Best Healthcare System in the World

[Vol8188]

It is fair to differentiate between the system in place and the personal responsibility of those in that system. I am choosing to roll those together only because the exceptional system of crisis management gives people a cavalier attitude about shunning their personal responsibility. I think they are connected.

Number 2 really isn't a refutation on my point as an adequate metric but more a presumption on what the narrative would be in our system if there was less pharm usage.

If personal responsibility is in play on point number 1, then it is in play in point number 3. We can't fault the system when it falls under personal responsibility. Therefore, I don't think we can credit the system by faulting personal responsibility.

I think you missed the mark on point 4. There will be a bell curve of "quality of life" under any system. What you missed is the bell curve moving wholly further right along the x axis so that there are higher numbers with good to great quality of life even though there will still be those in the curve with a lesser degree compared to others in the curve. But comparing both bell curves in both systems we can declare one approach leads to more people with high quality of life compared to the other curve from the other approach.

2. The merits of medication use as an indicator of health are obviously flawed. A prehistoric system could rank #1 in that category simply due to their lack of medication. The same with a country to poor to afford medications or a people who truly lack access (the way it’s claimed we do). Neither you nor I know the appropriate number of medications per capita that should be dispensed nor is it a number we could come up with for a baseline. So higher or lower either could be the better value.

3. Obviously we should credit the system here. If you wish to use length of life as a measure of the healthcare system you should not include things unrelated to the healthcare system such as homicide and vehicle crashes. Neither of those are markers of healthcare quality and when removed, our system ranks 1st.

4. I think the problem is you’re assuming a bell curve where increasing life span means an increase in median of your curve (I’m assuming that would be the point here where life quality begins to diminish). A lot of our increases in life span have been unrelated to our ability to make 30, 40, and 50 year olds healthier (although we obviously have) but is more related to our ability to extend lower quality life. If my claim is true (intuitively I think it is, but I’m unaware of any data either way) than by expanding life we are diminishing quality of life (I feel like I’m making the weak smoker argument right now of “you can have those last ten years of life, I don’t want them anyway).

 

[Vol8188]

*US Healthcare is not immediately available to all.

That statement only has value comparatively. Relative to utopia, no we do not. Relative to the rest of the world, we 100% do. That’s why I shared the example of how Americans are more likely to survive strokes, have more MRI machines, higher cancer survival rates, and are more likely to be treated/medicated for their chronic illnesses

 

[McDad]

2. The merits of medication use as an indicator of health are obviously flawed. A prehistoric system could rank #1 in that category simply due to their lack of medication. The same with a country to poor to afford medications or a people who truly lack access (the way it’s claimed we do). Neither you nor I know the appropriate number of medications per capita that should be dispensed nor is it a number we could come up with for a baseline. So higher or lower either could be the better value.

3. Obviously we should credit the system here. If you wish to use length of life as a measure of the healthcare system you should not include things unrelated to the healthcare system such as homicide and vehicle crashes. Neither of those are markers of healthcare quality and when removed, our system ranks 1st.

4. I think the problem is you’re assuming a bell curve where increasing life span means an increase in median of your curve (I’m assuming that would be the point here where life quality begins to diminish). A lot of our increases in life span have been unrelated to our ability to make 30, 40, and 50 year olds healthier (although we obviously have) but is more related to our ability to extend lower quality life. If my claim is true (intuitively I think it is, but I’m unaware of any data either way) than by expanding life we are diminishing quality of life (I feel like I’m making the weak smoker argument right now of “you can have those last ten years of life, I don’t want them anyway).

There really isn't any more to discuss, then.

 

[Septic]

My 2 Cents -

The United States has the best healthcare in the world, for the people that can afford it. US Healthcare is not available to all Americans, we're the only 1st world country that has this problem.

FYP

 

[Vol8188]

FYP

Then how do we lead the world in cancer survival rate, treatment rates for chronic disease, stroke survival rates, etc?

 

[Septic]

Do you know which areas of healthcare we are most out of alignment in the Cost vs Outcomes analysis?

U.S. pays more for health care with worse population health outcomes

In 2016, the U.S. spent nearly twice as much on health care as other high-income countries, yet had poorer population health outcomes.

