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Here's why we'll never see affordable health care in this country

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  • TarponatorTarponator Under a BridgePosts: 17,011 AG
    cpr wrote: »
    You can't compare infant mortality rates. They are different in the US because we use a lower weight to deem an infant non viable.

    I don't believe the graph I posted takes weight into account. But please explain in more detail what you mean.
  • mustang190mustang190 Posts: 10,104 AG
    To compare the U.S. to Japan is ridiculous. Japan is a homogenous country. Same with Scandinavia.
    Blacks have higher incidences of heart disease and diabetes than Caucasian. Hispanics also have higher incidences of obesity and it's problems.
  • TarponatorTarponator Under a BridgePosts: 17,011 AG
    How is it ridiculous? Japanese and Scandinavians are human just like us. So are their cancers, heart disease, etc. And there are lots of far less homogeneous populations that are doing much better than the USA on that list.

    You are right about blacks, but I would argue that your are neglecting the issue poverty in favor of race, because once you normalize for income, suddenly the numbers are in line with each other.

    And you're wrong about obesity, which is far and away a white man's disease:

    db131_fig3.png

    You were saying?
  • mplspugmplspug Palmetto FloridaPosts: 12,885 AG
    Tarponator wrote: »
    I was referring to the post I was responding to. The one that said that we're more unhealthy than other nations. My point was that preventative healthcare (or a lack thereof) is a factor in that equation, and perhaps if we spent a bit more there rather than in other (not coincidentally, much more profitable) acute care that we would live longer.

    And after all, a longer and healthier life is the ultimate measure.

    Instead, our profit driven healtcare system seeks to address areas of healthcare where the most money can be made -- acute healthcare -- extending the lives of the very sick. Rather than what should be the goal, leading longer and healthier lives.

    In my opinion, of course...Mike

    And to my point, I think insurances would disagree with you. They would prefer to spend a little in preventative care than pay those higher cost, "more profitable" and lengthy treatments. In fact, I bet most doctors would prefer to say that they caught a cancer in time than to tell you sorry, but your cancer is terminal.

    Who is spending this extra money? The government?

    It comes down to individuals willing to do preventative care. It is voluntary. How about incentives to be healthier like HSAs? Make being healthy profitable.

    Captain Todd Approves

  • cprcpr Posts: 9,309 Admiral
    The first nuance is one of definition. Infant mortality is defined as the death of babies under the age of one year, but some of the differences between countries can be explained by a difference in how we count. Is a baby born weighing less than a pound and after only 21 weeks' gestation actually "born?" In some countries, the answer is no, and those births would be counted as stillbirths. In the United States, on the other hand, despite these premature babies' relatively low odds of survival, they would be considered born -- thus counting toward the country's infant mortality rates.

    https://www.sciencedaily.com/releases/2016/10/161013103132.htm

    Also
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856058/

    to Mustang's point

    Genetics key to African-Americans' hypertension
    BY AMY ADAMS

    National health records have shown that African-Americans are more prone to high blood pressure than Caucasians, but pinning down the roots of that difference has proven elusive. Now, researchers at the School of Medicine have narrowed down the search for genes that contribute to this difference in disease risk.

    Finding such a gene could have several benefits for African-Americans and other ethnic groups. One is that by knowing the normal role of the gene, doctors can better understand the disease and devise new drugs or treatments to keep blood pressure under control. It could also lead to genetic tests to help identify people at higher risk of heart disease.

    The work takes advantage of genetic differences between people of African and European descent to home in on the location of the gene or genes. Future research will be needed to pinpoint exactly which genes in these regions are the culprit in heart disease risk.
    http://news.stanford.edu/news/2005/january26/med-hypertension-012605.html

    AFRICAN GENETIC DIVERSITY: Implications for Human Demographic History, Modern Human Origins, and Complex Disease Mapping

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953791/


    Study identifies genetic predeterminants for diabetes in African-Americans

    Researchers at the University of North Carolina at Chapel Hill School of Medicine say a recent discovery suggests that inherited genetic variations exist between whites and blacks living in the U.S., leading to less efficient metabolism of glucose and predisposition to diabetes in blacks.

    http://www.med.unc.edu/www/newsarchive/2009/december/study-identifies-genetic-predeterminants-for-diabetes-in-african-americans


    The health disparities between blacks and whites run deep, no matter the age or ailment. Adult obesity rates for African-Americans are higher than those for whites in nearly every state. They have higher rates of diabetes, hypertension and heart disease than other groups. Black children have a 500 percent higher death rate from asthma compared to white children. And African-American adults with cancer are much less likely to survive prostate, breast and lung cancer than white adults.


