Aces High Bulletin Board
General Forums => The O' Club => Topic started by: Silat on November 04, 2005, 03:19:43 PM
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http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=33532
Kaiser Daily Health Policy Report
Friday, November 04, 2005
Coverage & Access
U.S. Patients Experience Higher Out-Of-Pocket Costs, More Medical Errors Than Patients in Other Nations, Survey Says
Out-of-pocket health care costs and medical error rates are higher for patients in the U.S. than in five other Western nations, according to a Commonwealth Fund survey published on Thursday in the online version of Health Affairs, the Washington Post reports. For the report, researchers surveyed 6,957 adults between March and June 2005 who recently had been hospitalized, had surgery or reported health problems in the U.S., Australia, Canada, Britain, New Zealand and Germany. The survey, which is the largest to examine health care in several nations during the same time period, found that U.S. residents were more likely to forego medical care than patients in other nations because of costs. In addition, U.S. respondents reported the easiest access to specialists but the most difficulty getting care during nights and weekends (Stein, Washington Post, 11/4). Patients from all six countries reported medical errors, uncoordinated care and poor management of chronic diseases (CQ HealthBeat, 11/3). The study also found the following:
34% of U.S. patients surveyed reported getting the wrong medication or dose, incorrect test results, a mistake in their treatment or late notification of abnormal test results, compared with 30% of Canadians, 27% of Australians, 25% of New Zealanders, 23% of Germans and 22% of Britons;
About half of U.S. residents reported that they had decided not to fill a prescription, see a doctor while sick or have recommended follow-up tests because of costs, compared with 38% of patients in New Zealand, 34% in Australia, 28% in Germany, 26% in Canada and 13% in Britain;
Nearly one-third of U.S. patients reported paying more than $1,000 in out-of-pocket medical expenses in the past year, compared with 14% of Canadian and Australian patients and a much lower proportion of patients in the other countries (Washington Post, 11/4);
15% of U.S. residents said they had no out-of-pocket health care costs in the past year, compared with 65% of British patients;
Most patients in New Zealand and Germany reported ease in acquiring same-day appointments, compared with 30% of U.S. patients;
8% of U.S. residents surveyed reported waiting four months or more for nonemergency surgery, compared with 41% of British patients;
7% of U.S. residents who had been hospitalized in the past two years reported developing an infection while in the hospital, compared with 10% of Britons and 3% of Germans (CQ HealthBeat, 11/3); and
More than half of U.S. patients surveyed received appropriate care for chronic conditions such as hypertension or diabetes.
Reaction
Cathy Schoen, one of the study's authors, attributed the U.S. medical error rate to a lack of coordination among health care providers. She said, "Many of those patients were seeing multiple physicians and taking four or more prescriptions" (Higgins, Washington Times, 11/4). She added, "What's striking is that we are clearly a world leader in how much we spend on health care. We should be expecting to be the best. Clearly, we should be doing better" (Washington Post, 11/4). Agency for Healthcare Research and Quality officials said the national effort to create an electronic health record system could help with coordination problems and reduce health care costs (Washington Times, 11/4). AHRQ Director Carolyn Clancy said, "The findings show that we have a lot to learn from our colleagues," adding, "The findings here reinforce how difficult it is coordinating care." Lucian Leape, a professor and patient safety researcher at the Harvard School of Public Health, said, "This provides confirming evidence for what more and more health policy thinkers have been saying, which is, 'The American health care system is quietly imploding, and it's about time we did something about it" (Washington Post, 11/4).
Full Report http://content.healthaffairs.org/cgi/content/full/hlthaff.w5.509/DC1
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had cataract surgery last summer, my HMO billed me $35 for the office visits (5) and $50 for the surgery.
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Originally posted by john9001
had cataract surgery last summer, my HMO billed me $35 for the office visits (5) and $50 for the surgery.
Ouch! How did you cope? Thats a high expense! We need to socialize our medicine and decline the quality of health care we currently have in the U.S. !
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rip, it was not easy, i had to take the money out of my beer budget, that ment i had to fly AH only half drunk most nights.
but now i can read the budwiser label, "this is the famous budwiser beer, etc etc"
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I'd be interested to see the medical practices between nations in the study vrs. malpractice setlments/claims.
I'm not saying our system is perftect (honestly I have to make statments like this because of liberals like Nash jumpin on my ever sentence) I would really like to see how that impacts our medical systems compared to other countries. IE does it really make a difference or not?