• The main drivers of higher health care spending in the U.S. are generally high prices — for salaries of physicians and nurses, pharmaceuticals, medical devices, and administration.
• Contrary to commonly held beliefs, high utilization of health care services and low spending on social services do not appear to play a significant role in higher U.S. health care costs.
• In addition, despite poor population health outcomes, quality of health care delivered once people are sick is high in the U.S.
  • The U.S. spends more on health care as a share of the economy — nearly twice as much as the average OECD country — yet has the lowest life expectancy and highest suicide rates among the 11 nations.
  • The U.S. has the highest chronic disease burden and an obesity rate that is two times higher than the OECD average.
  • Americans had fewer physician visits than peers in most countries, which may be related to a low supply of physicians in the U.S.
  • Americans use some expensive technologies, such as MRIs, and specialized procedures, such as hip replacements, more often than our peers.
  • The U.S. outperforms its peers in terms of preventive measures — it has the one of the highest rates of breast cancer screening among women ages 50 to 69 and the second-highest rate (after the U.K.) of flu vaccinations among people age 65 and older.
  • Compared to peer nations, the U.S. has among the highest number of hospitalizations from preventable causes and the highest rate of avoidable deaths.

U.S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes?

 

[85SugarVol]

FYP

You certainly fleshed it out more, but I believe my post incorporated most of what you laid out there.

 

[85SugarVol]

U.S. pays more for health care with worse population health outcomes

In 2016, the U.S. spent nearly twice as much on health care as other high-income countries, yet had poorer population health outcomes.

• The main drivers of higher health care spending in the U.S. are generally high prices — for salaries of physicians and nurses, pharmaceuticals, medical devices, and administration.
• Contrary to commonly held beliefs, high utilization of health care services and low spending on social services do not appear to play a significant role in higher U.S. health care costs.
• In addition, despite poor population health outcomes, quality of health care delivered once people are sick is high in the U.S.
  • The U.S. spends more on health care as a share of the economy — nearly twice as much as the average OECD country — yet has the lowest life expectancy and highest suicide rates among the 11 nations.
  • The U.S. has the highest chronic disease burden and an obesity rate that is two times higher than the OECD average.
  • Americans had fewer physician visits than peers in most countries, which may be related to a low supply of physicians in the U.S.
  • Americans use some expensive technologies, such as MRIs, and specialized procedures, such as hip replacements, more often than our peers.
  • The U.S. outperforms its peers in terms of preventive measures — it has the one of the highest rates of breast cancer screening among women ages 50 to 69 and the second-highest rate (after the U.K.) of flu vaccinations among people age 65 and older.
  • Compared to peer nations, the U.S. has among the highest number of hospitalizations from preventable causes and the highest rate of avoidable deaths.

U.S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes?

We’re fat. We like guns.

 

[Vol8188]

U.S. pays more for health care with worse population health outcomes

In 2016, the U.S. spent nearly twice as much on health care as other high-income countries, yet had poorer population health outcomes.

• The main drivers of higher health care spending in the U.S. are generally high prices — for salaries of physicians and nurses, pharmaceuticals, medical devices, and administration.
• Contrary to commonly held beliefs, high utilization of health care services and low spending on social services do not appear to play a significant role in higher U.S. health care costs.
• In addition, despite poor population health outcomes, quality of health care delivered once people are sick is high in the U.S.
  • The U.S. spends more on health care as a share of the economy — nearly twice as much as the average OECD country — yet has the lowest life expectancy and highest suicide rates among the 11 nations.
  • The U.S. has the highest chronic disease burden and an obesity rate that is two times higher than the OECD average.
  • Americans had fewer physician visits than peers in most countries, which may be related to a low supply of physicians in the U.S.
  • Americans use some expensive technologies, such as MRIs, and specialized procedures, such as hip replacements, more often than our peers.
  • The U.S. outperforms its peers in terms of preventive measures — it has the one of the highest rates of breast cancer screening among women ages 50 to 69 and the second-highest rate (after the U.K.) of flu vaccinations among people age 65 and older.
  • Compared to peer nations, the U.S. has among the highest number of hospitalizations from preventable causes and the highest rate of avoidable deaths.

U.S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes?

Maybe the issue is you're looking at the wrong criteria. Notice they do not look at treatment rates nor outcomes. Instead they talk about "poorer population health outcomes".