    https://www.usnews.com/opinion/blogs/policy-dose/articles/2016-04-14/theres-a-huge-health-equity-gap-between-whites-and-minorities


    And actually, DNA related health issues can be traced to where in Africa a persons ancestors were from, west central, south .........
    "The test of a first-rate intelligence is the ability to hold two opposed ideas in the mind at the same time, and still retain the ability to function." F. Scott Fitzgerald

    "Prediction is very difficult, especially if it's about the future." Niels Bohr
  • mplspugmplspug Palmetto FloridaPosts: 12,885 AG
    Tarponator wrote: »
    How is it ridiculous? Japanese and Scandinavians are human just like us. So are their cancers, heart disease, etc. And there are lots of far less homogeneous populations that are doing much better than the USA on that list.

    Wait, what countries are less homogeneous than us?

    Captain Todd Approves

  • cprcpr Posts: 9,309 Admiral
    Tarponator wrote: »
    How is it ridiculous? Japanese and Scandinavians are human just like us. So are their cancers, heart disease, etc. And there are lots of far less homogeneous populations that are doing much better than the USA on that list.

    You are right about blacks, but I would argue that your are neglecting the issue poverty in favor of race, because once you normalize for income, suddenly the numbers are in line with each other.

    And you're wrong about obesity, which is far and away a white man's disease:

    db131_fig3.png

    You were saying?


    Western lifestyle brings epidemic of heart disease to China: study

    http://www.japantimes.co.jp/news/2016/08/16/asia-pacific/science-health-asia-pacific/western-lifestyle-brings-epidemic-heart-disease-china-study/#.WTG4ihRlluU

    http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0174848
    "The test of a first-rate intelligence is the ability to hold two opposed ideas in the mind at the same time, and still retain the ability to function." F. Scott Fitzgerald

    "Prediction is very difficult, especially if it's about the future." Niels Bohr
  • cprcpr Posts: 9,309 Admiral
    Later, getting ready for work, someone has to keep the dying alive.
    "The test of a first-rate intelligence is the ability to hold two opposed ideas in the mind at the same time, and still retain the ability to function." F. Scott Fitzgerald

    "Prediction is very difficult, especially if it's about the future." Niels Bohr
  • TarponatorTarponator Under a BridgePosts: 17,011 AG
    mplspug wrote: »
    It comes down to individuals willing to do preventative care. It is voluntary. How about incentives to be healthier like HSAs? Make being healthy profitable.

    Now we're getting somewhere. We need to incent being healthy on both the healthcare industry and the individual. That's not, at all, what we're doing though, and thus the focus on acute healtcare and extending lives through outcomes rather than solving the underlying issues.

    And insurance companies are not at all interested in lengthening lives. They are interested in profit margins, which essentially becomes paying out as little as they can and bringing in the most they can...not lengthening lives.

    Don't believe me? Compare preventive care to acute care expenditures in the insurance industry. Despite the obvious cost savings outcome you are right to point out -- every dollar in preventative care saves more than a dollar in terms of spending -- they still lag by an order of magnitude to acute care payments.

    Why? Because the measure of success should not be profit (i.e. acute care), but rather longer healthier lives (i.e. preventative care).

    In my opinion, of course...Mike
  • TarponatorTarponator Under a BridgePosts: 17,011 AG
    mplspug wrote: »
    Wait, what countries are less homogeneous than us?

    I never said less homogeneous than us, I said less than Scandinavia or Japan.

    For example, Canada, Germany, & France.
  • stc1993stc1993 Albany, GA Carrabelle, FLPosts: 7,679 Admiral
    Gary S wrote: »
    All these countries that was listed as better and cheaper medical care, how much do their citizens pay in taxes to pay for it? I don't know what other people pay for insurance but I pay $1400 a month for my wife and I. Both 62.No major illnesses wife has mild high blood pressure and a family history of diabetes. I still take nothing and am pretty healthy. I have friends that moved from south Fla. and their rates went way down.
    The other thing that pisses me off is when you can buy medicine made here cheaper in another country. I don't care what their rules are our rule should be same price here if it's sold cheaper there.