[rant]
PS I have free healt care provided by the dept of deffense wich first diagnosed my daughter with Athsma....then a week later said it was actually Bronchitis.....then yet another week of being sick and caughing till she pukes they finally said she had pnemonia and gave her antibiotics. She's still sick but doing better after almost a month. Currently I sleep on the couch because my wife and son caugh all night long and I work with explosives and need my sleep. [/rant]
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Originally posted by Gunslinger
I'm not saying our system is perftect (honestly I have to make statments like this because of liberals like Nash jumpin on my ever sentence) I would really like to see how that impacts our medical systems compared to other countries. IE does it really make a difference or not?
Jebus... That brings a tear to my eye.
And good questions.
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Originally posted by Gunslinger
I'd be interested to see the medical practices between nations in the study vrs. malpractice setlments/claims.
I'm not saying our system is perftect (honestly I have to make statments like this because of liberals like Nash jumpin on my ever sentence) I would really like to see how that impacts our medical systems compared to other countries. IE does it really make a difference or not?
[rant]
PS I have free healt care provided by the dept of deffense wich first diagnosed my daughter with Athsma....then a week later said it was actually Bronchitis.....then yet another week of being sick and caughing till she pukes they finally said she had pnemonia and gave her antibiotics. She's still sick but doing better after almost a month. Currently I sleep on the couch because my wife and son caugh all night long and I work with explosives and need my sleep. [/rant]
You're quite correct, no heath care system is perfect. There are just some that I would not prefer.
Hope your family gets healthy, Gun...
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Over 45 000 000 americans without health insurance makes your health care sistem bad, unafordable for poors, nonacceptable in the richest country in the world,
It's sad to see all the discoverys and progress in health care, but are for rich only that can aford it, to live longer
I live in Canada, we have it "free", but we pay more taxes,and the services are worst , my brother been waiting 2 weeks for a kidney scan, non emergency ,
But i still think the Canadian way is better,
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and yet... they come here for operations...
What did it say about dental care?
lazs
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Most of those other countries have nationalized health care, so you are depending upon bureacrats to report negative things about themselves---My wife had cancer---in the space of 6 weeks from 1st doctor visit re: chest pain to precise diagnosis, sher had a Ptscan, 4 xrays, CT scan, 2 biopsies, and a port installed in her arm for the endless IV's (And we live in a somewhat rural area--not like I had to drive to Johns Hopkins). How fast does that scenario occur in other places? --Following that, 6 months chemo..good as new, save for the fact her right lung is largely useless due to the tumor mashing the diaphragm for some time
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Originally posted by Gunslinger
[rant]
PS I have free healt care provided by the dept of deffense wich first diagnosed my daughter with Athsma....then a week later said it was actually Bronchitis.....then yet another week of being sick and caughing till she pukes they finally said she had pnemonia and gave her antibiotics. She's still sick but doing better after almost a month. Currently I sleep on the couch because my wife and son caugh all night long and I work with explosives and need my sleep. [/rant]
My daughter had something similar last year :
2 chest radiography
Antibiotics
3 days in hospital
cost (for me) Zero
result : cured in 7 days.
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Originally posted by ghi
Over 45 000 000 americans without health insurance makes your health care sistem bad, unafordable for poors, nonacceptable in the richest country in the world,
It's sad to see all the discoverys and progress in health care, but are for rich only that can aford it, to live longer
I live in Canada, we have it "free", but we pay more taxes,and the services are worst , my brother been waiting 2 weeks for a kidney scan, non emergency ,
But i still think the Canadian way is better,
Not sure if you're aware of this, but the State hospitals never turn away a patient in need.
And, your glorious health care system is a dismal failure, we may have people not covered, but its primarily they're choice, either deciding they're young and don't want to pay the premium, or not working.
~~The head of trauma care at Vancouver's largest hospital announces that they turn away more cases than any other center in North America. He's quoted as saying this would be unheard of in the United States.
~~In Manitoba, the premier--the political equivalent of a governor--concedes that his pledge to end hallway medicine has fallen short. Hallway medicine is the phenomenon where the emergency rooms are so filled with patients that people are forced to lie on stretchers in hallways, often for days. Overcrowding is a periodic problem. In fact, the overcrowding is worse than last year. The community is rocked by the death of a 74-year old man who had waited in the emergency room for three hours and had not been seen.
