American economic dominance

[Jeff Lebowski]

Didn’t one of the doctors that used to post here spend some time in New Zealand and he basically validated that rationing is a problem. I remember him discussing how MRIs are very difficult to get done down there without a very significant problem since there is limited equipment due to the lack of funding since it’s all government funded.

Yes. ERCoug.

[Northwestcoug]

Didn’t one of the doctors that used to post here spend some time in New Zealand and he basically validated that rationing is a problem. I remember him discussing how MRIs are very difficult to get done down there without a very significant problem since there is limited equipment due to the lack of funding since it’s all government funded.

I can't speak for New Zealand, but 'rationing' is a loaded term. For many areas the limiting factor is population, which is becoming an increasing problem even in the states. Critical access hospitals are barely keeping afloat because of staffing. The rural hospitals where I was a laboratory medical director were constantly cycling between locoms and non-burned out physicians to keep even ERs staffed. Hell, for a time even in Bend the wait list to see a GI doc was 6 months, even for colonoscopies. The problem was corrected by funding, but whether by private or public funds it's still an issue until it's solved.

In my neck of the rural woods, there is sufficient coverage for routine screening visits, surgeries, and cancer care. But partly because of government funding and geography, a lot of the more complex needs are managed in urban areas. That necessitates coordination for travel and time off work. Mrs. NWC is getting Mohs surgery this summer. We have to travel to Vancouver for at least a day to get it done, and we were told in no uncertain terms that it would be difficult to reschedule if we couldn't make that time. Will there be a Mohs surgeon that sets up shop here? Probably if the population gets large enough. But I guarantee you large swaths of the American public are under similar constraints. In one of my prior rural hospitals oncology only visited once a month, and if someone needed care sooner they had to travel. That is implicit rationing of health care.

By the way, socialist utopia here reimburses a lot of our expenses when travel is needed

[tooblue]

I call BS on those numbers. Stats like that are often manufactured by someone with an agenda to push.

Furthermore, with the mostly private health care system we have in the US, it is more expensive to the end user, but the efficiency, accessibility, and standard of care is very high. And the US pharmaceutical industry's innovation benefits the entire world. With single payer/socialized medicine, there is more equal access, but you have more rationing, longer wait times, higher taxes, and ultimately higher poverty levels and reduced standard of living overall due to the economic drag of the social safety net. If a country like Canada decides to go the single payer route, fine - knock yourself out. I can certainly respect the reasoning behind that choice. But please spare us the moralizing. Both systems have tradeoffs. If you think there aren't a significant number of deaths in a single payer system due to rationing and long wait times, you are a fool.

https://www.theguardian.com/us-news/2020/jan/07/americans-healthcare-medical-costs

"A 2009 study conducted by researchers at Harvard Medical School found 45,000 Americans die every year as a direct result of not having any health insurance coverage. In 2018, 27.8 million Americans went without any health insurance for the entire year."

https://pnhp.org/news/lack-of-insurance-to-blame-for-almost-45000-deaths-study/

"As many as 44,789 Americans of working age die each year because they lack health insurance, more than the number who die annually from kidney disease."

[tooblue]

https://www.theguardian.com/us-news/...-medical-costs

"A 2009 study conducted by researchers at Harvard Medical School found 45,000 Americans die every year as a direct result of not having any health insurance coverage. In 2018, 27.8 million Americans went without any health insurance for the entire year."

https://pnhp.org/news/lack-of-insura...-deaths-study/

"As many as 44,789 Americans of working age die each year because they lack health insurance, more than the number who die annually from kidney disease."

Study from Yale university:

https://pmc.ncbi.nlm.nih.gov/articles/PMC8572548/

"Despite higher national healthcare expenditure than any other country, constituting 18% of GDP,^5,6 the US ranks below 30 countries for many public health indicators, including preventable deaths,⁷ infant survival,⁸ maternal mortality,⁹ and overall life expectancy.<sup>10"

"</sup>Universal health insurance would also lead to positive economic externalities by enhancing workforce productivity. For example, prostate cancer causes $5.4 billion in lost productivity among patients, a sum further compounded by the $3.0 billion in lost productivity among spouses of these patients.<sup>72"

Of course Yale is likely even more left leaning than Harvard, so here are the thoughts from researchers at what is considered the most conservative Ivy League school:</sup>

https://spia.princeton.edu/news/qa-p...an-health-care

"The United States is the most expensive health care system in the world. We spend 18% of our GDP on health care compared to average of 8.9% of GDP for countries in the Organization for Economic Cooperation and Development (OECD) in 2017. Per capita, the U.S. spent more than $10,000 in 2017 compared to the OECD average of $3,992.