    I know, when my wife was taking all her medicine before she was eligible for part D. Her Dr. would write her 3 month prescriptions for Canada it was so much cheaper there.
  • TarponatorTarponator Under a BridgePosts: 17,011 AG
    cpr wrote: »
    The first nuance is one of definition. Infant mortality is defined as the death of babies under the age of one year, but some of the differences between countries can be explained by a difference in how we count. Is a baby born weighing less than a pound and after only 21 weeks' gestation actually "born?" In some countries, the answer is no, and those births would be counted as stillbirths. In the United States, on the other hand, despite these premature babies' relatively low odds of survival, they would be considered born -- thus counting toward the country's infant mortality rates.

    https://www.sciencedaily.com/releases/2016/10/161013103132.htm

    Also
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856058/

    to Mustang's point

    Genetics key to African-Americans' hypertension
    BY AMY ADAMS

    National health records have shown that African-Americans are more prone to high blood pressure than Caucasians, but pinning down the roots of that difference has proven elusive. Now, researchers at the School of Medicine have narrowed down the search for genes that contribute to this difference in disease risk.

    Finding such a gene could have several benefits for African-Americans and other ethnic groups. One is that by knowing the normal role of the gene, doctors can better understand the disease and devise new drugs or treatments to keep blood pressure under control. It could also lead to genetic tests to help identify people at higher risk of heart disease.

    The work takes advantage of genetic differences between people of African and European descent to home in on the location of the gene or genes. Future research will be needed to pinpoint exactly which genes in these regions are the culprit in heart disease risk.
    http://news.stanford.edu/news/2005/january26/med-hypertension-012605.html

    AFRICAN GENETIC DIVERSITY: Implications for Human Demographic History, Modern Human Origins, and Complex Disease Mapping

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953791/


    Study identifies genetic predeterminants for diabetes in African-Americans

    Researchers at the University of North Carolina at Chapel Hill School of Medicine say a recent discovery suggests that inherited genetic variations exist between whites and blacks living in the U.S., leading to less efficient metabolism of glucose and predisposition to diabetes in blacks.

    http://www.med.unc.edu/www/newsarchive/2009/december/study-identifies-genetic-predeterminants-for-diabetes-in-african-americans


    The health disparities between blacks and whites run deep, no matter the age or ailment. Adult obesity rates for African-Americans are higher than those for whites in nearly every state. They have higher rates of diabetes, hypertension and heart disease than other groups. Black children have a 500 percent higher death rate from asthma compared to white children. And African-American adults with cancer are much less likely to survive prostate, breast and lung cancer than white adults.


    https://www.usnews.com/opinion/blogs/policy-dose/articles/2016-04-14/theres-a-huge-health-equity-gap-between-whites-and-minorities


    And actually, DNA related health issues can be traced to where in Africa a persons ancestors were from, west central, south .........

    Thanks for that.

    What happens to those numbers when normalized for income?

    In other words, is the rich American of west African descent any different from the poor one?

    I contend there is a strong correlation to income and I'll try to dig up some stats on this point.

    And by the way, that birth mortality paper you posted, includes the conclusion that even when you normalize for all those factors, the USA still lags....and it also includes a very interesting section (5.1) that delves into income as one of the factors, one of the points I was trying to make above.

    Thanks for posting it.
  • mplspugmplspug Palmetto FloridaPosts: 12,885 AG
    Tarponator wrote: »
    I never said less homogeneous than us, I said less than Scandinavia or Japan.

    For example, Canada, Germany, & France.
    And there are lots of far less homogeneous populations that are doing much better than the USA on that list.
    :huh

    Is it 4:00 yet?

    Captain Todd Approves

  • stc1993stc1993 Albany, GA Carrabelle, FLPosts: 7,679 Admiral
    In last months AARP magazine there is an article about prescription prices. To me it looks like big pharma paid off the politicians when they passed part D medicare. The price is non negotiable for medicare. they are free to charge what they want. The VA is allowed to negotiate prices & they save billions yearly. Why did congress pass a bill not allowing price negotiating? I think payola is the cause. We could be saving billions every year.

    I forgot to add that big pharma donated millions to the politicians last year. And the greased wheel keeps turning.
  • TarponatorTarponator Under a BridgePosts: 17,011 AG
    mplspug wrote: »
    :huh

    Is it 4:00 yet?

    You forgot the sentence I was responding to, you know, the one where you pointed out that Scandinavia and Japan are homogeneous.

    To which I replied there are lots of far less homogeneous populations [than Scandinavia or Japan] on that list, and gave you three examples.

    Nowhere did I say that Canada, Germany, or France are as heterogeneous as the USA is.

    It's 4:21.

    Do you get it yet?
  • cprcpr Posts: 9,309 Admiral
    Tarponator wrote: »
    Thanks for that.

    What happens to those numbers when normalized for income?

    In other words, is the rich American of west African descent any different from the poor one?

    I contend there is a strong correlation to income and I'll try to dig up some stats on this point.

