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The US WHO rankings in 2000:
We ranked #37 in overall in healthcare
We ranked #24 in life expectancy
We ranked #72 in health performance
2002 thru 2005:
#2 in total expenditure % per GDP
Something is totally out of balance in our country because we certainly don't get what we are paying for in healthcare. These are horrible statistics for the richest country on earth.
Source: http://www.photius.com/rankings/healthranks.html
Exercise Cancer Prenatal care Surgery Nephritis Malaria Pregnancy Diabetes Erythema nodosum Hypertension Pain Obesity Lung cancer
LIfe expectancy is affected by many other factors besides healthcare. I just saw a program that touted statistics that we have about the highest obesity and lack of exercise statistics of any country in the world. Both of these factors affect disease and life expectancy more than anything. Same with infant mortality....when you read the high infant mortality rates, what is not included is the high teen pregnancy rate which has a high probability for infant mortality and also lack of proper prenatal care which is also a behavioral factor. When I lived in Florida which had at the time one of the highest malpractice insurance rates for OB/GYNs in the country and I had a hard time finding an OB/GYN as a result since not many were willing to practice there due to cost, one of the OBs in the group told me that a perfect example of the problems they face was illustrated by something that happened to him. He took a woman as a patient against his instincts not to, who was late in her pregnancy, had not come for prenatal care until her third trimester, was grossly overweight plus had some preexisting health conditions. She did not comply with his medical advise of diet control, sodium restriction, etc. and she developed complications in her last few weeks and ended up with an early delivery and complications in labor and delivery and the baby went into distress, etc. etc. And I might add, he came highly recommended with an impressive educational and experiential background and was an excellent doctor. When this irresponsible woman's baby suffered complications that could not be prevented, she sued him. He told me he should have known she was trouble since she was a high risk classification the minute she walked in his office due to her medical history. I don't call that failure of the healthcare system, but failure on the part of the patient. Doctors can not save us from ourselves. I would be curious to see what they base those statistics on. I have had a few bad experiences but overall I am very pleased with my healthcare. Another factor that often is not mentioned is the size of the country. Most of the European countries are the size of one of our mid sized states and of course we represent 50 of them and have millions more people. There are far more people who come here to the USA for healthcare from other countries than vice versa. There has to be a reason. The only really bad overall inferior healthcare I have experienced was in the US Naval hospital/clinic system. What I prefer about our system is the fact if you see a doctor you are not pleased with, you can change doctors since we have so many to choose from at least in most areas.
At MD Anderson they have an international center since they have so many people who come from over 90 countries for treatment. Here is the link: http://medicaltourismmag.com/detail.php?Req=247&issue=11
These statistics are from the World Health Organization and are based on a % of the total population therefore the size of a country is taken into consideration -this an apples to apples comparison. I noticed that some of the countries with better statistics then the US are countries who have that feared "socialized" health system. I have family members in England and some are enrolled in the national health system and others chose to pay a premium for private health insurance. My family members (middle to upper income people) are happy with the national healthcare they receive --I was visiting once when my auntie experienced what she thought were hypertension problems--she called her PCP and was seen the same day--this is the norm not the unusual.
I agree that poor self care behavior can lead to disease and death. But lack of access to care is often the issue. I worked several years at a University based Cancer Center and many our patients had a delayed cancer diagnosed due to lack of access to health care not due their lack of attention to self care.
Do you think that health care insurance premium costs should be related to self health behaviors-- examples: those who don't have a yearly physical exam at the PCP should pay more or even those who are over weight should pay a higher premium than those who maintain a normal weight?
People go to other countries for care not just to the US. My friend's daughter in law could not get the pituitary gland brain surgery she needed here and went to Canada for it (this surgery is now performed here)and I know of someone else who went to Europe for a vaccine treatment for her NHL . And we can't forget that Farrah Fawcett went to Germany for her cancer treatment It is a two way street. Also, many drugs are approved in other countries more quickly therefore those with financial ability sometimes go abroad without the wait.