~~New Brunswick announces that they will send cancer patients south to the United States for radiation therapy. New Brunswick, a small maritime province, is the seventh to publicly announce its plans to send patients south. In the best health care system in the world, the vast majority of provinces now rely on American health care to provide radiation therapy. Provinces do this because the clinically recommended waiting time for treatment is often badly exceeded. Ordinarily, oncologists suggest that there should be a two-week gap between the initial consult by the family doctor and the referral to the oncologist, and then two weeks more from the oncologist to the commencement of radiation therapy. In most Canadian provinces, we exceed that by one to two months, sometimes three.
~~In Alberta earlier this year, a young man dies because of the profound emergency room overcrowding. He is 23. On a winter's night, he develops pain in his flank and goes to the local emergency room. It is so crowded that he grows impatient and goes to another. There, he waits six hours. No one sees him. Exhausted and frustrated, he goes home. The pain continues, so he finally decides to go to the local community hospital. It's too late: His appendix ruptured. He dies from the complications hours later.
Sounds like a great health care system, Ghi, just hope you don't need it...
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Originally posted by straffo
cost (for me) 60% of my income for taxes
;)
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Oh yah, I pay $87 every 2 weeks for dental and Health...my out-of-pocket for this whole thing was about $4k
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Originally posted by ghi
Over 45 000 000 americans without health insurance makes your health care sistem bad, unafordable for poors, nonacceptable in the richest country in the world,
It's sad to see all the discoverys and progress in health care, but are for rich only that can aford it, to live longer
I live in Canada, we have it "free", but we pay more taxes,and the services are worst , my brother been waiting 2 weeks for a kidney scan, non emergency ,
But i still think the Canadian way is better,
45 million huh? For some strange reason that number doesn't quite sound right. Either way we wouln't be the "richest country in the world" if we provided everyone with health care. I'd rather those people got jobs that offered them affordable health care and keep the govt out of it all together.
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Originally posted by Ripsnort
;)
I would be happy to pay 60% of my income as I will have the max income :)
Actually it's about 20%.
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Originally posted by straffo
I would be happy to pay 60% of my income as I will have the max income :)
Actually it's about 20%.
:lol Thats funny. YOU may pay that, but your average countrymen do not.
Revenues calculated on an exchange rate basis:
http://www.nationmaster.com/graph-T/eco_bud_rev_cap
THe average tax payer in France pays $16568.
The average tax payer in USA pays $6296.
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I don't know how is done the computation ,btw I would be happy to pay 16000$ :D
Actually it's about 4000€ direct taxes plus an unknown amount of indirect (VAT) for a 75000€ income
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Originally posted by Gunslinger
45 million huh? For some strange reason that number doesn't quite sound right. Either way we wouln't be the "richest country in the world" if we provided everyone with health care. I'd rather those people got jobs that offered them affordable health care and keep the govt out of it all together.
I think i read in "USA today', few monts ago about those #s, 40 or 45 milions, i may be wrong
I'll bet 24 cold "Blue Labatt", that your goverment is going to go on same sistem like in Canada, or something inbetween
It work in most of the Europe and here, i know you are right, you have better quality services
We have the option here to buy private health insurance, soo no need to relay on slow goverment services only,
Soo what choices is going to have your gov.? let milions uncovered ? Let GM, Ford and many other colapse under health care costs?
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Originally posted by straffo
I don't know how is done the computation
Originally posted by Ripsnort
Revenues calculated on an exchange rate basis:
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Originally posted by ghi
Over 45 000 000 americans without health insurance makes your health care sistem bad, unafordable for poors, nonacceptable in the richest country in the world,
It's sad to see all the discoverys and progress in health care, but are for rich only that can aford it, to live longer
I live in Canada, we have it "free", but we pay more taxes,and the services are worst , my brother been waiting 2 weeks for a kidney scan, non emergency ,
But i still think the Canadian way is better,
Btw, wife was chatting with a friend on a Hodgkins bbs site--girl lives in Sasketchewan (ok, like YOU can spell that!) She desperately needs a PTscan done (this is the ONLY way to search the entire body at once for ANY tumors--Hodgkins tends to put them all over) the nearest machine is in Ontario, and the wait is 2 months+, and it is her understanding that she will have to wait even longer due to where she lives. I live in maybe the 10th largest city of a small state, and WE have one--wait was 1 week .:aok
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Originally posted by ghi
I think i read in "USA today', few monts ago about those #s, 40 or 45 milions, i may be wrong
I'll bet 24 cold "Blue Labatt", that your goverment is going to go on same sistem like in Canada, or something inbetween
It work in most of the Europe and here, i know you are right, you have better quality services
We have the option here to buy private health insurance, soo no need to relay on slow goverment services only,
Soo what choices is going to have your gov.? let milions uncovered ? Let GM, Ford and many other colapse under health care costs?
yes by all means let the coorporations do it. Them along witht he private sector can manage healthcare so much more efficiently than the federal govt. I'm not heartless when I say don't cover these people. They will get care if they go to a hospital in most cases but people shouldn't be dependent on govt for something like this. There's allways the oppertunity to makes ones life better.