    And by the way, that birth mortality paper you posted, includes the conclusion that even when you normalize for all those factors, the USA still lags....and it also includes a very interesting section (5.1) that delves into income as one of the factors, one of the points I was trying to make above.

    Thanks for posting it.


    Heading out the door
    here you go mike have fun

    https://scholar.google.com/scholar?q=geography+and+hypertension&hl=en&as_sdt=0&as_vis=1&oi=scholart&sa=X&ved=0ahUKEwiltqKlgKDUAhVG2SYKHQzNCj8QgQMIKDAA
    "The test of a first-rate intelligence is the ability to hold two opposed ideas in the mind at the same time, and still retain the ability to function." F. Scott Fitzgerald

    "Prediction is very difficult, especially if it's about the future." Niels Bohr
  • GardawgGardawg Posts: 10,066 AG
    The illness care cartel (Big Pharma, Big Insurance, AMA) has bribed our legislators to allow them to gouge us.

    That is why we pay so much more than others.
    “Today a young man on acid realized that all matter is merely energy condensed to a slow vibration, that we are all one consciousness experiencing itself subjectively, there is no such thing as death, life is only a dream, and we are the imagination of ourselves.

    Heres Tom with the Weather.”
  • TarponatorTarponator Under a BridgePosts: 17,011 AG
    cpr wrote: »

    That's geography and hypertension, not income.

    I'll try to do some digging myself.....
  • TarponatorTarponator Under a BridgePosts: 17,011 AG
    Gardawg wrote: »
    The illness care cartel (Big Pharma, Big Insurance, AMA) has bribed our legislators to allow them to gouge us.

    That is why we pay so much more than others.

    I would say bribe is a bit of a strong word, as it's completely legal through campaign contributions.

    What the politicians have done, effectively, is make bribery legal.

    And I think you're completely right that it is the foundation of most of the problems in our country, including healthcare.
  • GardawgGardawg Posts: 10,066 AG
    Tarponator wrote: »
    I would say bribe is a bit of a strong word, as it's completely legal through campaign contributions.

    What the politicians have done, effectively, is make bribery legal.

    And I think you're completely right that it is the foundation of most of the problems in our country, including healthcare.

    call it what you will ... feces smells just the same as sh-t
    “Today a young man on acid realized that all matter is merely energy condensed to a slow vibration, that we are all one consciousness experiencing itself subjectively, there is no such thing as death, life is only a dream, and we are the imagination of ourselves.

    Heres Tom with the Weather.”
  • gettinwetgettinwet Posts: 1,366 Officer
    Baits Out wrote: »
    Last year my wife had many many issues -- many doctor visits, many pharmacy and lab needs, and many hospital stays.

    At the end of the year our total billing was a little over $400,000.

    Her Humana PPO plan covered most so our share was almost $4,000. The insurance costs about $250/month.

    Do the math, . . . and why I am not complaining.

    Obamacare is a total scam and failure, as people are now learning.

    :wink

    And I bet that insurance coverage is heavily subsidized through her employer. I paid a bit more for decent Cigna coverage for my family but my employer was paying 3 times as much as I was. So yeah, if you have decent benefits from your work life is good...........but if you can't...........not so good. Go shop an individual private policy in this state and you will see what I mean..........
    There are only so many casts in life, so shut up and fish!!
  • TarponatorTarponator Under a BridgePosts: 17,011 AG
    Some bedtime reading....

    http://healthaffairs.org/blog/2014/10/30/povertys-association-with-poor-health-outcomes-and-health-disparities/

    "The authors linked data from multiple sources (i.e. California Health Information Survey, Census Bureau’s American Community Survey, health facility discharge data) and used geographic information system (GIS) analyses and regression analyses to identify amputation “hot spots” and uncovered a 10-fold variation in LEA rates between low-income and high-income neighborhoods."

    http://www.newyorker.com/tech/elements/why-america-is-losing-the-health-race

    "It seems likely that many Americans would respond to these figures—and to the role poverty plays in poor health outcomes—by assuming that the data for all Americans is being skewed downward by the health of the poorest. That is, they understand that poor Americans have worse health, and presume that, because the United States has more poor people than other wealthy countries, the average health looks worse. But one of the most interesting findings in the NRC-IOM report is that even white, college-educated, high-income Americans with healthy behaviors have worse health than their counterparts in other wealthy countries. "

    and

    "The superior health outcomes achieved by other wealthy countries demonstrate that Americans are—to use the language of negotiators—“leaving years of life on the table.” The causes of this problem are many: poverty, widening income disparity, underinvestment in social infrastructure, lack of health insurance coverage and access to health care. Expanding insurance coverage under the Affordable Care Act will help (whoops!), but pouring more money into health care is not the only answer. Most experts estimate that modern medical care delivered to individual patients—such as physician and hospital treatments covered by health insurance—has only been responsible for between ten and twenty-five percent of the improvements in life expectancy over the last century. The rest has come from changes in the social determinants of health, particularly in early childhood. "

    and some more:

    http://www.commonwealthfund.org/publications/fund-reports/2013/sep/low-income-scorecard

