Brad Sallows
Army.ca Legend
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How do you figure you'd be liable for all that money? Would you not buy health insurance for your family if taxpayers didn't do it?
retiredgrunt45 said:Fine for the people who can afford insurance or are covered through their work. What about the millions who aren't or can't afford insurance? Low wage earners, jobless people, etc. How do they pay for their care? The good will of others, charity, handouts?
Just because you have insurance in the U.S, doesn't mean your of the hook for fees. Theres the Co-payment and depending on the % of the co-Payment and the amount of the bill, it could still be in the thousands.
Up here in Canada, everyone is covered, rich, poor, jobless etc. I really wish people would get their heads out of the sand, have good look around and see how good we have it up here. I do think that unless someone is confronted with a serious illness in their family, that they will contiinue to take our system for granted and will never really know the real benefits of a system like ours has.
Heres some interesting stats completed in 2004, done by the (STATE COVERAGE INITIATIVES PROGRAM), showing how many americans aren't covered. The numbers speak for themselves.
(PDF)http://www.statecoverage.net/pdf/coverage.pdf
(HTML) http://72.14.205.104/search?q=cache:O0Brajp4bbcJ:www.statecoverage.net/pdf/coverage.pdf+Health+care+in+the+united+states&hl=en&ct=clnk&cd=9&gl=ca
How do you figure you'd be liable for all that money? Would you not buy health insurance for your family if taxpayers didn't do it?
Everyone is "covered" in the USA, too. No one is turned away from hospital emergency rooms.
RG45 Glad to hear of the happy outcome - For me, it's all I can take when one
of my cats get sick.
Flip said:...
It's a lousy way to use the most expensive resource in the healthcare system.
...
There are no controls on the amounts of money people are permitted to spend on their housing or automobile choices, and there is no suggestion that people be protected against their money management problems as a result.
E.R. Campbell said:But, the fact (and it is a fact) is that the USA also has the most "effective" health care in the world - in terms of "outcomes" when the healthcare system is utilized. The US system is not very "efficient," however, because a whole bunch of people, for a whole host of reasons, don't use it when and as they should. That's why there are such shocking statistics around some medical situations.
Overview
Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries. This report—an update to two earlier editions—includes data from surveys of patients, as well as information from primary care physicians about their medical practices and views of their countries' health systems. Compared with five other nations—Australia, Canada, Germany, New Zealand, the United Kingdom—the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes. The inclusion of physician survey data also shows the U.S. lagging in adoption of information technology and use of nurses to improve care coordination for the chronically ill.
...
Summary and Implications
Findings in this report confirm many of the findings from the earlier two editions of Mirror, Mirror. The U.S. ranks last of six nations overall. As in the earlier editions, the U.S. ranks last on indicators of patient safety, efficiency, and equity. New Zealand, Australia, and the U.K. continue to demonstrate superior performance, with Germany joining their ranks of top performers. The U.S. is first on preventive care, and second only to Germany on waiting times for specialist care and non-emergency surgical care, but weak on access to needed services and ability to obtain prompt attention from physicians.
Any attempt to assess the relative performance of countries has inherent limitations. These rankings summarize evidence on measures of high performance based on national mortality data and the perceptions and experiences of patients and physicians. They do not capture important dimensions of effectiveness or efficiency that might be obtained from medical records or administrative data. Patients' and physicians' assessments might be affected by their experiences and expectations, which could differ by country and culture.
The findings indicate room for improvement across all of the countries, especially in the U.S. If the health care system is to perform according to patients' expectations, the nation will need to remove financial barriers to care and improve the delivery of care. Disparities in terms of access to services signal the need to expand insurance to cover the uninsured and to ensure that all Americans have an accessible medical home. The U.S. must also accelerate its efforts to adopt health information technology and ensure an integrated medical record and information system that is accessible to providers and patients.
While many U.S. hospitals and health systems are dedicated to improving the process of care to achieve better safety and quality, the U.S. can also learn from innovations in other countries—including public reporting of quality data, payment systems that reward high-quality care, and a team approach to management of chronic conditions. Based on these patient and physician reports, the U.S. could improve the delivery, coordination, and equity of the health care system by drawing from best practices both within the U.S. and around the world.
Background: Differences in medical care in the United States compared with Canada, including greater reliance on private funding and for-profit delivery, as well as markedly higher expenditures, may result in different health outcomes.
