I could only find numbers for 1996, but I'd only imagine that they are worse today. Americans, per capita, see a doctor 9 times a year, in Sweden that is 2.9. So, even if it is the higher number you posted, it is still not more than triple what the Swedes pay. So, double the cost for three times the doctor's visits, doesn't sound all that bad.

Sweden also has a higher life expectancy rate though. True less people smoke there, which makes up part of the dfference. There are many other factors other than doctor visits included in spending on healthcare, such as the cost of medication and administrative costs. As I mentioned before, the U.S. pays a very large percentage of money on administrative costs with HMOs.

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quote:

Originally posted by NeoPhono I could only find numbers for 1996, but I'd only imagine that they are worse today. Americans, per capita, see a doctor 9 times a year, in Sweden that is 2.9. So, even if it is the higher number you posted, it is still not more than triple what the Swedes pay. So, double the cost for three times the doctor's visits, doesn't sound all that bad.

that argument is flawed tho, at least to my understanding the normal visits to the doctor is not what coasts money, but all the more advanced operations/treatmens (correct me if im wrong). So unless you have a lot more seriously sick people that argument doesnt hold. Of course it would be some more, but not that much more. and then you could also wounder how many times you really need to go to a doctor per year, i have been at a doctor perhaps 4-5 times in my life what i can remember and i feel perfectly fine still...

and yeah, the adminstrative costs in the US are high, i saw that they were like 3 times higher than in canada for example.

quote:

Originally posted by St_Andrew that argument is flawed tho, at least to my understanding the normal visits to the doctor is not what coasts money, but all the more advanced operations/treatmens (correct me if im wrong). So unless you have a lot more seriously sick people that argument doesnt hold. Of course it would be some more, but not that much more. and then you could also wounder how many times you really need to go to a doctor per year, i have been at a doctor perhaps 4-5 times in my life what i can remember and i feel perfectly fine still... and yeah, the adminstrative costs in the US are high, i saw that they were like 3 times higher than in canada for example.

Sure, it's not exact, but it gives you an idea of how much health care Americans ask for a year. It may not be a dollar amount, but it is a time and resources amount.

There are many factors that go into health care quality. If we're looking at sheer numbers, one way in which America is at a statistical disadvantage to other countries is in its population centers. Whereas most, if not all European countries are city-centric, that is not the case in the United States. Our urban/rural population distribution is almost equal which makes health care much less available to many geographically. When you live 25 miles away from the nearest hospital, it is going to affect your health care and the cost when you do recieve it. There are also cultural and social issues (the topic of my first reply in this thread) that also must be taken into consideration.

America spends the most, based on GNP and requires the second most (second to Japan) health care time per capita in the world. This will not change under a socialized system, in fact I would arugue that it would make both of these worse, as the government would require more money to run things than the private sector, and as I stated before, the idea of "free" health care only makes people demand more of it.

quote:

Originally posted by NeoPhono America spends the most, based on GNP and requires the second most (second to Japan) health care time per capita in the world. This will not change under a socialized system, in fact I would arugue that it would make both of these worse, as the government would require more money to run things than the private sector, and as I stated before, the idea of "free" health care only makes people demand more of it.

Then why does Medicare have far less administrative costs than HMOs, especially when Medicare deals with mainly senior citizens, who require more health care services and therefore more paperwork? Government programs that are setup for public service do not have to also factor in profit margins into the equation. I have to agree with St. Andrew also that early treatment cuts down costs in the long run, because early detected problems in many cases are treated before they require expensive treatment. Many of the people that are going in for care that can't be refused because it so severe they can't be turned away, even though they are not given the highest quality care, are already placing a burden on the system with the need for extensive care. If they were to have seen a doctor earlier when first detected or on a routine checkup before even noticing a problem, the problem would likely be treated at a lesser cost in terms of the government's finances and the person's health. For instance, Elizabeth Edwards (who has health insurance but chose not to go for her checkup) was diagnosed much later than she should have for cancer and her treatment would likely have been less rigorous and costly on her health and pocketbook had she gone to the doctor when she was supposed to.

I will absolutely agree with Neophono on certain cultural factors that are more unique to the U.S., which I think need to be addressed, but the health care system could clearly be improved by moving away from the HMO system. I think more public investment in healthcare would greatly reduce socio-economic inequalities and improve healthcare for many, but obviously smoking and diet also hinder U.S. health for rich and poor.

I should also mention, because I haven't meintioned it earlier, but I do believe I saw in this thread or another that Neophono works at a cancer hospital, so I just wanted to say you deserve a tremendous amount of respect for doing that, as not only is it a very noble profession, but also has to be one of the toughest jobs to deal with on a daily basis I could imagine.