    "Lower-income populations are at increased risk of experiencing worse access, lower-quality care—particularly in outpatient settings—and worse health outcomes compared to those with higher incomes in their home state. Income-related disparities were most pronounced on measures of access, prevention, potentially unsafe prescription medication, and health outcomes. "

    and a relatively down the middle article on the topic:

    https://www.forbes.com/sites/modeledbehavior/2016/01/03/why-are-education-and-healthcare-outcomes-so-bad-in-the-us/#76353cce3abf

    "Poverty gets blamed depending on the context. Liberals tend to focus on poverty as the cause of bad education results, but underplay that as a cause of healthcare spending because it takes the blame off of healthcare industries. Conservatives tend to do the reverse. I’m speaking in generalizations of course, there are smart analysts of these issues on both sides.

    There are institutional issues in both cases, but the evidence does suggests poverty is a big factor and I want to focus on that in this post. In education, Martin Carnoy and Richard Rothstein argue that controlling for socioeconomic status improves the U.S. performance on international comparisons of student test scores, although it does not remove it."


    and then (CPR, please take note)

    "On the healthcare side, Alice Chen, Emily Oster, and Heidi Williams find that high infant mortality in the U.S. compared to European countries is due not to differences in access to technologically intensive post-birth medical care, but is due to a higher postneonatal mortality rate (eg months 1 through 12) for low socioeconomic status households."

    Have fun...Mike
  • mplspugmplspug Palmetto FloridaPosts: 12,885 AG
    Tarponator wrote: »
    You forgot the sentence I was responding to, you know, the one where you pointed out that Scandinavia and Japan are homogeneous.

    How is it ridiculous? Japanese and Scandinavians are human just like us. So are their cancers, heart disease, etc. And there are lots of far less homogeneous populations that are doing much better than the USA on that list.

    You need to work on your sentence structure.

    Captain Todd Approves

  • cadmancadman Home of the Gators Posts: 33,389 AG
    Mike,

    In each of your links is a link to the actual study and not some tidbits an author took from it. Read the studies.

    In everyone one of those, I would argue social choices are more of a factor than quality of medical care. One study says the U.S. leads in heart disease. Is that due to medical care of social choices, Lung Cancer was number 2 cause of death, again medical care or a social choice.

    Do the poor get less medical care, yes, But is it due to refusal of treatment or a social choice not to go to a doctor. If they go, do they follow his advice to change their lifestyle?

    I read several of the studies and need to read the rest, but one common thread was this, a lifestyle filled with oversized food portions, physical inactivity, and stress. . That is a social choice and not a indication of worse medical care.

    Your last one where the news article took the one tidbit, the study said:

    First, consistent with past evidence (MacDorman and Mathews,
    2009), differential reporting of births cannot offer a complete explanation for the US IMR disadvantage. However,
    accounting for differential reporting is quantitatively important. Compared to the average of the five European countries we analyze, limiting to a comparable sample lowers the apparent US IMR disadvantage from 2.5 deaths per 1000 births to 1.5 deaths. This finding highlights the importance of conducting cross-country comparisons in a setting where reporting differences can be addressed, which is typically not possible in the types of aggregate statistics compiled by the World Health Organization and the World Development Indicators (World Health Organization, 2006; World Bank, 2013).


    Kind of points to what CPR was saying. But in the study, lower income segments, especially the south, appear to have a higher infant mortality rate than other areas. But I did not see anything in the study to indicate why. Was it due to social choices or a lack of medical care. What was the cause of death in these cases?

    According to the CDC, the top five causes of infant death are birth defects, preterm birth, Maternal complications of pregnancy, sudden death syndrome, and injuries. which of these are higher in the U.S.?

    Another tidbit I found was abortions in Europe, due to a known birth defect was increasing.

    https://lozierinstitute.org/new-study-abortion-after-prenatal-diagnosis-of-down-syndrome-reduces-down-syndrome-community-by-thirty-percent/

    The odd thing about the article is, it is seen as something positive.

    Now, I will admit no data is available for the U.S. due to the political climate around abortion in this country.