Objectives: To systematically review studies comparing health outcomes in the United States and Canada among patients treated for similar underlying medical conditions.
Methods: We identified studies comparing health outcomes of patients in Canada and the United States by searching multiple bibliographic databases and resources. We masked study results before determining study eligibility. We abstracted study characteristics, including methodological quality and generalizability.
Results: We identified 38 studies comparing populations of patients in Canada and the United States. Studies addressed diverse problems, including cancer, coronary artery disease, chronic medical illnesses and surgical procedures. Of 10 studies that included extensive statistical adjustment and enrolled broad populations, 5 favoured Canada, 2 favoured the United States, and 3 showed equivalent or mixed results. Of 28 studies that failed one of these criteria, 9 favoured Canada, 3 favoured the United States, and 16 showed equivalent or mixed results. Overall, results for mortality favoured Canada (relative risk 0.95, 95% confidence interval 0.92–0.98, p = 0.002) but were very heterogeneous, and we failed to find convincing explanations for this heterogeneity. The only condition in which results consistently favoured one country was end-stage renal disease, in which Canadian patients fared better.
Interpretation: Available studies suggest that health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent.
Blackadder1916 said:What is your measurement of "effective" and "outcome"?
E.R. Campbell said:That those who (can) make proper use of the system get first rate and timely treatments. Those who fail to make good and proper use of the system don't - and I suspect that large, poor, ill-educated, frightened (of authorities) underclasses (there's more than one) pull all those statistics way down.
Broadly, US "healthcare" is below par while their "medical care" is first rate.
But I think that applies here, too. We offer good if often slow "medical care" but we provide little in the way of real, meaningful "healthcare." We, like the Americans, are in the business of treating the ill and injured, not in preventing illness or injury. On that basis the Americans do it faster and better for most people.
Quality: The indicators of quality were grouped into four categories: right (or effective) care, safe care, coordinated care, and patient-centered care. Compared with the other five countries, the U.S. fares best on provision and receipt of preventive care, a dimension of "right care." However, its low scores on chronic care management and safe, coordinated, and patient-centered care pull its overall quality score down. Other countries are further along than the U.S. in using information technology and a team approach to manage chronic conditions and coordinate care. Information systems in countries like Germany, New Zealand, and the U.K. enhance the ability of physicians to identify and monitor patients with chronic conditions. Such systems also make it easy for physicians to print out medication lists, including those prescribed by other physicians. Nurses help patients manage their chronic diseases, with those services financed by governmental programs.
Blackadder1916 said:...
If their provision of preventive care scores the best, how much worse are the others factors of quality (in comparison to the other countries)?
It was a rhetorical question.E.R. Campbell said:My, personal, short answer to your question, Blackadder1916, is: Dunno.
PROLOGUE: Over the past three decades, particularly during periods when the U.S. Congress has flirted with the enactment of national health insurance legislation, the provincial health insurance plans of Canada have been a subject of fascination to many Americans. What caught their attention was the system’s universal coverage; its lower costs; and its public, nonprofit administration. The pluralistic U.S. system, considerably more costly and innovative, stands in many ways in sharp contrast to its Canadian counterpart. What has remained a constant in the dialogue between the countries is that their respective systems have remained subjects of condemnation or praise, depending on one’s perspective.
Throughout the 1990s, opponents of the Canadian system gained considerable political traction in the United States by pointing to Canada’s methods of rationing, its facility shortages, and its waiting lists for certain services. These same opponents also argued that "refugees" of Canada’s single-payer system routinely came across the border seeking necessary medical care not available at home because of either lack of resources or prohibitively long queues.
This paper by Steven Katz and colleagues depicts this popular perception as more myth than reality, as the number of Canadians routinely coming across the border seeking health care appears to be relatively small, indeed infinitesimal when compared with the amount of care provided by their own system. ….
Abstract
….Results from these sources do not support the widespread perception that Canadian residents seek care extensively in the United States. Indeed, the numbers found are so small as to be barely detectible relative to the use of care by Canadians at home.
But a lot of the same people who praise our healthcare system would dearly love to be able to tell everyone what kind of car or house you should be allowed to buy.
I know; but the campaign to have them declared morally unfit to vote (ie. exercise power over others) is making very little headway.
retiredgrunt45 said:... I have a doctors appointment his afternoon, I must go and have my monthly mind control and brain washing session, free of charge of course...