This is a good article:
http://allcountries.org/health/usa_health_care_2008_nyt.html
I don't want to get into a political discussion here, but Shamrock, I am definitely on the same page as you about the state of our health care here in this country. Here is one interesting personal experience: since we rarely had ever used our health insurance prior to my diagnosis and I was diagnosed in the latter part of the year ( after my selections nwere chosen for the next year ), we had 2 years of $1000 deductibles, which is fine. However, in early 2008 when I went for my 3rd chemo treatment, they were not going to give me my chemo because I still owed them $680 from my deductible. This was only about 2 weeks after they billed us for that $680 ! I naively asked what would happen if I didn't have insurance and was told that they expect payment for chemo or else you can't receive it. That was very troubling to me.
In the interest of furthering the discussion on health care, a significant number of Americans believe that the answer to our health care problems is to rely on the free market. Health care can’t be marketed like bread or TVs. An explanation was eloquently brought out by Princeton economist Paul Krugman.
There are two strongly distinctive aspects of health care. One is that you don’t know when or whether you’ll need care, but if you do, the care can be extremely expensive.
It must be largely paid for by some kind of insurance. And this in turn means that someone other than the patient ends up making decisions about what to buy. Consumer choice is nonsense when it comes to health care. And you can’t just trust insurance companies either, they’re not in business for their health, or yours.
This problem is made worse by the fact that actually paying for your health care is a loss from an insurers’ point of view, they actually refer to it as “medical costs.” This means both that insurers try to deny as many claims as possible, and that they try to avoid covering people who are actually likely to need care.
Both of these strategies use a lot of resources, which is why private insurance has much higher administrative costs than single-payer systems.
The second thing about health care is that it’s complicated, and you can’t rely on experience or comparison shopping. That’s why doctors are supposed to follow an ethical code, why we expect more from them than from bakers or grocery store owners.
You could rely on a health maintenance organization to make the hard choices and do the cost management, and to some extent we do. But HMOs have been highly limited in their ability to achieve cost-effectiveness because people don’t trust them, they’re profit-making institutions, and your treatment is their cost.
Between those two factors, health care just doesn’t work as a standard market story.
There are a number of successful health-care systems, at least as measured by pretty good care much cheaper than here, and they are quite different from each other. There are, however, no examples of successful health care based on the principles of the free market, for one simple reason: in health care, the free market just doesn’t work. And people who say that the market is the answer are flying in the face of both theory and overwhelming evidence.
And what Krugman says about "medical costs" is explained by former Cigna Insurance Company executive Wendell Potter. The industry is driven by two key figures: earnings per share and the medical-loss ratio, or medical-benefit ratio. That is the ratio between what the company actually pays out in claims and what it has left over to cover sales, marketing, underwriting and other administrative expenses and, of course, profits.
Think about that term for a moment: The industry literally has a term for how much money it "loses" paying for health care.
The best way to drive down "medical-loss," is to stop insuring unhealthy people. You won't, after all, have to spend very much of a healthy person's dollar on medical care because he or she won't need much medical care. And the insurance industry accomplishes this through two main policies. One is policy "rescission." They look carefully to see if a sick policyholder may have omitted a minor illness, a pre-existing condition, when applying for coverage, and then they use that as justification to cancel the policy, even if the enrollee has never missed a premium payment.
Rescission is important to the business model. At a recent House Subcommittee on Oversight and Investigation meeting, Rep. Bart Stupak, the committee chairman, asked three insurance industry executives if they would commit to ending rescission except in cases of intentional fraud. "No," they each said.
Potter also emphasized the practice known as "purging." This is where insurers rid themselves of unprofitable accounts by slapping them with "intentionally unrealistic rate increases."
The issue isn't that insurance companies are evil. It's that they need to be profitable. They have a fiduciary responsibility to maximize profit for shareholders. Potter explained, he's watched an insurer's stock price fall by more than 20 percent in a single day because the first-quarter medical-loss ratio had increased from 77.9 percent to 79.4 percent.