    I was able to find out 3% of babies in the U.S. are born with a birth defect and 2% in the U.K.. Birth defects account for 20% of infants deaths.

    http://www.telegraph.co.uk/news/health/news/8953930/One-in-50-babies-has-a-birth-defect-research.html

    http://www.pcrm.org/research/resch/reschethics/birth-defect-statistics]

    Also 10% birth defects are a result of societal choices, environmental agent, drug, biologic, or nutritional factor.

    I will still state you will not get better medical care anywhere else in the world than you do here. Our health, due to our lifestyle, food choices, stress and other social factors is worse than many other countries. You keep trying to compare oranges to apples with limited data.

    You want to blame the medical society for a social problem.

    I will also state as a fact, the only way to reduce medical care costs is to reduce the salaries of those in the profession. Something that can not and should not be done. Tort reform is less than 5%. Private insurance is a 10% reduction at best https://www.forbes.com/sites/theapothecary/2011/06/30/the-myth-of-medicares-low-administrative-costs/#a561015140de

    The only major factor, other than drugs costing more, is the salaries in the medical profession.

    https://journal.practicelink.com/vital-stats/physician-compensation-worldwide/

    You will see a GP is about 27% higher than the next closest country. There are two countries where a specialist can make more, but the U.S. pay is more than double the European average.

    Mini Mart Magnate

    I am just here for my amusement. 

  • ResinheadResinhead Posts: 10,987 AG
    gettinwet wrote: »
    And I bet that insurance coverage is heavily subsidized through her employer. I paid a bit more for decent Cigna coverage for my family but my employer was paying 3 times as much as I was. So yeah, if you have decent benefits from your work life is good...........but if you can't...........not so good. Go shop an individual private policy in this state and you will see what I mean..........

    My wife retired when she was 40. We had 2 kids and she was good with raising the kids. Kids got older and she got board and found a management position with the state. We laughed at the mgmt salary but the bene's (4 weeks vaca and full health insurance) hit home. She's now up to I think double that vaca time and still no health insurance bills for us except copays.

    :beer
  • TarponatorTarponator Under a BridgePosts: 17,011 AG
    cadman wrote: »
    Mike,

    In each of your links is a link to the actual study and not some tidbits an author took from it. Read the studies.

    In everyone one of those, I would argue social choices are more of a factor than quality of medical care. One study says the U.S. leads in heart disease. Is that due to medical care of social choices, Lung Cancer was number 2 cause of death, again medical care or a social choice.

    Do the poor get less medical care, yes, But is it due to refusal of treatment or a social choice not to go to a doctor. If they go, do they follow his advice to change their lifestyle?

    I read several of the studies and need to read the rest, but one common thread was this, a lifestyle filled with oversized food portions, physical inactivity, and stress. . That is a social choice and not a indication of worse medical care.

    Your last one where the news article took the one tidbit, the study said:

    First, consistent with past evidence (MacDorman and Mathews,
    2009), differential reporting of births cannot offer a complete explanation for the US IMR disadvantage. However,
    accounting for differential reporting is quantitatively important. Compared to the average of the five European countries we analyze, limiting to a comparable sample lowers the apparent US IMR disadvantage from 2.5 deaths per 1000 births to 1.5 deaths. This finding highlights the importance of conducting cross-country comparisons in a setting where reporting differences can be addressed, which is typically not possible in the types of aggregate statistics compiled by the World Health Organization and the World Development Indicators (World Health Organization, 2006; World Bank, 2013).


    Kind of points to what CPR was saying. But in the study, lower income segments, especially the south, appear to have a higher infant mortality rate than other areas. But I did not see anything in the study to indicate why. Was it due to social choices or a lack of medical care. What was the cause of death in these cases?

    According to the CDC, the top five causes of infant death are birth defects, preterm birth, Maternal complications of pregnancy, sudden death syndrome, and injuries. which of these are higher in the U.S.?

    Another tidbit I found was abortions in Europe, due to a known birth defect was increasing.

    https://lozierinstitute.org/new-study-abortion-after-prenatal-diagnosis-of-down-syndrome-reduces-down-syndrome-community-by-thirty-percent/

    The odd thing about the article is, it is seen as something positive.

    Now, I will admit no data is available for the U.S. due to the political climate around abortion in this country.

    I was able to find out 3% of babies in the U.S. are born with a birth defect and 2% in the U.K.. Birth defects account for 20% of infants deaths.

    http://www.telegraph.co.uk/news/health/news/8953930/One-in-50-babies-has-a-birth-defect-research.html

    http://www.pcrm.org/research/resch/reschethics/birth-defect-statistics]

    Also 10% birth defects are a result of societal choices, environmental agent, drug, biologic, or nutritional factor.

