Several people have mentioned higher stress in the US. I don’t find it more stressful than the UK. Well, I suppose people could be making themselves sick by stressing out over how they will be able to afford treatment if they get sick.
The walking argument makes sense to me. People will drive from store to store in the same strip mall rather than walk 30 yards.
I also think that the high use of MRIs in the USA is largely defensive-the doctor is trying to make a paper trail, demonstrating that he is aware of the possibility of a lawsuit. This is one reason for the high cost of healthcare in the US. I also think that doctors may well have a finacial interest in carrying out a lot of tests-their referrals to test services are probably appreciated
Thanks for standing up for something I was about to mention. The reason us Brits are so reluctant to go private, which is a perfectly feasible think to do here, is that we have an attitude that we should get this stuff when we want it, because we pay for it in our tax.
The figures for elective surgery quoted earlier are therefore largely irrelevant, since the electives could go private/insurance immediately, any time they were ready to pay - same as the US.
I believe the point of the article wasn’t the quality of the equipment or treatment but the quantity of each. It’s easy to save money when people are forced to wait: (same Boston Globe article)
As it happens, the real-world consequences of single-payer healthcare – also known as socialized medicine or national health insurance – are well-documented. Single-payer care exists in Canada, New Zealand, Great Britain, and much of Western Europe. And wherever it has been tried, writes John C. Goodman, president of the National Center for Policy Analysis, '‘rationing by waiting is pervasive, putting patients at risk and keeping them in pain.’'
If Brits have this option and there are doctors available then I stand corrected. As it stands now, Canadians are bypassing the wait by coming to the United States where there is a better doctor/patient ratio. And yes, I pay a percentage of my medical bills so money was involved in my decision. And no, I don’t think nurses are allowed to remove ureter stints, which are removed by way of the bladder. I could be wrong. Either way, you REALLY want someone who knows what they are doing and is exceptionally quick at it. Not the worst pain in the world but it’s…. unpleasant.
What I went through was elective. I was given a choice. The choice was made available after a diagnosis based on a CT scan. The wait for a CT scan was measured in minutes and the operation in hours.
I think that’s it. Some Americans are bastions of fitness, watching their diet, going to the gym & hitting the weights & treadmills. But lots of other Americans are fat-asses who drive everywhere and their idea of lawncare is calling a service.
Brits may not hit the gym as much, but they’re more likely to walk, and do things like their own lawncare.
I’ve lived in Germany off and on, and I’m usually more healthy there, because I’m expected to walk to the corner store, not drive. And when I take care of my garden, it’s more by hand, then immigrant leafblowers & riding lawnmowers
Again, the study claims to have controled for differences in exercise. That’s why it’s so interesting, they isolated out all the obvious reasons for there to be differences in health (exercise, wealth, healthcare, race, etc.) and still got a measurable difference.
I wasn’t responding to the story but to your statement: “I was in a lot of pain and the response was instantaneous. I want access to the best equipment and medical procedures.”, which so far as I can tell means that you think Brits wouldn’t have access to the best equipment and medical proceedures. I think the study suggests that this isn’t the case.
From the National Center for Policy Analysis “about us” section on thier website:
Not exactly an unbiased voice. Doesn’t mean the claim is wrong, but it isn’t really a useful cite. Anyhoo, I got a bunch of cites regarding rationing and the like in single-payer systems, but I’m gonna hold off and start a new thread just about that topic this weekend when I have more time as we’re starting to hijack this thread, which after all is about a study that specifically says the difference it observes is not due to differences in the healthcare system.
Heh, I got the urethra and the ureter confused. You’re probably right, sorry. Obvously whatever healthcare system is the best one is one that won’t let me anywhere near a scalpel.
If they controlled for exercise, then I’d go with Askia’s idea that Americans tend to be under more stress. We go to the gym, but then we stress about not getting fired, or finding a better job and making enough money to afford the expensive gym membership, etc.
That certainly seems possible, though it’s a hell of a thing to try and quantify. I’m a little suspicious of it as an explanation for that reason, as it seems kinda mumbo-jumbo. I mean do brits really not worry about getting fired, or getting a better job or affording expensive gym memberships? Is it a nation of mellow hippies who just sorta let this stuff ride? The last time I was there was when I was 11, so maybe, but I’m a little skeptical there is such a huge cultural difference between British and American societies.
