U.S. Healthcare system ranked 37th in the World (WHO)

#26
#26
BigPapaVol said:
this is the biggest fallacy in the whole debate. comparable care can mean a number of things, but reality would suggest that it means less capable, or, IMO, not comparable. that's why those who can afford it, roll their show to the US for serious surgery. Being "comparable" is not a word that should be tossed around when we're talking about Open Heart surgery. WHO can say what they'd like and you can toe the party line regarding the uninsured, but our system generates the best practices and best docs and any schmoe has access.

I had twins born almost 4 months premature and paid enormous money (along with CIGNA) for their NICU stay at a very highly regarded Children's Hospital. The education part for me was the number of uninsured, no income families receiving the exact same level of care that mine received. In fact, the preponderance of those in the NICU for long periods were uninsured. The NICU is some of the most expensive care on earth, and everyone had equal access. IMO, the uninsured problem only applies to preventative care because those uninsured opt for less of it.
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some good points...
 
#27
#27
I think a lot of things could be solved if items such as taxes and health insurance premiums were no longer allowed to be withheld from paychecks. Can you imagine the outcry in the general public once Joe Sixpack had to stroke a check for his own health insurance and income taxes and realized how much he was actually spending?
 
#28
#28
One of the cost drivers is our system of medical innovation. As is the case in other industries, the capitalism motor keeps companies increasingly focused on medical advancements.

Accordingly, we have the best care at the top end coupled with high costs. Many of the countries above us on the list benefit from this innovation - it's not in there system (to the same extent) and doesn't have to be since the US system is providing the bulk of the discoveries and advancements.

The problem with nationalizing is that you begin to cripple the innovation engine. You may increase coverage in the short-term but reduce health care quality in the long-term. Likewise, the impact would be felt globally.

Clearly changes need to be made but as is the case with most things, the repercussions might be worse than the original problem.
 
#29
#29
extensiThere is also the "free good" aspect of medical coverage. Many of the insured view medical care as a free good since their personal costs do not change with usage. There is no incentive for an individual to reduce his/her medical costs since the out of pocket impact is hidden.

Likewise, the 3rd party payer system can lead to the use of quick diagnostic testing and treatment attempts since tests and treatments are often reimbursed at a set rate but not at a total rate for all tests/treatments. It's like having a dealer do warranty work on your car - the mfg. pays them a set labor rate and the mechanics keep replacing parts until they finally (by luck often) fix the problem. A good independent mechanic on the other hand may actually do a better diagnosis and fix it right the first time since he/she does not have unlimited reimbursement resources.
 
#30
#30
BigPapaVol said:
this is the biggest fallacy in the whole debate. comparable care can mean a number of things, but reality would suggest that it means less capable, or, IMO, not comparable. that's why those who can afford it, roll their show to the US for serious surgery. Being "comparable" is not a word that should be tossed around when we're talking about Open Heart surgery. WHO can say what they'd like and you can toe the party line regarding the uninsured, but our system generates the best practices and best docs and any schmoe has access.

I had twins born almost 4 months premature and paid enormous money (along with CIGNA) for their NICU stay at a very highly regarded Children's Hospital. The education part for me was the number of uninsured, no income families receiving the exact same level of care that mine received. In fact, the preponderance of those in the NICU for long periods were uninsured. The NICU is some of the most expensive care on earth, and everyone had equal access. IMO, the uninsured problem only applies to preventative care because those uninsured opt for less of it.
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What do say to these people who are doing the opposite? Who are traveling to India to have surgery instead of having it done in the U.S. because of the cost?

Outsourcing Your Heart - TIME

Herniated disk surgery in Bangkok: $10,000
In the U.S.: $90,000

55,000 patients last year alone from the U.S. went to this same hospital in Bangkok for surgery, a 30% increase. 75% of them flew from the U.S. to have the surgery.