    I will still state you will not get better medical care anywhere else in the world than you do here. Our health, due to our lifestyle, food choices, stress and other social factors is worse than many other countries. You keep trying to compare oranges to apples with limited data.

    You want to blame the medical society for a social problem.

    I will also state as a fact, the only way to reduce medical care costs is to reduce the salaries of those in the profession. Something that can not and should not be done. Tort reform is less than 5%. Private insurance is a 10% reduction at best https://www.forbes.com/sites/theapothecary/2011/06/30/the-myth-of-medicares-low-administrative-costs/#a561015140de

    The only major factor, other than drugs costing more, is the salaries in the medical profession.

    https://journal.practicelink.com/vital-stats/physician-compensation-worldwide/

    You will see a GP is about 27% higher than the next closest country. There are two countries where a specialist can make more, but the U.S. pay is more than double the European average.

    Thank you for the thoughtful reply.

    And for what it's worth, I've never denied that societal factors are at play here. Whether they are bad choices, or lack of quality care in certain areas, or any other myriad of issues, the societal impact can't be downplayed.

    I guess I just disagree with you that health problems and social problems are separate. I see them as interrelated parts of one underlying issue -- the health of our people. And while we are among the top countries on earth for acute care -- even leading the world in many -- that doesn't change the indisputable fact that we don't live as long as other countries.

    And just because you continue to repeat yourself that we have the best healthcare in the world doesn't make it true. Even the information you shared on infant survival rates just argues that our gap is narrower than the numbers suggest. Alas, the gap still remains, and all those dead infants are still dead. Don't agree? Cool. Show me statistics proving your point, not an argument that suggests we're not as bad, but still worse, as other developed countries when it comes to infant mortality.

    And our costs are out of control because nobody is incented to reduce them. We have competing profit centers -- pharma, physicians/nurses/medical technicians, hospitals, insurance companies -- that all have powerful lobbies in Washington I might add. Hell, the average pill counter (i.e. pharmacist) in the USA makes over $120k. As one of them (insurance) effectively sets the rates for the rest of them, is it any wonder that we've had the out of control medical costs that we have? After all, if insurance companies were effective in controlling costs, they would also limit their profits, and that's never going to happen...unless the government steps in. You know, like the most of the rest of the developed world has done.

    Moving past all that: Have you ever experienced healthcare anywhere outside the USA? If so, where? What was your experience?

    I have, in Tokyo, and the whole experience was eye opening....Mike
  • cadmancadman Home of the Gators Posts: 33,389 AG
    Tarponator wrote: »
    Thank you for the thoughtful reply.

    And for what it's worth, I've never denied that societal factors are at play here. Whether they are bad choices, or lack of quality care in certain areas, or any other myriad of issues, the societal impact can't be downplayed.

    I guess I just disagree with you that health problems and social problems are separate. I see them as interrelated parts of one underlying issue -- the health of our people. And while we are among the top countries on earth for acute care -- even leading the world in many -- that doesn't change the indisputable fact that we don't live as long as other countries.

    And just because you continue to repeat yourself that we have the best healthcare in the world doesn't make it true. Even the information you shared on infant survival rates just argues that our gap is narrower than the numbers suggest. Alas, the gap still remains, and all those dead infants are still dead. Don't agree? Cool. Show me statistics proving your point, not an argument that suggests we're not as bad, but still worse, as other developed countries when it comes to infant mortality.

    And our costs are out of control because nobody is incented to reduce them. We have competing profit centers -- pharma, physicians/nurses/medical technicians, hospitals, insurance companies -- that all have powerful lobbies in Washington I might add. Hell, the average pill counter (i.e. pharmacist) in the USA makes over $120k. As one of them (insurance) effectively sets the rates for the rest of them, is it any wonder that we've had the out of control medical costs that we have? After all, if insurance companies were effective in controlling costs, they would also limit their profits, and that's never going to happen...unless the government steps in. You know, like the most of the rest of the developed world has done.

    Moving past all that: Have you ever experienced healthcare anywhere outside the USA? If so, where? What was your experience?

    I have, in Tokyo, and the whole experience was eye opening....Mike

    Why was Tokyo eye opening? Was it the 30% you had to pay? Or were you uninsured and responsible for 100%.

    How was it better than the U.S.?

    I have not had care outside the U.S., but I have known people who lived in Germany, Thailand, Australia, and China. Thailand and China we won't discuss since you avoid the hospital from what I was told. The companies with branches there have private facilities for employees. I did hear Australia had very good medical care. In Germany you also went to a private hospital and not the government operated ones. This is just hearsay, but I trust the people who told me.

