Hospital, Dignity, Reality

[Flicka]

Half my family are doctors and my little sis is doing her final year in med school and I don't think either of them would ever want to work where there wasn't public healthcare. Some of them have worked in the States but wouldn't go back there - it's a whole different climate in the profession they say. I have no idea if they're right or not, but I know that my mother with very advanced lupus (she's a nurse, btw) received excellent care when she was hospitalized this summer, and it cost her app ten dollars a day, so she got great value for her money!

 

[sheeplady]

Half my family are doctors and my little sis is doing her final year in med school and I don't think either of them would ever want to work where there wasn't public healthcare. Some of them have worked in the States but wouldn't go back there - it's a whole different climate in the profession they say. I have no idea if they're right or not, but I know that my mother with very advanced lupus (she's a nurse, btw) received excellent care when she was hospitalized this summer, and it cost her app ten dollars a day, so she got great value for her money!

I have heard similar things from other people, who ended up working on either continent in the end. The medical system in the U.S. is so different than the rest of the world.

 

[jamespowers]

This shouldn't be considered a big run one way or the other but facts have a tendency to get in the way of perception:


From Scott Atlas
Freeman Spogli Institute for International Studies at Stanford

"Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world. Economists, government officials, insurers, and academics beat the drum for a far larger government role in health care. Much of the public assumes that their arguments are sound because the calls for change are so ubiquitous and the topic so complex. Before we turn to government as the solution, however, we should consider some unheralded facts about America’s health care system.

1. Americans have better survival rates than Europeans for common cancers. Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

2. Americans have lower cancer mortality rates than Canadians. Breast cancer mortality in Canada is 9 percent higher than in the United States, prostate cancer is 184 percent higher, and colon cancer among men is about 10 percent higher.

3. Americans have better access to treatment for chronic diseases than patients in other developed countries. Some 56 percent of Americans who could benefit from statin drugs, which reduce cholesterol and protect against heart disease, are taking them. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians receive them.

4. Americans have better access to preventive cancer screening than Canadians. Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate, and colon cancer:

• Nine out of ten middle-aged American women (89 percent) have had a mammogram, compared to fewer than three-fourths of Canadians (72 percent).
• Nearly all American women (96 percent) have had a Pap smear, compared to fewer than 90 percent of Canadians.
• More than half of American men (54 percent) have had a prostatespecific antigen (PSA) test, compared to fewer than one in six Canadians (16 percent).
• Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with fewer than one in twenty Canadians (5 percent).

5. Lower-income Americans are in better health than comparable Canadians. Twice as many American seniors with below-median incomes self-report “excellent” health (11.7 percent) compared to Canadian seniors (5.8 percent). Conversely, white, young Canadian adults with below-median incomes are 20 percent more likely than lower-income Americans to describe their health as “fair or poor.”

6. Americans spend less time waiting for care than patients in Canada and the United Kingdom. Canadian and British patients wait about twice as long—sometimes more than a year—to see a specialist, have elective surgery such as hip replacements, or get radiation treatment for cancer. All told, 827,429 people are waiting for some type of procedure in Canada. In Britain, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.

7. People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand, and British adults say their health system needs either “fundamental change” or “complete rebuilding.”

8. Americans are more satisfied with the care they receive than Canadians. When asked about their own health care instead of the “health care system,” more than half of Americans (51.3 percent) are very satisfied with their health care services, compared with only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).

9. Americans have better access to important new technologies such as medical imaging than do patients in Canada or Britain. An overwhelming majority of leading American physicians identify computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade—even as economists and policy makers unfamiliar with actual medical practice decry these techniques as wasteful. The United States has thirty-four CT scanners per million Americans, compared to twelve in Canada and eight in Britain. The United States has almost twenty-seven MRI machines per million people compared to about six per million in Canada and Britain.

10. Americans are responsible for the vast majority of all health care innovations. The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other developed country. Since the mid- 1970s, the Nobel Prize in medicine or physiology has gone to U.S. residents more often than recipients from all other countries combined. In only five of the past thirty-four years did a scientist living in the United States not win or share in the prize. Most important recent medical innovations were developed in the United States.
Despite serious challenges, such as escalating costs and care for the uninsured, the U.S. health care system compares favorably to those in other developed countries."