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edit: deleted post... not worth my headaches later nor the future lack of job security.
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Not a major emergency, but still....
Tooth pain, put it off for 4 days, finally called my dentist. Got an appointment the next day.
In that day....had the dental appointment, DDS referred me to a endodontist, drove there and went right in, endodontist said unfortunately there was no way to save the cracked tooth, refferred me to an oral surgeon for extraction, again, drove right there and was in the chair in 15 minutes.
3 medical offices in 3 hours with only one days notice for the first DDS appointment. Even got a follow up call from the oral surgeon later that evening. Total out of pocket, none as yet, probably about $30 for the visits, but may be nothing.
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I'll bet 24 cold "Blue Labatt", that your goverment is going to go on same sistem like in Canada, or something inbetween
I'd take that bet the moment you wager real bear.
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Originally posted by Ripsnort
And, your glorious health care system is a dismal failure
50 years ago just before it was nationalized both countries had pretty much the same health care, the same life expectancy and infant mortality rates. now canadians live two to three years longer than americans and the infant mortality rate is lower as well.
the system is antiquated to handle the baby boomers, open buffet season is over. it needs some fundamental changes and user and abuser accountablitiy.
bus loads of seniors on weekend drug junkets, medical expenses a leading cause of personal bankruptcy...glorious.
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Originally posted by Ripsnort
Ouch! How did you cope?
It's easy. You just have to forget that you spent any money at all on medical insurance.
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November 7, 2005
Op-Ed Columnist
Pride, Prejudice, Insurance
By PAUL KRUGMAN
General Motors is reducing retirees' medical benefits. Delphi has declared
bankruptcy, and will probably reduce workers' benefits as well as their
wages. An internal Wal-Mart memo describes plans to cut health costs by
hiring temporary workers, who aren't entitled to health insurance, and
screening out employees likely to have high medical bills.
These aren't isolated anecdotes. Employment-based health insurance is the
only serious source of coverage for Americans too young to receive Medicare
and insufficiently destitute to receive Medicaid, but it's an institution in
decline. Between 2000 and 2004 the number of Americans under 65 rose by 10
million. Yet the number of nonelderly Americans covered by employment-based
insurance fell by 4.9 million.
The funny thing is that the solution - national health insurance, available
to everyone - is obvious. But to see the obvious we'll have to overcome
pride - the unwarranted belief that America has nothing to learn from other
countries - and prejudice - the equally unwarranted belief, driven by
ideology, that private insurance is more efficient than public insurance.
Let's start with the fact that America's health care system spends more, for
worse results, than that of any other advanced country.
In 2002 the United States spent $5,267 per person on health care. Canada
spent $2,931; Germany spent $2,817; Britain spent only $2,160. Yet the
United States has lower life expectancy and higher infant mortality than any
of these countries.
But don't people in other countries sometimes find it hard to get medical
treatment? Yes, sometimes - but so do Americans. No, Virginia, many
Americans can't count on ready access to high-quality medical care.
The journal Health Affairs recently published the results of a survey of the
medical experience of "sicker adults" in six countries, including Canada,
Britain, Germany and the United States. The responses don't support claims
about superior service from the U.S. system. It's true that Americans
generally have shorter waits for elective surgery than Canadians or Britons,
although German waits are even shorter. But Americans do worse by some
important measures: we find it harder than citizens of other advanced
countries to see a doctor when we need one, and our system is more, not
less, rife with medical errors.
Above all, Americans are far more likely than others to forgo treatment
because they can't afford it. Forty percent of the Americans surveyed failed
to fill a prescription because of cost. A third were deterred by cost from
seeing a doctor when sick or from getting recommended tests or follow-up.
Why does American medicine cost so much yet achieve so little? Unlike other
advanced countries, we treat access to health care as a privilege rather
than a right. And this attitude turns out to be inefficient as well as
cruel.