The fact that Americans are obese, consume alcohol and tobacco, and use illicit drugs at the highest levels in the world is not a failure of the healthcare system nor of insurance.

And making the government pay for your healthcare is not going to make people less fat, drink less, consume less alcohol and tobacco, or use less illicit drugs.

This is like saying Toyota failed to produce a reliable car because the engine is destroyed from you not changing the oil, and then deciding "well, I guess the government should produce the cars now because Toyota failed".

 

[Septic]

Then how do we lead the world in cancer survival rate, treatment rates for chronic disease, stroke survival rates, etc?

You're conflating issues and cherry picking outcomes and splitting hairs over a few percentage points.

We have the lowest life expectancy of any of our peers, highest chronic disease burden and we're the fattest. We pay twice as much as our peers, are our outcomes twice as good? Did you realize that the US is dead last in five year survivability for cervical cancer? You can cherry pick, but are we REALLY getting twice the value? I think the answer is a resounding hell no.

 

[Vol8188]

You're conflating issues and cherry picking outcomes and splitting hairs over a few percentage points.

We have the lowest life expectancy of any of our peers, highest chronic disease burden and we're the fattest. We pay twice as much as our peers, are our outcomes twice as good? Did you realize that the US is dead last in five year survivability for cervical cancer? You can cherry pick, but are we REALLY getting twice the value? I think the answer is a resounding hell no.

We have the highest life expectancy if you remove vehicle accidents and homicides. What do those things have the do with healthcare? Our healthcare system is bad because less people take the bus?

You're the one conflating. You're taking none healthcare related issues and then claiming the problem is our system. Single payer will not fix obesity, alcoholism, nor drug abuse. Things we are world leaders in.

You then try to conflate life expectancy with our healthcare system, which is absurd. Did doctors design our highway/interstate systems? Do doctors commit homicide at disproportionate rates? When you remove those factors we have the highest life expectancy.

So since life expectancy is something you decided to bring up, and we lead the world in it, are you going to now admit we have the best healthcare system in the world or just ignore the point entirely?

We lead the world in 5 year survivability for nearly every cancer. Idk where you're getting we are last in that. I can cite sources showing us above the UK for example in that 1 cancer. But the average across the board we lead the world in 5 year cancer survival rates. That's a well known fact

Cancer Survival Rates by Country 2022

 

[Septic]

Maybe the issue is you're looking at the wrong criteria. Notice they do not look at treatment rates nor outcomes. Instead they talk about "poorer population health outcomes".

The fact that Americans are obese, consume alcohol and tobacco, and use illicit drugs at the highest levels in the world is not a failure of the healthcare system nor of insurance.

And making the government pay for your healthcare is not going to make people less fat, drink less, consume less alcohol and tobacco, or use less illicit drugs.

This is like saying Toyota failed to produce a reliable car because the engine is destroyed from you not changing the oil, and then deciding "well, I guess the government should produce the cars now because Toyota failed".

No one is suggesting that healthcare in the U.S. is "poor", it's just a terrible value when compared to the outcomes and cost our 1st world peers are enjoying. You're acting like there's some grand chasm between our outcomes and our peers, the only gulf is between what we're paying for it and what they are.

 

[Vol8188]

No one is suggesting that healthcare in the U.S. is "poor", it's just a terrible value when compared to the outcomes and cost our 1st world peers are enjoying. You're acting like there's some grand chasm between our outcomes and our peers, the only gulf is between what we're paying for it and what they are.

You're comparing non-healthcare related outcomes. What does the fact that the average American drives twice as far daily as the average German have to do with healthcare? The obvious answer is nothing. But it has a ton to do with the "outcomes" you're choosing to measure. When you adjust for those, we lead the world in "outcomes"

So if that's the outcome you wish to look at to rate healthcare outcomes (you brought it up) would you not have to admit we are the best in that category?

 

[Septic]

We have the highest life expectancy if you remove vehicle accidents and homicides. What do those things have the do with healthcare? Our healthcare system is bad because less people take the bus?

You're the one conflating. You're taking none healthcare related issues and then claiming the problem is our system. Single payer will not fix obesity, alcoholism, nor drug abuse. Things we are world leaders in.

You then try to conflate life expectancy with our healthcare system, which is absurd. Did doctors design our highway/interstate systems? Do doctors commit homicide at disproportionate rates? When you remove those factors we have the highest life expectancy.