 

[sheeplady]

10. Americans are responsible for the vast majority of all health care innovations. The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other developed country. Since the mid- 1970s, the Nobel Prize in medicine or physiology has gone to U.S. residents more often than recipients from all other countries combined. In only five of the past thirty-four years did a scientist living in the United States not win or share in the prize. Most important recent medical innovations were developed in the United States.
Despite serious challenges, such as escalating costs and care for the uninsured, the U.S. health care system compares favorably to those in other developed countries."

This is not true if you consider herbal preparations or things that the FDA does not consider "drugs" and therefore does not regulate or if you consider preventative non-drug interventions; single European countries beat our output for these types of clinical trials. Also, our clinical trials tend to be much smaller than in most European countries. In a country with socialized medicine it is possible and likely that a trial drug will be used in a large scale study at multiple hospitals, increasing the likelihood that people can get access to the latest and greatest medicine, without having to travel or have access to a specialized clinic; which in this country is not available to everyone (which skews the results of the trials).

Also, some of those tests are considered medically non-necessary. For young healthy women who have a low risk for cervical cancer it's been recommended that women go once a year to every 3 years. (Low risk women are the ones that have no family history of cervical cancer, are young, have a single partner who is monogamous and/or are not sexually active.) The only reason why so many women go in the U.S. is that most birth control is tied to a pap- don't go for a pap, you won't get your birth control for a year. If you hold a bunch of low risk women hostage for their birth control by requiring PAPs, you end up with a lot of women getting PAPs who are low risk and shouldn't be tested- it's a waste of resources.

ETA: For every one of those U.S-positive statistics- one could throw back a European statistic that is better. Look at how the U.S. rates in infant mortality compared to the rest of the world, and look at some of those countries that fall before us on that list- it's really kind of disgusting that we don't demand better.

 

[LizzieMaine]

For me, it came down to dollars and cents -- in Canada I could get for $12,000 what would have cost me $25,000 in the USA, with no perceptible difference in the quality of service. Except the food in the Canadian hospital was far better than anything I've had stateside.

 

[jamespowers]

This is not true if you consider herbal preparations or things that the FDA does not consider "drugs" and therefore does not regulate or if you consider preventative non-drug interventions; single European countries beat our output for these types of clinical trials. Also, our clinical trials tend to be much smaller than in most European countries. In a country with socialized medicine it is possible and likely that a trial drug will be used in a large scale study at multiple hospitals, increasing the likelihood that people can get access to the latest and greatest medicine, without having to travel or have access to a specialized clinic; which in this country is not available to everyone (which skews the results of the trials).

Also, some of those tests are considered medically non-necessary. For young healthy women who have a low risk for cervical cancer it's been recommended that women go once a year to every 3 years. (Low risk women are the ones that have no family history of cervical cancer, are young, have a single partner who is monogamous and/or are not sexually active.) The only reason why so many women go in the U.S. is that most birth control is tied to a pap- don't go for a pap, you won't get your birth control for a year. If you hold a bunch of low risk women hostage for their birth control by requiring PAPs, you end up with a lot of women getting PAPs who are low risk and shouldn't be tested- it's a waste of resources.

ETA: For every one of those U.S-positive statistics- one could throw back a European statistic that is better. Look at how the U.S. rates in infant mortality compared to the rest of the world, and look at some of those countries that fall before us on that list- it's really kind of disgusting that we don't demand better.

I think I prefer a smaller trial group rather than testing a drug at multiple hospitals without knowing what the reaction might be. lol lol I prefer my drugs tested before them being tried out on me thanks. lol It is bad enough that I am allergic to Celebrax and found that out the hard way....:eusa_doh:
Some testing is better than none at all.

ETA: That all depends on where you get that data from The discredited data from the UN that made it so that they didn't even put out any subsequent data or the CDC that gets it wrong every year purposely.

 

[4spurs]

If you receive poor, or rude treatment there are steps you can take.

Every hospital is supposed to have a patient advocate who you can go see.

Every hospital has to have licenses, and the state agency that issues the licenses, or another state agency, will have a process in place for you to file a complaint.

Make a stink early, and persistently if you are in the hospital for a period of time and immediate intervention would be helpful. Speak up to the nurse in charge of the shift and ask to speak to the medical director --basically make a lot of noise and scare the beejezus out of them.

 

[sheeplady]

I think I prefer a smaller trial group rather than testing a drug at multiple hospitals without knowing what the reaction might be. lol lol I prefer my drugs tested before them being tried out on me thanks. lol It is bad enough that I am allergic to Celebrax and found that out the hard way....:eusa_doh:
Some testing is better than none at all.