Bumrungrad alone, according to CEO Curtis Schroeder, saw its stream of American patients climb to 55,000 last year, a 30% rise. Three-quarters of them flew in from the U.S.; 83% came for noncosmetic treatments. Meanwhile, India's trade in international patients is increasing at the same rate.
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At current rates, the U.S. will be spending $1 of every $5 of its GDP on health care by 2015, yet more than 1 in 4 workers will be uninsured.
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United Group Programs (UGP) of Boca Raton, Fla., a third-party administrator that sells a low-premium, bare-bones form of coverage called a mini--medical plan, this month began promoting Bumrungrad Hospital as a preferred provider to its customers.
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But health-care costs are hurting the company. So a Blue Ridge team plans to visit hospitals in India to assess their quality of care. If it gives the green light, Blue Ridge will begin promoting the option to its 2,000 workers.
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Double By-Pass in India $6650

Wayne Steinard, 59, a general contractor from Winter Haven, Fla., is one of those U.S. patients "who fall through the cracks" of the health-care system, as he says. Steinard landed in New Delhi last week with his daughter Beth Keigans to get a clogged artery cleared and a stent installed. Steinard, too rich for Medicaid and too poor for insurance, certainly didn't have the $60,000 he would have had to pay back home. So he contacted PlanetHospital, a Malibu, Calif., medical-tourism agency, and learned he could get it done for about a tenth as much at Max Healthcare's Devki Devi Heart & Vascular Institute.
Things have not gone as Steinard expected. When surgeon Pradeep Chandra scanned Steinard's angiogram last week, he found the artery 90% blocked. "A stent is out of the question," he told Keigans. "Your father is going to need a double bypass, and he needs it immediately." The blood drained from Keigans' face. While she loved their plush hospital suite and the staff had been superb, this was all happening too far from home. Steinard, though, was blunt about his choices. It's either this, he said, or a fatal heart attack back home. The surgery last week was successful; the hospital's bill: $6,650.
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#31
#31
so, is travel to India cheap? what about the lengthy recovery period after open heart surgery?
 
#33
#33
I'd say the best indicator of quality of healthcare would be where the wealthy go because they have the widest variety of options. They don't pack their stuff for the third world for surgery.
 
#34
#34
BigPapaVol said:
I'd say the best indicator of quality of healthcare would be where the wealthy go because they have the widest variety of options. They don't pack their stuff for the third world for surgery.
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Actually, by the standards of the rest of the world, the majority of the people in the U.S. are wealthy.
 
#37
#37
I read the article. So people that can choose, make a choice. Stunning. A whopping 55,000 at one hospital. Reread my post, the majority of people in the US seek healthcare in the US. You believe otherwise?
 
#38
#38
allvol123 said:
I read the article. So people that can choose, make a choice. Stunning. A whopping 55,000 at one hospital. Reread my post, the majority of people in the US seek healthcare in the US. You believe otherwise?
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If they had to pay for the entire cost out of pocket and were aware of how easy it would be to travel out of country and have the same surgery performed at 1/10 of the cost, no I don't think they would. Why spend 90K when you can have the same procedure done for 10k elsewhere?
 
#39
#39
oklavol said:
If they had to pay for the entire cost out of pocket and were aware of how easy it would be to travel out of country and have the same surgery performed at 1/10 of the cost, no I don't think they would. Why spend 90K when you can have the same procedure done for 10k elsewhere?
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You got a big "if" in there. Most don't have to pay entirely out of pocket, why would you ever make that assumption? Again, if people make this decision, then good for them. Not sure how this would correspond to the idea that America does not have the best healthcare providers in the world and the overwhelming majority of citizens choose to get their treatment here.
 
#40
#40
3 San Marino
4 Andorra
5 Malta

.........These countries actually exist?!
 
#41
#41
allvol123 said:
You got a big "if" in there. Most don't have to pay entirely out of pocket, why would you ever make that assumption? Again, if people make this decision, then good for them. Not sure how this would correspond to the idea that America does not have the best healthcare providers in the world and the overwhelming majority of citizens choose to get their treatment here.
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People without insurance pay out of pocket, and there are 42 million Americans without insurance. Its not difficult to understand how that can happen. If your in a postion and you have to pay out of pocket, which do you choose? 90k or 10k?
 