The reason we generally like markets is that the profit incentive spurs useful innovations. But in some markets, that's not the case. We don't allow a bustling market in heroin, for instance, because we don't want a lot of innovation in heroin creation, packaging and advertising. Are we really sure we want a bustling market in how to cleverly revoke the insurance of people who prove to be sickly?
Hi gpawelski,
Thanks for your reply. You have always been so informative on this message board. I think others would also be interested in conversing about healthcare insurance reform. To bring attention to this subject would you be so kind to repost your response in a new discussion called healthcare insurance reform or give it another title. The title of this discussion is US Healthcare ranking and I fear it won't draw enough attention to those who are interested like myself in this very timely topic.
This study is very misleading. There are basically 3 categories on which nations are scored.
1. Responsiveness of the system
2. Health based on life-expectancy/disability
3. Equality (broadly defined)
US ranks #1 in responsiveness, #24 on health (life expectancy/disability) and #55 on equality of financial contribution.
BUT ... here is the twist. The weighting of Responsiveness is only 12.5% where as equality of contribution is 62.5% in the overall ranking! Clearly most of us would prefer a responsive system that meets are needs as opposed to equality of financial contribution.
It gets more interesting when you see that for the third measure US is rated #55 behind countries like Columbia (#1), Djibouti (#3), Libya and Bangladesh which get high ratings because they spend next to nothing and hence have less disparity. This measure is laughable! No wonder it drags down the overall score for US.
Clearly using this study to make policy decision about how good or bad US health care is, well, ... not what the doctor ordered.
Source: WHO Study http://www.who.int/whr/2000/en/whr00_en.pdf
Page 54 (Box 2.4) and page 152 (Annex Table 1)
I am suspect of the "truthfulness" of the data compiler.
My husband took alot of statistic classes in college.
He always says u can make statistics say what ever u want them to say.
He proved statisticly that dimes cause cancer
so like PT16 said u need to look at how the statistics were arrived at.
A Duke Professor Explaines What the Health Care Bill Actually says
http://www.rushlimbaugh.com/home/daily/site_081209/content/01125108.guest.h tml
I too am very interested in this topic, and have yet to figure out who is telling the truth. The insurance companies spin one way, liberals spin another. It seems to me that we need two systems, one for everyday sniffles, flu, simple things, and another system for people with life-threatening diseases.
I was in the emergency room with my husband not too long ago, and a mother brought her child in BY AMBULANCE (approx. age nine or ten) because the little girl had a sore throat. Seriously! We paid a $100 deductible plus whatever our insurance paid. This woman paid nothing. My husband was in a serious situation, the little girl had a sore throat. That is why I would suggest two systems, one for emergencies and another plan for people who use the emergency room as a doctor's office.
Another question, I understand the AMA is supporting current plan, but I have yet to talk to an individual physician who favors it. One dr. (primary care) told me he would leave the country if it becomes law, and another (orthopedic surgeon) said it would push up his plans for retirement. I have an appt. with my oncologist next week and I am very interested in what he has to say on the subject.
I believe this is the biggest issue to come before this country in my lifetime. We definitely need reform. It is just very frightening what that reform may look like.
White House Response to the fear mongering:
8 ways reform provides security and stability to those with or without coverage
Ends Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.
Ends Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
Ends Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
Ends Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
Ends Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.
Ends Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
Extends Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.
Guarantees Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won't be allowed to refuse renewal because someone became sick.
8 common myths about health insurance reform
Reform will stop "rationing" - not increase it: It’s a myth that reform will mean a "government takeover" of health care or lead to "rationing." To the contrary, reform will forbid many forms of rationing that are currently being used by insurance companies.
We can’t afford reform: It's the status quo we can't afford. It’s a myth that reform will bust the budget. To the contrary, the President has identified ways to pay for the vast majority of the up-front costs by cutting waste, fraud, and abuse within existing government health programs; ending big subsidies to insurance companies; and increasing efficiency with such steps as coordinating care and streamlining paperwork. In the long term, reform can help bring down costs that will otherwise lead to a fiscal crisis.