ETA: That all depends on where you get that data from The discredited data from the UN that made it so that they didn't even put out any subsequent data or the CDC that gets it wrong every year purposely.

You do realize that they need your permission to participate in a clinical trial in the vast majority of countries (with exceptions for countries that steal organs form prisoners and do other unethical things) and before a drug makes it to a clinical trial it has been significantly tested?

Listing a personal allergic reaction as a reason for not doing large scale medical trials is ridiculous. It's a personal risk you take for possibly getting care that is going to save your life over conventional treatments and there is no guaranteeing that you won't react badly to conventional treatment if concerned about allergies.

 

[jamespowers]

You do realize that they need your permission to participate in a clinical trial in the vast majority of countries (with exceptions for countries that steal organs form prisoners and do other unethical things) and before a drug makes it to a clinical trial it has been significantly tested?

Listing a personal allergic reaction as a reason for not doing large scale medical trials is ridiculous. It's a personal risk you take for possibly getting care that is going to save your life over conventional treatments and there is no guaranteeing that you won't react badly to conventional treatment if concerned about allergies.

Yes, I know that. I would not do it either.

And further on infant mortality and life expectancy:
"When you take out suicides and fatal car accidents, factors that Atlas argues are unrelated to the health care system, the United States has the longest life expectancy in the world. A similar change occurs when measuring infant mortality--foreign data do not include as many at-risk births as in the United States and the measure of a birth is not comparable."

 

[jamespowers]

If you receive poor, or rude treatment there are steps you can take.

Every hospital is supposed to have a patient advocate who you can go see.

Every hospital has to have licenses, and the state agency that issues the licenses, or another state agency, will have a process in place for you to file a complaint.

Make a stink early, and persistently if you are in the hospital for a period of time and immediate intervention would be helpful. Speak up to the nurse in charge of the shift and ask to speak to the medical director --basically make a lot of noise and scare the beejezus out of them.

All excellent points. I had forgotten about the Patient Advocate.

 

[sheeplady]

Yes, I know that. I would not do it either.

And further on infant mortality and life expectancy:
"When you take out suicides and fatal car accidents, factors that Atlas argues are unrelated to the health care system, the United States has the longest life expectancy in the world. A similar change occurs when measuring infant mortality--foreign data do not include as many at-risk births as in the United States and the measure of a birth is not comparable."

I was not talking about life expectancy, I was talking about infant mortality. Infant mortality and life expectancy are two different issues. I do care that our healthcare is so poor that so many infants die in their first year of life. Quite frankly we should demand better from our healthcare system.

I'm not sure what your point is about not doing clinical trials personally. I'm not sure how you relate the issues of clinical trials across different countries to a personal choice. If you wouldn't participate in a clinical trial in either country, how does that have any bearing on the effectiveness and strategy of the difference in clinical trials?

I thank god for the large scale clinical trials that have taken place in Europe. Because of them, I've taken two medications in the past month that have probably saved my life- they wouldn't have been approved if not for some other country taking on the issue and actually testing them. And thanks to those clinical trials, I know they work. The FDA does consider clinical trials from other countries in their decisions, and since many medications are introduced in Europe first, I'm glad they do so.

 

[vitanola]

This shouldn't be considered a big run one way or the other but facts have a tendency to get in the way of perception:


From Scott Atlas
Freeman Spogli Institute for International Studies at Stanford

"Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world. Economists, government officials, insurers, and academics beat the drum for a far larger government role in health care. Much of the public assumes that their arguments are sound because the calls for change are so ubiquitous and the topic so complex. Before we turn to government as the solution, however, we should consider some unheralded facts about America’s health care system.

1. Americans have better survival rates than Europeans for common cancers. Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

2. Americans have lower cancer mortality rates than Canadians. Breast cancer mortality in Canada is 9 percent higher than in the United States, prostate cancer is 184 percent higher, and colon cancer among men is about 10 percent higher.

3. Americans have better access to treatment for chronic diseases than patients in other developed countries. Some 56 percent of Americans who could benefit from statin drugs, which reduce cholesterol and protect against heart disease, are taking them. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians receive them.

4. Americans have better access to preventive cancer screening than Canadians. Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate, and colon cancer:

• Nine out of ten middle-aged American women (89 percent) have had a mammogram, compared to fewer than three-fourths of Canadians (72 percent).
• Nearly all American women (96 percent) have had a Pap smear, compared to fewer than 90 percent of Canadians.
• More than half of American men (54 percent) have had a prostatespecific antigen (PSA) test, compared to fewer than one in six Canadians (16 percent).
• Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with fewer than one in twenty Canadians (5 percent).