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quote:

Originally posted by wolverine16 Then why does Medicare have far less administrative costs than HMOs, especially when Medicare deals with mainly senior citizens, who require more health care services and therefore more paperwork?

Well, it's also bankrupt and cutting its payments for healthcare by about 8% a year. In fact, in the field of oncology, medicare has cut its payments for chemo therapy to 85% of the wholesale value for the medications. Doctors have to over-charge, or eat the costs themselves for the drugs required by patients because medicare won't cover the full cost for them. You also have to take into account the administrative costs to hospitals for working with medicare and medicare patients, which I would say are triple what a normal HMO costs, simply due to the paperwork involved (110,000 page diagnosis coding book for example!!!)

quote:

I should also mention, because I haven't meintioned it earlier, but I do believe I saw in this thread or another that Neophono works at a cancer hospital, so I just wanted to say you deserve a tremendous amount of respect for doing that, as not only is it a very noble profession, but also has to be one of the toughest jobs to deal with on a daily basis I could imagine.

Thanks for the kind words. It's kind of funny, because in normal "chit chat," I'm always asked where I work. Suffice to say, as soon as I say "with cancer patients," the conversation abruptly ends. It doesn't seem to be a topic most want to talk about. It has some very difficult moments, but if you can totally seperate yourself from work when you're not there, you'll be okay. There have been a number of nurses I work with that have had complete breakdowns because they haven't been able to. Seeing death and suffering every day is challenging, but it gives a great perspective on life, but a horrible fear of ending up in a position similar to the ones I see.

FYI, here is where I work. http://www.jamesline.com/

quote:

Originally posted by NeoPhono Well, it's also bankrupt and cutting its payments for healthcare by about 8% a year. In fact, in the field of oncology, medicare has cut its payments for chemo therapy to 85% of the wholesale value for the medications. Doctors have to over-charge, or eat the costs themselves for the drugs required by patients because medicare won't cover the full cost for them. You also have to take into account the administrative costs to hospitals for working with medicare and medicare patients, which I would say are triple what a normal HMO costs, simply due to the paperwork involved (110,000 page diagnosis coding book for example!!!) Thanks for the kind words. It's kind of funny, because in normal "chit chat," I'm always asked where I work. Suffice to say, as soon as I say "with cancer patients," the conversation abruptly ends. It doesn't seem to be a topic most want to talk about. It has some very difficult moments, but if you can totally seperate yourself from work when you're not there, you'll be okay. There have been a number of nurses I work with that have had complete breakdowns because they haven't been able to. Seeing death and suffering every day is challenging, but it gives a great perspective on life, but a horrible fear of ending up in a position similar to the ones I see. FYI, here is where I work. http://www.jamesline.com/

True the financial numbers of Medicare aren't adding up right now and it is estimated by the Medicare Trustees to go broke in 2019. It needs some shoring up, but the administrative costs will not reach near the levels of HMOs, nor include profit margin. Medicare funding has been hurt greatly because the costs of technology and needs of patients have gone up while the pertcentage of medicare paid by workers and their employers have not gone up since 1985. It also has to do in part with some of the changes made in the Medicare Reform Act of 2003, which mandates managed care in many instances, which is at a greater cost. The higher costs for tchnology, increased patient needs and the aging of the baby boom generation will all add to HMO costs as well.

My background in healthcare came for 1 1/2 years when I was doing social work at a nursing home when I took some time off from school. The nursing home was basically divided into two wings on each floor, one private pay, one medicare/public aid. Naturally lots of people eventually moved from the private pay side to the other, as their money ran out as they were there for long term care and so I was able to see a difference in the care they received. People paying privately or through insurance did not receive the same amount of care, because that is where overworked staff chose to cut corners, because the other wing had government mandated goals, procedures, etc. that had to be met and extensively documented. I know all too well that the documentation can get overwhelming,as I went through much of it myself, at least on the social aspects, so I think that funding would have to be met to provide staff for the level of paperwork, but I think there would be a significant increase in the quality of care, though I realize not everyone would agree.

I'm gonna go watch the 2nd half of the Colts/Pats game, but I'll definitely check out the link tonight. I dealt on a very limited basis with some elderly people dying of cancer and it was pretty rough just seeing them a few times a week and not knowing if you'd see them again after a couple days off.

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Wow, is anyone watching the healthcare-related Simpsons episode on right now?

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Thurs May 15: Influence @ Tini Martini w/ Kris B. vs. Nosmo, Rikler & Mike Palmeri
Thurs June 5: Under the Influence @ Tini Martini w/Mathias Matthew, Jack Kim & more TBA