Reform would encourage "euthanasia": It does not. It’s a malicious myth that reform would encourage or even require euthanasia for seniors. For seniors who want to consult with their family and physicians about end-of life decisions, reform will help to cover these voluntary, private consultations for those who want help with these personal and difficult family decisions.
Vets' health care is safe and sound: It’s a myth that health insurance reform will affect veterans' access to the care they get now. To the contrary, the President's budget significantly expands coverage under the VA, extending care to 500,000 more veterans who were previously excluded. The VA Healthcare system will continue to be available for all eligible veterans.
Reform will benefit small business - not burden it: It’s a myth that health insurance reform will hurt small businesses. To the contrary, reform will ease the burdens on small businesses, provide tax credits to help them pay for employee coverage and help level the playing field with big firms who pay much less to cover their employees on average.
Your Medicare is safe, and stronger with reform: It’s myth that Health Insurance Reform would be financed by cutting Medicare benefits. To the contrary, reform will improve the long-term financial health of Medicare, ensure better coordination, eliminate waste and unnecessary subsidies to insurance companies, and help to close the Medicare "doughnut" hole to make prescription drugs more affordable for seniors.
You can keep your own insurance: It’s myth that reform will force you out of your current insurance plan or force you to change doctors. To the contrary, reform will expand your choices, not eliminate them.
No, government will not do anything with your bank account: It is an absurd myth that government will be in charge of your bank accounts. Health insurance reform will simplify administration, making it easier and more convenient for you to pay bills in a method that you choose. Just like paying a phone bill or a utility bill, you can pay by traditional check, or by a direct electronic payment. And forms will be standardized so they will be easier to understand. The choice is up to you – and the same rules of privacy will apply as they do for all other electronic payments that people make.
8 Reasons We Need Health Insurance Reform Now
Coverage Denied to Millions: A recent national survey estimated that 12.6 million non-elderly adults – 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market – were in fact discriminated against because of a pre-existing condition in the previous three years or dropped from coverage when they became seriously ill. Learn more: http://www.healthreform.gov/reports/...age/index.html
Less Care for More Costs: With each passing year, Americans are paying more for health care coverage. Employer-sponsored health insurance premiums have nearly doubled since 2000, a rate three times faster than wages. In 2008, the average premium for a family plan purchased through an employer was $12,680, nearly the annual earnings of a full-time minimum wage job. Americans pay more than ever for health insurance, but get less coverage. Learn more: http://www.healthreform.gov/reports/...sts/index.html
Roadblocks to Care for Women: Women’s reproductive health requires more regular contact with health care providers, including yearly pap smears, mammograms, and obstetric care. Women are also more likely to report fair or poor health than men (9.5% versus 9.0%). While rates of chronic conditions such as diabetes and high blood pressure are similar to men, women are twice as likely to suffer from headaches and are more likely to experience joint, back or neck pain. These chronic conditions often require regular and frequent treatment and follow-up care. Learn more: http://www.healthreform.gov/reports/women/index.html
Hard Times in the Heartland: Throughout rural America, there are nearly 50 million people who face challenges in accessing health care. The past several decades have consistently shown higher rates of poverty, mortality, uninsurance, and limited access to a primary health care provider in rural areas. With the recent economic downturn, there is potential for an increase in many of the health disparities and access concerns that are already elevated in rural communities. Learn more: http://www.healthreform.gov/reports/hardtimes
Small Businesses Struggle to Provide Health Coverage: Nearly one-third of the uninsured – 13 million people – are employees of firms with less than 100 workers. From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. Much of this decline stems from small business. The percentage of small businesses offering coverage dropped from 68% to 59%, while large firms held stable at 99%. About a third of such workers in firms with fewer than 50 employees obtain insurance through a spouse. Learn more: http://www.healthreform.gov/reports/helpbottomline
The Tragedies are Personal: Half of all personal bankruptcies are at least partly the result of medical expenses. The typical elderly couple may have to save nearly $300,000 to pay for health costs not covered by Medicare alone. Learn more: http://www.healthreform.gov/reports/inaction
Diminishing Access to Care: From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. An estimated 87 million people - one in every three Americans under the age of 65 - were uninsured at some point in 2007 and 2008. More than 80% of the uninsured are in working families. Learn more: http://www.healthreform.gov/reports/...ing/index.html
The Trends are Troubling: Without reform, health care costs will continue to skyrocket unabated, putting unbearable strain on families, businesses, and state and federal government budgets. Perhaps the most visible sign of the need for health care reform is the 46 million Americans currently without health insurance - projections suggest that this number will rise to about 72 million in 2040 in the absence of reform. Learn more:
http://www.WhiteHouse.gov/assets/documents/CEA_Health_Care_Report.pdf
Source: The White House
To those naysayers regarding the World Health Organization's statistics I have shared:
>WHO statistics noted are from 2000 through 2005. If they are incorrect then the US needs to respond and challenge with correct data----I have found no government rebuttal.