5. Lower-income Americans are in better health than comparable Canadians. Twice as many American seniors with below-median incomes self-report “excellent” health (11.7 percent) compared to Canadian seniors (5.8 percent). Conversely, white, young Canadian adults with below-median incomes are 20 percent more likely than lower-income Americans to describe their health as “fair or poor.”

6. Americans spend less time waiting for care than patients in Canada and the United Kingdom. Canadian and British patients wait about twice as long—sometimes more than a year—to see a specialist, have elective surgery such as hip replacements, or get radiation treatment for cancer. All told, 827,429 people are waiting for some type of procedure in Canada. In Britain, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.

7. People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand, and British adults say their health system needs either “fundamental change” or “complete rebuilding.”

8. Americans are more satisfied with the care they receive than Canadians. When asked about their own health care instead of the “health care system,” more than half of Americans (51.3 percent) are very satisfied with their health care services, compared with only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).

9. Americans have better access to important new technologies such as medical imaging than do patients in Canada or Britain. An overwhelming majority of leading American physicians identify computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade—even as economists and policy makers unfamiliar with actual medical practice decry these techniques as wasteful. The United States has thirty-four CT scanners per million Americans, compared to twelve in Canada and eight in Britain. The United States has almost twenty-seven MRI machines per million people compared to about six per million in Canada and Britain.

10. Americans are responsible for the vast majority of all health care innovations. The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other developed country. Since the mid- 1970s, the Nobel Prize in medicine or physiology has gone to U.S. residents more often than recipients from all other countries combined. In only five of the past thirty-four years did a scientist living in the United States not win or share in the prize. Most important recent medical innovations were developed in the United States.
Despite serious challenges, such as escalating costs and care for the uninsured, the U.S. health care system compares favorably to those in other developed countries."

How odd that you mention Dr. Atlas' tangential affiliation with Stanford's Freeman-Spongli Insitiute for Iternational Studies, yet you do not point out his principal position, as a Fellow of the Hoover Institution, a partisan think-tank.

Dr. Atlas' most recent position was as advisor to the Romney campaign. In this position he wrote campaign articles which appeared ipn the national media, including articles such as "War on Women a Fabrication of the Liberal Media Elite", and , of course the "study" which you quoted, which was referred to as a "Talking Point Paper" by Politico.

The paper that you mention was produced as an explicitly political documnet. I am o my IPad, at the moment. Will reply inn more detail tomorrow.

 

[Old Rogue]

I was not talking about life expectancy, I was talking about infant mortality. Infant mortality and life expectancy are two different issues. I do care that our healthcare is so poor that so many infants die in their first year of life. Quite frankly we should demand better from our healthcare system.

I really debated posting this response since I don't have the information readily at hand, but I recall reading somewhere a year or so ago that the statistics commonly quoted regarding the relative infant mortality rates between the US and other countries are extremely misleading due to the differences in the definitions of what constitutes and infant. Basically, if you compare apples to apples the infant mortality rates in the US are actually lower than most of the countries that supposedly lead us in this area. The old adage that if you torture the data long enough it will confess to anything applies here, the lesson being that before we accept any argument based on statistics we should closely examine the underlying data.

 

[sheeplady]

I really debated posting this response since I don't have the information readily at hand, but I recall reading somewhere a year or so ago that the statistics commonly quoted regarding the relative infant mortality rates between the US and other countries are extremely misleading due to the differences in the definitions of what constitutes and infant. Basically, if you compare apples to apples the infant mortality rates in the US are actually lower than most of the countries that supposedly lead us in this area. The old adage that if you torture the data long enough it will confess to anything applies here, the lesson being that before we accept any argument based on statistics we should closely examine the underlying data.

Here is information on how they are calculated in the U.S: http://www.marchofdimes.com/peristats/calculations.aspx?reg=&top=&id=15 There is a standard way to calculate these things.

I really can't understand someone quibbling over the rankings- anything less than being the leader in preventing infant mortality is unacceptable given the costs of care in this country.

 

[vitanola]

I really debated posting this response since I don't have the information readily at hand, but I recall reading somewhere a year or so ago that the statistics commonly quoted regarding the relative infant mortality rates between the US and other countries are extremely misleading due to the differences in the definitions of what constitutes and infant. Basically, if you compare apples to apples the infant mortality rates in the US are actually lower than most of the countries that supposedly lead us in this area. The old adage that if you torture the data long enough it will confess to anything applies here, the lesson being that before we accept any argument based on statistics we should closely examine the underlying data.