So since life expectancy is something you decided to bring up, and we lead the world in it, are you going to now admit we have the best healthcare system in the world or just ignore the point entirely?

We lead the world in 5 year survivability for nearly every cancer. Idk where you're getting we are last in that. I can cite sources showing us above the UK for example in that 1 cancer. But the average across the board we lead the world in 5 year cancer survival rates. That's a well known fact

Cancer Survival Rates by Country 2022

i didn't claim there's a problem in our system, at all. Only that we pay twice as much and lead our peers by the thinnest of margins in some outcomes.

You seem to be taking that fact personally, stop doing that.

Our outcomes are better in some regards, yes - but is it worth twice the cost? Not to me.

To recap, our healthcare is marginally better than our peers in terms of out comes, but it's twice as expensive and unlike our peers - not everyone even gets to have it.

YAY, murica.

 

[Septic]

You're comparing non-healthcare related outcomes. What does the fact that the average American drives twice as far daily as the average German have to do with healthcare? The obvious answer is nothing. But it has a ton to do with the "outcomes" you're choosing to measure. When you adjust for those, we lead the world in "outcomes"

So if that's the outcome you wish to look at to rate healthcare outcomes (you brought it up) would you not have to admit we are the best in that category?

I should have known you'd create an argument no one else was having and stomp it out completely.

 

[Vol8188]

I should have known you'd create an argument no one else was having and stomp it out completely.

No one is suggesting that healthcare in the U.S. is "poor", it's just a terrible value when compared to the outcomes and cost our 1st world peers are enjoying. You're acting like there's some grand chasm between our outcomes and our peers, the only gulf is between what we're paying for it and what they are.

When you state this, what outcomes were you talking about? To my knowledge I’ve addressed the outcomes you mentioned (cost and life expectancy).

You seem to be accusing me of a strawman but idk how. If life expectancy is not your standard (idk why you brought it up if it wasn’t), what standard are you using to make this claim?

 

[Septic]

When you state this, what outcomes were you talking about? To my knowledge I’ve addressed the outcomes you mentioned (cost and life expectancy).

You seem to be accusing me of a strawman but idk how. If life expectancy is not your standard (idk why you brought it up if it wasn’t), what standard are you using to make this claim?

What part of "we're getting a terrible value versus that of our peers" is stumping you?

 

[Vol8188]

What part of "we're getting a terrible value versus that of our peers" is stumping you?

You're conflating issues and cherry picking outcomes and splitting hairs over a few percentage points.

We have the lowest life expectancy of any of our peers, highest chronic disease burden and we're the fattest. We pay twice as much as our peers, are our outcomes twice as good? Did you realize that the US is dead last in five year survivability for cervical cancer? You can cherry pick, but are we REALLY getting twice the value? I think the answer is a resounding hell no.

The part where you intentionally use non-healthcare related data to falsely pretend we have poor outcomes and high cost, while intentionally missing the point that the non-healthcare related things (bold) that you brought up will not be fixed by single payer and are the cause of the high cost.

This is your argument right now: "We need single payer because we pay too much but have the lowest life expectancy, fattest population, and highest chronic disease burden".

1. Those are the reasons we pay so much, not "outcomes". Outcomes are things like cancer survival rates.

2. Single payer will not lead to American's driving less, having less chronic disease (primarily caused by age and obesity), nor a skinner population.

 

[Septic]

The part where you intentionally use non-healthcare related data to falsely pretend we have poor outcomes and high cost, while intentionally missing the point that the non-healthcare related things (bold) that you brought up will not be fixed by single payer and are the cause of the high cost.

This is your argument right now: "We need single payer because we pay too much but have the lowest life expectancy, fattest population, and highest chronic disease burden".

1. Those are the reasons we pay so much, not "outcomes". Outcomes are things like cancer survival rates.

2. Single payer will not lead to American's driving less, having less chronic disease (primarily caused by age and obesity), nor a skinner population.

You've literally made up an argument for me. Again.

I've not said anything about single payer. I also never stated we had poor outcomes.

This whole thread is you looking to pick a fight over the quality of U.S. Healthcare - something NO ONE is arguing about.