The U.S. system is much more bureaucratic, with much higher administrative
costs, than those of other countries, because private insurers and other
players work hard at trying not to pay for medical care. And our fragmented
system is unable to bargain with drug companies and other suppliers for
lower prices.
Taiwan, which moved 10 years ago from a U.S.-style system to a
Canadian-style single-payer system, offers an object lesson in the economic
advantages of universal coverage. In 1995 less than 60 percent of Taiwan's
residents had health insurance; by 2001 the number was 97 percent. Yet
according to a careful study published in Health Affairs two years ago, this
huge expansion in coverage came virtually free: it led to little if any
increase in overall health care spending beyond normal growth due to rising
population and incomes.
Before you dismiss Taiwan as a faraway place of which we know nothing,
remember Chile-mania: just a few months ago, during the Bush
administration's failed attempt to privatize Social Security, commentators
across the country - independent thinkers all, I'm sure - joined in a chorus
of ill-informed praise for Chile's private retirement accounts. (It turns
out that Chile's system has a lot of problems.) Taiwan has more people and a
much bigger economy than Chile, and its experience is a lot more relevant to
America's real problems.
The economic and moral case for health care reform in America, reform that
would make us less different from other advanced countries, is overwhelming.
One of these days we'll realize that our semiprivatized system isn't just
unfair, it's far less efficient than a straightforward system of guaranteed
health insurance.
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Obtain an article written by a moderate and I'll read it... I don't trust anyone that has clear one sided opinion.
What I erased from my post earlier was the lack of oversight in State run and Federal government financed facilities, it leads to poor quality of care, and a lack of reporting as they only have a single group to report to (the State) whereas a private facility has to report to their internal insurance company, the State (which almost always leads to a inspection), and often the patient's insurance company.
With our current situation, national health will end up neglecting alot of people... I've seen it, but unfortunately, I cannot post examples.
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Originally posted by Sandman
It's easy. You just have to forget that you spent any money at all on medical insurance.
as opposed to spending all the same money and more on taxes for "free", substandard medical care in which everyone flocks to the healthcare "system" for every sneaze and caugh in order to get their god given right to "free" healthcare.
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AFAIK, the doctors that take medicare will also take insurance. What's the difference?
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I'd rather pay for health insurace and have the world's best health care, than pay a high tax rate so I can have "free" health care on par with Canada or the UK.
Heck, even when I had no insurance, I recieved the world's best health care, and fast.
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Nationalized health care is imo not too good for USA. First of all USA is a LARGE country with more than quarter billion people and its gonna be inneficient. Sure nationalized health care works at other countries whose population is equal to that of CALIFORNIA, NEW YORK, TEXAS, or even NEVADA... but USA is BIG and there's no way to manage it in nationa level...
is this good solution?
* leave the *national health care* dillema to states.
or
* leave it to regional level...
(http://www.aphis.usda.gov/lpa/issues/bse/surveillance/4bse03f.jpg)
OR
status quo... let the private companies run US healthcare.
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Originally posted by NUKE
Heck, even when I had no insurance, I recieved the world's best health care, and fast.
Somebody payed for it. ;)
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silat... what lefty site did you cut and paste that last from?
lazs
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Originally posted by tikky
status quo... let the private companies run US healthcare.
And get a Microsoft of health care. "Trust us, we know what we are doing."
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Originally posted by Lye-El
And get a Microsoft of health care. "Trust us, we know what we are doing."
as opposed to govt: "I Know you never get sick but if you do you'll recieve mediocre health care. In the meantime we will take 20% of your earnings to pay for everyone else. Oh and trust us, we know what we are doing"
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Originally posted by Delirium
Obtain an article written by a moderate and I'll read it... I don't trust anyone that has clear one sided opinion.
What I erased from my post earlier was the lack of oversight in State run and Federal government financed facilities, it leads to poor quality of care, and a lack of reporting as they only have a single group to report to (the State) whereas a private facility has to report to their internal insurance company, the State (which almost always leads to a inspection), and often the patient's insurance company.
With our current situation, national health will end up neglecting alot of people... I've seen it, but unfortunately, I cannot post examples.
Del just because its Krugman doesnt meant that some of what is written here isnt factual.
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Originally posted by lazs2
silat... what lefty site did you cut and paste that last from?
lazs
Its a Krugman Editorial...
Like all things you must get over your fears and try to find the facts in any article. Even if its written by Hannity:)