    The rest of the world controls the salaries of those who work in the medical field and in other fields. Would you like the government to decide what your talents are worth to lower the cost of certain goods or services. Or are you employed by the government?

    I do not think you see the underlying problem of why we don't live longer or why the infant mortality rate is higher since you keep blaming it on medical care. You will also notice I use the term medical care, since that is what really are talking about and not healthcare. Your healthcare depends on your social choices.

    I am not disagreeing it costs more here, I have told you why. That will not change and should not since it gives the government the right to decide what a person's talents are worth. I do not want the government to dictate what a pharmacist, doctor, you, me, or anyone else gets paid. That is not the job of government in our society. The government can not and should not step in to control what a person can earn for their talents.

    The only advice I can give you and others who say how much better it is in other countries is, if you ever get diagnosed with a serious medical condition where the quality of medical care can save or end your life, then by all means go to the country that you feel has the best medical care. I know I will stay right here myself.

    The only system I heard about that would work here is Germany's. They have a dual system. A basic government run clinics and hospitals paid by a kind of tax and an optional private insurance system you can purchase. You get to choose which you want.

    http://www.germanyhis.com/

    Mini Mart Magnate

    I am just here for my amusement. 

  • Gary SGary S Posts: 2,313 Captain
    You'll complain when the person who fills you perceptions who has had extensive medical training makes $120,000 or a doctor who holds the power of life and death in their hands makes the salary they make. But you will pay to watch a football game or go watch a movie.
  • mustang190mustang190 Posts: 10,104 AG
    Gardawg wrote: »
    The illness care cartel (Big Pharma, Big Insurance, AMA) has bribed our legislators to allow them to gouge us.

    That is why we pay so much more than others.

    To a degree your right but,,
    The abandonment of free market principles has more to do with along with government interference.
    Ask yourself what would happen to your auto or even your home owners insurance was interfered with like health insurance is?
    Why should a healthy 30 something male non-smoker be paying for prostrate cancer or even ovarian cancer??
    A lot of people have forgotten what the definition of "insurance" really means.
    Do you use your auto insurance to buy new tires or brakes?? So why should you have to use your medical insurance for a check up or even a blood test?
  • cadmancadman Home of the Gators Posts: 33,389 AG
    mustang190 wrote: »
    To a degree your right but,,
    The abandonment of free market principles has more to do with along with government interference.
    Ask yourself what would happen to your auto or even your home owners insurance was interfered with like health insurance is?
    Why should a healthy 30 something male non-smoker be paying for prostrate cancer or even ovarian cancer??
    A lot of people have forgotten what the definition of "insurance" really means.
    Do you use your auto insurance to buy new tires or brakes?? So why should you have to use your medical insurance for a check up or even a blood test?

    Uhmmm, your analogy makes no sense. You ask why should a healthy non smoker be paying for prostate cancer or ovarian cancer? Why should a home owner pay for a fire that never happens? Why should a safe driver who never had an accident pay for liability insurance? Because the unexpected happens. Also, you don't seem to understand how insurance works. Everyone pays in, hoping they never use it, but are glad to have if the unexpected happens. It spreads out the risk so one person doesn't have a million dollar bill. Another person pay never get a return, but that is how insurance goes. I have paid over $30,000 in homeowners insurance in my lifetime and never filed a claim, my payments went to others who had to file a claim and some profit for the company.

    I also doubt you realize how much your auto and homeowners is regulated by the state. There is as much or more interference in home owners as there is health insurance. It is why we have companies like Citizen insuring home owners funded partially by taxpayer dollars.

    There are automobile policies that will handle tires and brakes. You can eliminate having your health insurance pay for basic stuff by raising your deductible.

    The free market won't lower prices. Why do you think it will? Please give me some rules and regulations that have increased the cost of insurance. I an think of a couple, but they only account for a 10% increase in policy premiums. In a free market system, there has to be a method of reducing production costs or reducing profit to lower the price of a good. Large companies do this and eliminate the small independent guy. Do you want Walmart to be your doctor? If you need a triple bypass, are you going to pick the lowest cost doctor or do you want the best doctor? You want to get your prescription drugs from China? You want to call your doctor and get a guy in India reading a computer screen diagnose your health issue?

    Free market isn't going to lower prices since the good doctors aren't going to lower their fees. Most feel they are underpaid by the insurance companies already. We are already headed to a point where Nurse Practitioners are seeing patients more than doctors in many offices.

    Mini Mart Magnate

    I am just here for my amusement. 

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