Vol8188: "U.S. is da bestest healthcare in the world. D3Bate Me"

Everyone: "OK..."

Vol8188: "No, you're wrong. Fight me."

 

[Vol8188]

You've literally made up an argument for me. Again.

I've not said anything about single payer. I also never stated we had poor outcomes.

This whole thread is you looking to pick a fight over the quality of U.S. Healthcare - something NO ONE is arguing about.



Vol8188: U.S. is da bestest healthcare in the world.

Everyone: OK...

Vol8188: No, you're wrong. Fight me.

You're right about single payer. I confused it with a separate discussion in a healthcare/guns thread. That's on me.

The rest still holds true. Did you not bring those things up as indicators of poor outcomes?

If not, why did you mention them? In the context, it appeared to me you were claiming our low life expectancy was a poor outcome along with obesity and chronic disease?

What am I missing?

 

[Septic]

You're right about single payer. I confused it with a separate discussion in a healthcare/guns thread. That's on me.


What am I missing?

The ability to debate things people actually say instead of what you wish they had said.

 

[Vol8188]

The ability to debate things people actually say instead of what you wish they had said.

You're conflating issues and cherry picking outcomes and splitting hairs over a few percentage points.

We have the lowest life expectancy of any of our peers, highest chronic disease burden and we're the fattest. We pay twice as much as our peers, are our outcomes twice as good? Did you realize that the US is dead last in five year survivability for cervical cancer? You can cherry pick, but are we REALLY getting twice the value? I think the answer is a resounding hell no.

I accepted I was wrong about one of my claims. Can you tell me what I am wrong about here? Are you not proclaiming these are indicators of poor outcome?

 

[PKT_VOL]

I don't think my take is exactly what you're looking for but since no one is able to provide the content you asked for, I'll share.
I don't believe we have the best healthcare in the world. I believe we have the most innovative, the best emergency, and the best critical care in the world. Basically, we excel at crisis care. We also do a pretty good job of managing chronic issues pharmacologically.
With that said, I admit it is next to impossible to identify where the best healthcare is. The best healthcare is where the state of being healthy is best managed. We don't focus on retention of good health as much as we focus on the what to do once the good health is jeopardized.

It begs the question, is what you outlined a function of the healthcare system or a byproduct of our culture?

It is hard to argue that the healthcare system does a poor job of telling Americans about optimal lifestyle choices. I don't know anyone who doesn't know that eating clean and exercising is key to maintaining good health.

On the other hand, I don't think one can argue that the healthcare system does an optimal job of spreading and browbeating patients into making better decisions. Although there have certainly been many nutritional missteps over the years and a desire for a one size fits all approach, the overeating and lack of exercise are naturally excluded from that potential weakness.

 

[Septic]

I accepted I was wrong about one of my claims. Can you tell me what I am wrong about here? Are you not proclaiming these are indicators of poor outcome?

Nope. You inferred that as you have a propensity to do.

In fact those are merely symptoms of a health delivery system that largely thumbs its nose at holistic or preventative care. Our system is reactionary, not proactive.

You keep trying to shoehorn razor thin improvements in some cancer/stroke outcomes as evidence that "w3'Re da B3SteSt." Great. Our outcomes are a few percentage points better than our peers in a few areas you deem to be more important than others.

You apparently refuse to address that we pay twice the cost and even then - not everyone gets it.

I'm just saying I'd take an L on a couple of % points and have healthcare security.

 

[PKT_VOL]

A good chunk of that is because the other states hide the costs of their care. All of them have higher tax rates that go into their healthcare.

So when they spend less of their take home pay on healthcare, that's because they have already paid a bigger withholding, and thus dont know the true costs of their care.

I have yet to see a break down that averages everything out for costs and also for specific individuals. The typical european is healthier than the typical american. Makes sense their healthcare is cheaper. What if you compare their 400lb lardarses with ours, and take the tax thing into account. Is their still a large difference in costs paid vs care received?

I would think with the larger averages at play with a single payer system that their 400lbers are paying less than ours with all things considered. But I would think that delta is pretty small. Small enough where it doesnt justify scrapping our system.

Agreed. Drives me nuts when they don't compare apples to apples; then, spin a misleading narrative about the differences of the two systems.

Having said that, they are clearly heathier. All things equal, this should lead to a cheaper healthcare system.