#42
#42
oklavol said:
People without insurance pay out of pocket, and there are 42 million Americans without insurance. Its not difficult to understand how that can happen. If your in a postion and you have to pay out of pocket, which do you choose? 90k or 10k?
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I am not sure how any of what you say has anything to do with not having the best available healthcare in the world? I probably choose the 90K option if it is a health issue my life depends on.
 
#43
#43
oklavol said:
If they had to pay for the entire cost out of pocket and were aware of how easy it would be to travel out of country and have the same surgery performed at 1/10 of the cost, no I don't think they would. Why spend 90K when you can have the same procedure done for 10k elsewhere?
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But it has already been stated that 45 million Americans are uninsured... so they all pay medical expenses out of pocket... meaning that the argument that the majority of people who pay out of pocket go elsewhere is flawed.
 
#44
#44
oklavol said:
People without insurance pay out of pocket, and there are 42 million Americans without insurance. Its not difficult to understand how that can happen. If your in a postion and you have to pay out of pocket, which do you choose? 90k or 10k?
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Exactly, so only 55k of that 42 mil are going out of the country? That's around 0.1%!!!
 
#46
#46
oklavol said:
55k to ONE hospital in Thailand alone.
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So find the total numbers, I doubt they rise much more. If so, the article would have been elated to share them.

Also, sounds like healthcare done by Sam's or Costco. Buyer beware.
 
#47
#47
TennTradition said:
Could it be that the best healthcare in the world is available to some.....but not to all?
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Absolutely not. The healthcare system in the U.S. is unarguably the best in the world, and it is available to all. No, "available" doesn't mean "free."

Obviously, quality in the areas of neurosurgery, cardiac care, neonatal medicine, and innovative medications and immunizations doesn't come cheap. However, it is impossible to put a price tag on the value of the aforementioned treatment of, say, a pair of 24-week-gestation twins. Having worked firsthand in the NICU for three years, I can certainly vouch for that.

Bottom line: If you can't afford healthcare, get a job with insurance. If your employer doesn't offer insurance, you have two choices: change jobs, or ban together with other workers and demand coverage. I do believe that there are certain groups that should have their care provided by the government/tax dollars if they are unable to work or obtain care otherwise: children, the disabled, and the elderly. Also, there are less expensive options (walk-in clinics, generic medications and about-to-expire sample distributors) and payment/discount programs at most hospitals.

If you really want to get at the meat of why medicine costs so much here, you must take a very long look at medical malpractice. The AMA and many other professional organizations have made Medical Liability Reform their number one agenda. There are plenty of physicians who must pay MORE for insurance than they make in a year. Chew on that.
 
#48
#48
allvol123 said:
So find the total numbers, I doubt they rise much more. If so, the article would have been elated to share them.

Also, sounds like healthcare done by Sam's or Costco. Buyer beware.
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You haven't supported your arguements with any articles or statistics. Why am I suppose to defend this article I simply link to which gives at the end of the article its sources and statistics? When you haven't provide anything to support your own position?
 
#49
#49
kiddiedoc said:
Bottom line: If you can't afford healthcare, get a job with insurance. If your employer doesn't offer insurance, you have two choices: change jobs, or ban together with other workers and demand coverage.
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Exactly . . . and there's also option #3 - buy your own coverage individually.

I don't know when it happened, but at some point people started viewing health insurance as an entitlement.
 
#50
#50
oklavol said:
You haven't supported your arguements with any articles or statistics. Why am I suppose to defend this article I simply link to which gives at the end of the article its sources and statistics? When you haven't provide anything to support your own position?
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My position is fine, look at the people in America, I know where they go to find treatment. You are the one relying on some ridiculous article with some minuscule statistics for your argument. Read through this thread, I don't see anyone that thinks your position is even reasonable.
 
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