Yes, Sean Hannity maintained this, and it was picked up by the talk radio programs, but this "statistical evidence" has appeared only on Newsmax and on Talk radio so far. certainly not in any peer reviewed journal.

 

[jamespowers]

I was not talking about life expectancy, I was talking about infant mortality. Infant mortality and life expectancy are two different issues. I do care that our healthcare is so poor that so many infants die in their first year of life. Quite frankly we should demand better from our healthcare system.

I'm not sure what your point is about not doing clinical trials personally. I'm not sure how you relate the issues of clinical trials across different countries to a personal choice. If you wouldn't participate in a clinical trial in either country, how does that have any bearing on the effectiveness and strategy of the difference in clinical trials?

I thank god for the large scale clinical trials that have taken place in Europe. Because of them, I've taken two medications in the past month that have probably saved my life- they wouldn't have been approved if not for some other country taking on the issue and actually testing them. And thanks to those clinical trials, I know they work. The FDA does consider clinical trials from other countries in their decisions, and since many medications are introduced in Europe first, I'm glad they do so.

Quite simply infant mortality rates and life expectancy are connected in the sense that if a child dies at six month he lowers the life expectancy with his half a year of life. That makes a difference.
Second, life expectancy is really not a measure of health care. How suicide and car accidents relate to life expectancy I have no idea and when you back those out it makes a huge difference in the statistics. Health care is not responsible if you don't survive a gunshot wound to the head.

Infant mortality figures are ridiculous. Again you have caluclation errors that lead to statistical errors due to the definition of life being different across the different countries. We count EVERY birth. That means we count any sign of life, any heart rate, any respiration, no matter how premature the infant, no matter how small the infant, no matter how immediate the death is. Many other countries, even civilized ones, do not count a births as live if the baby does not live for 24hours or so. Some base it on size and weight. Some won't count it unless the baby does not survive for 48 hours or even a week! These differences distort the calculation. When you back out the fragile infants that we count no matter then the figures tell a different tale. We can save babies now down to four months. We do a full court press to save babies that other countries do not even try to do---thanks to the advanced technologies we employ every time. It winds up being down to 5.87 per thousand---statistically meaning almost all born survive. You just have to compare apples to apples.

 

[jamespowers]

How odd that you mention Dr. Atlas' tangential affiliation with Stanford's Freeman-Spongli Insitiute for Iternational Studies, yet you do not point out his principal position, as a Fellow of the Hoover Institution, a partisan think-tank.

Dr. Atlas' most recent position was as advisor to the Romney campaign. In this position he wrote campaign articles which appeared ipn the national media, including articles such as "War on Women a Fabrication of the Liberal Media Elite", and , of course the "study" which you quoted, which was referred to as a "Talking Point Paper" by Politico.

The paper that you mention was produced as an explicitly political documnet. I am o my IPad, at the moment. Will reply inn more detail tomorrow.

He holds both positions. What is your point?

Gee, like politico is not biased. :rofl:

It is not political if the statistics are correxct and they are. He didn't get the statistics himself. They came from an external source. Did you read the entire book and check the footnotes? Obviously not.

 

[jamespowers]

I really can't understand someone quibbling over the rankings- anything less than being the leader in preventing infant mortality is unacceptable given the costs of care in this country.

We are the leader when you look at the statistics as I mentioned above.

 

[V.C. Brunswick]

Gotta love these IGIWMTT moments.

 

[sheeplady]

We can save babies now down to four months. We do a full court press to save babies that other countries do not even try to do---thanks to the advanced technologies we employ every time.

This is absolutely *not* universally true. In the U.S., we do not typically employ life saving procedures until the infant is 23-24 weeks from the mother's LMP, even if the baby is born alive. This is called the "viability" date, despite a low survival rate. The practices vary by state, in my state it is 24 weeks and that is the recommended procedure that my OBs follow and my local level 4 NICU follows. My insurance will not cover a baby's NICU stay that is born before 24 weeks. I know this personally because it's relevant to me.

The survival rate under 24 weeks is only about 10% at best even if they decided to try. Although there have been exceptions to this, most of them are because the doctor's mistakenly thought the mother was further along. Technically, in this country, any birth considered before 24 weeks but after 20 is a late miscarriage if they don't intervene.