I’m suggesting that a smaller doctor to patient ratio (only Canada quoted in the article) means a longer wait. The article specifically mentioned CT scans as something with a waiting line which is why I used my own experience as an example. I’m extrapolating from the article that under the same circumstances I would have waited longer for the same care. Since it wasn’t a medical necessity that I have the stones removed there is a likely chance I would have had to wait it out. That is what I would like to avoid in a federally structured insurance program. Which is why I hope we approach it with extreme caution.
Actually, this seems to be a variant of the “French Paradox”, which has provisionally been solved with the help of portion sizes, although people are still arguing over other explanatory factors. Do you know if the study was controlled for amount and type of food consumed?
Careful with the controls for exercise… Europeans are likely to under-report their exercise. We do things we don’t notice doing but which became evident to me when I went to the US. You can’t bloody walk there!
Many people think that you’re exercising only if you do it consciously. I know many women in my hometown in Spain who, when asked how much they exercise in a week, would say:
“uhm… go to Eroski and come back… 3kmx2… 6km… I do it on weekdays… so 30km/wk of walks. No, no, that’s all, I don’t do none of that gym stuff or whatever”.
But they’d be wrong. They’re only counting their “exercise walk”, not the time spent walking to stores, carrying toddlers, pulling on toddlers who don’t want to walk, lifting 15-kilo pressure cookers or 12-pound potted plants, etc etc.
My hometown’s most recent expansion has brought, for the first time ever, areas that look like American suburbia. Rows of houses, not a store in sight. People take the car to go to the store, to work or downtown. People started noticing that those who moved into those areas were likely to start gaining weight. They were exercising (consciously, remember?) as much as before, eating like before, etc. But they were gaining weight, feeling less energetic, etc. Nothing earth-shaking, but, why would the sister who’d just moved to a new flat downtown be all pumped up and the one who’d just moved to a suburban house be all bleh? At first, we all thought we were having collective hallucinations, but it was so all-pervading they’re conducting some official research on it. My SIL-the-doctor is involved and the conclussions seem to be that no, we were not hallucinating.
“Suburbia” with playgrounds strewn about seem to have less of an ill effect. Again, people are walking the kid to the playground, instead of getting into the car, driving to one of the playgrounds downtown and parking right there.
Err…
StEnts can certainly be removed by nurses, I’ve had them on a number of occasions and they are not that painful. Uncomfortable, sure, they make your toes curl a little, but no more painful than having a urethral catheter removed (which again isn’t really painful, just unusual). The nastiest thing about stents is how long they are, you think they’re almost all out and then they just seem to go on forever.
I’ve never had a single tube, stitch, clip, staple, dressing or canula removed by a doctor, and it’s not like I’ve not given them the chance.
My rant:
The thing about the NHS is the bad stories in the press are anomalies, there’s no money in writing about the 18million admissions that go smoothly every year, it’s the single horror story that sells papers. So one person has to wait 18 months for an elective surgery is a story, but the baby who is born with the rare heart condition gets surgery the next day is conveniently ignored.
Spend some time in Great Ormond Street Hospital for Sick Children, or one of the other world-class specialist centres (there are quite a few), and then tell me that medicine in the UK is backward (which seems to be the common perception amongst right-leaning americans).
Even though you were given the option, I’m not sure that kidney stones as bad as your example would be considered “elective surgery” in the countries you’re talking about.
I realize this is anecdotal and does not constitute “evidence” but Jamie Oliver (a british TV chef often shown on the Food Channel here) did a series of shows in Northern England elementary schools to help them plan a healthier menu for the kids. He was in an area reported by English health authoroties as being the least healthy in the entire contry by some statistical measure. They showed lots of kids on the playground while Jamie was doing his show and I did not see a single heavy (overweight) kid in the frame. Not in line for the school made lunches. Nowhere. While in the US a smiliar “unhealthy” neighbourhood would certainly reveal many obese children.
So I don’t know what makes the British kids unhealthy. Perhaps they smoke and drink at the pub after class.