> If we don't believe these WHO's statistics then we shouldn't rely on WHO's current HiN1 flu, Aids, Malaria, etc. statistics?
>WHO has "no dog in this fight"--the statistics are not bent to emphasize the US poor outcomes related to our current health care insurance reform debate.
http://www.who.int/whosis/en/
We can all agree on one thing....our healthcare system needs reform. I think the difference in opinions comes in how and what. I am troubled by so many medical professionals not being in favor of the current Congressional and White House public option. They are the people we rely on for our healthcare and it makes sense to me that they be consulted in large numbers for what they think would be best. And I think it is wrong to demonize them as money mongers since I have not seen that. In fact, quite the opposite, I have had to push for expensive tests that my docs have said, "let's wait and see". My doctors have all operated on what's in my best interest in their professional opinion. There may be some that are motivated by money but that is not what I have experienced. In fact, some of my doctors do charity medicine on the side...work in free clinics, do some free services or just don't charge for something, etc. I hear nothing being mentioned about tort reform which jacks up the cost of all of our healthcare.
i agree. so many are afraid to change our current system, however the truth is that the current system is not working. i think we can borrow from other systems that are working and start slowly with one aspect such as prescription drugs. cleaning up merely one or two things at a time would save billions and likely improve aspects of our current sytstem. thank you for posting those stats i have been talking about them but forgot the source.
I might add, I probably have grounds for a malpractice suit since I developed an allergic reaction to nafcillin given me for a postop infection that I developed within the first 24 hours of surgery. I pointed out the rash on my thighs that resulted to the resident and she argued with me when I expressed concern that I might be experiencing an allergic reaction, dismissing it as a side effect. It was in fact an allergic reaction to which I developed intersitial nephritis and it was not diagnosed and treated until 4 weeks post surgery, leaving me with permanent kidney damage. Not only was it misdiagnosed, it was never checked again by the nurses, doctors, not anyone, nor was I given any tests before discharge which may have discovered it early before it could have caused permanent kidney damage. It was charted once, and there is no other mention in my chart about it again. I know as I requested copies of my records from the hospital. The way I view it is that a lawsuit will not bring back my kidney function and any money I would get not only 1/3 goes in some attorney's pocket, but that money takes money away from the very healthcare providers who saved my life and may save others' as well as mine again. But many people sue for far less and win, which results in exorbitant malpractice insurance fees which is passed on to all of us receiving healthcare. My main goal was and is to make sure that mistake is never made again and I have been on a mission to get this info to the drug manufacturer and the hospital. I have chosen not to seek compensation for the damages done to my health but certainly have grounds. I still think highly of the gyn/onc who did my surgery as it was his resident who made the mistake and if anything he did not supervise her adequately. I doubt there is any profession out there where people are correct 100% of the time and in medicine the complexity of the body and the lack of uniformity in individual makeups results in an imperfect science and practice and I think it is unrealistic for people to expect total accuracy from doctors. My daughter was also misdiagnosed once by two doctors with a rare condition that resulted in septicemia and a nephritis. Again, I didn't fault those doctors since it was rare. It was the third doctor who diagnosed it and saved her life. She had a strep infection that attacked her kidneys and the only outward symptoms initially was erythema nodosum which the other doctors thought might be a spider bite. Right after the third doctor figured it out, only then did she manifest blood in her urine so it was easily misdiagnosed. Also I watch Discovery channel medical programming with real health situations and from that you often see rare conditions taking awhile to be diagnosed correctly. And let me add one more thing...when my mother had terminal small cell lung cancer and it had metasticized to her pancreas and adrenal glands, her bloodwork was normal. I remember the doc saying "well, on paper you are perfectly fine" but he and we knew she was not. Medicine is a complex science as we are complex beings with many differences in each individual. We are blessed that we have the wonderful medical professionals out there working hard to cure and treat us. I thank the Lord everyday for them. I would not be here if not for the many medical professionals who saved my life. I think we should consult them for ideas on solving this healthcare crisis.
dwm26,
John David Lewis also says that health care is not a right:
http://www.huffingtonpost.com/john-david-lewis/why-say-there-is-a-right_b_2 58188.html
Momanderson920,
I have spoken to physicians who I know and the majority are in favor of this reform. In fact, my friend's husband has a small town family practice and wants a public option so that he can give his employees healthcare insurance because he can't afford a private plan for them.
Possibly the disconnect between physicians I have spoken with and you have contact with is in relation to geographical location.
God bless my GYN oncology surgeon who donates 2 weeks of his time every year to help poor women in 3rd world countries. These physicians who donate their time and skill feel they should give back because they are financially rewarded above the average person. But they are the rarity not the usual.
http://www.valuemd.com/physiciansalary2.php
In the UK where there is a single payer system and private insurance is also an option for people proving that single payer systems do not put private insurers out of business.
I recently watched the movie"Sicko" on Showtime --it is available to rent as a DVD. I am not a Michael Moore fan by any means and I question the Cuban healthcare part that it lauds but other then that part it is an eye opener. Physicians are interviewed in the movie along with patients who are quite happy with national health services in their countries.
I don't see why I can't have the opportunity for a public health option the same as those on Medicare and Tricare. I haven't heard any of these participants asking the government to delete their programs.
Momanderson920,
I agree there needs to be Tort Reform enacted but at present malpractice lawsuits make hospitals and physicians improve their care standards. There should be an alternative mechanism to replace this present tool.
The huge grossly inappropriate malpractice lawsuit rewards can sometimes be blamed on the jury--they are people just like you and me. Some malpractice lawsuits do not go to jury and are settled out of court. If a physician settles out of court but feels he/she is innocent they should no fold in --this only adds to their own and other physicians increasing cost of malpractice insurance.
Another bothersome area are the limits for malpractice lawsuits. Some States have put tort limits around $200,000 for malpractice and that amount in no way reimburses a family to care for a severely child injured through a malpractice incident to care for child's lifetime.
There are no easy answers to tort reform.
Shamrock, in most cases one third of the settlement goes to the lawyer. That needs reform. What has caused alot of this are people who do not have legitimate claims but often result in large settlements out of court. I think there should be a panel of doctors and civilians who review a case for court before it is accepted. I know a doctor who was sued and the patient did not follow postoperative instructions and caused much of what resulted in improper healing. I don't doubt there are legitimate cases but there are many that are not that have made malpractice insurance cost prohibitive, and a large portion of that goes in the pocket of attorneys, not patients. I also think the medical community needs to do a better job of policing their own. All too often you hear of some dangerous doctor who has either killed or nearly killed multiple people and their licenses are not yanked. Personally I think the idea of a credit union sort of approach...nonprofit health insurance co-ops where the buyers are the shareholders and all profits go back into the co-op, hopefully keeping costs down and control what is covered to some extent. For those who have catastrophic illness, obviously the government needs to come in and provide care. That certainly needs improvement.
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