The high cost of American health care has priced out tens of millions of Americans from needed health care. Before Obamacare, we had around 40 to 45 million Americans without health insurance. Whether they received health care was based not on their health care needs but on their ability to pay. For poor people, that usually meant they went without needed health care. Uwe said that “our health insurance markets ration by price and income.” Obamacare reduced the number of uninsured in America but did not eliminate the problem. As of 2016, we still had some 27 million uninsured, and that number has climbed since."

[frank ryan]

I can't speak for New Zealand, but 'rationing' is a loaded term. For many areas the limiting factor is population, which is becoming an increasing problem even in the states. Critical access hospitals are barely keeping afloat because of staffing. The rural hospitals where I was a laboratory medical director were constantly cycling between locoms and non-burned out physicians to keep even ERs staffed. Hell, for a time even in Bend the wait list to see a GI doc was 6 months, even for colonoscopies. The problem was corrected by funding, but whether by private or public funds it's still an issue until it's solved.

In my neck of the rural woods, there is sufficient coverage for routine screening visits, surgeries, and cancer care. But partly because of government funding and geography, a lot of the more complex needs are managed in urban areas. That necessitates coordination for travel and time off work. Mrs. NWC is getting Mohs surgery this summer. We have to travel to Vancouver for at least a day to get it done, and we were told in no uncertain terms that it would be difficult to reschedule if we couldn't make that time. Will there be a Mohs surgeon that sets up shop here? Probably if the population gets large enough. But I guarantee you large swaths of the American public are under similar constraints. In one of my prior rural hospitals oncology only visited once a month, and if someone needed care sooner they had to travel. That is implicit rationing of health care.

By the way, socialist utopia here reimburses a lot of our expenses when travel is needed

It almost makes you wonder if standards like infant mortality rates and life expectancy could be referenced to inform an opinion of what medical coverage methods provide best outcomes.

Oh here:

https://www.healthsystemtracker.org/chart-collection/u-s-life-expectancy-compare-countries/#Life%20expectancy%20at%20birth%20by%20sex,%20in%20years,%202024

and here

https://www.healthsystemtracker.org/chart-collection/infant-mortality-u-s-compare-countries/#Mortality%20rates%20(deaths%20per%201,000%20live%20births)%20for%20the%20five%20leading%20causes%20of%20neonatal%20and%20postneonatal%20death,%202017

[Jeff Lebowski]

“The most conservative Ivy League school”. Lol

Every one of these studies has a specific agenda, and that agenda drives all of the assumptions upon which the numbers are based.. Don’t kid yourself.

[Copelius]

“The most conservative Ivy League school”.

Is that like the tallest midgetlittle person? Or the smartest Ute?

[tooblue]

“The most conservative Ivy League school”. Lol

Every one of these studies has a specific agenda, and that agenda drives all of the assumptions upon which the numbers are based.. Don’t kid yourself.

Stating that every study has an agenda, is a fallacy. All research operates with intent, and assuming that intent invalidates the findings creates a false equivalency.

Don't kid yourself.

[tooblue]

Is that like the tallest midgetlittle person? Or the smartest Ute?

And in comes the second fallacy: attacking the institution and not the argument ... lol

[frank ryan]

“The most conservative Ivy League school”. Lol

Every one of these studies has a specific agenda, and that agenda drives all of the assumptions upon which the numbers are based.. Don’t kid yourself.

Shoot the messenger! I realize it's no Nick Shirley expose

Those ranking aren't controversial. You can find those numbers in other places.

[Jeff Lebowski]

Haha. We are 15 pages in and you (and Frank) are still committed to the bit.

"Oh no, 30-50K people in the US are dying every year because they don't have socialized medicine! Whah!"

Meanwhile, in the UK:

https://www.theguardian.com/society/...s-waiting-list

‘National tragedy’: figures show large rise in people dying while on NHS waiting list

Figures obtained by Labour show an estimated 120,695 people died in England while awaiting treatment

More than 120,000 people in England died last year while on the NHS waiting list for hospital treatment, figures obtained by Labour appear to show.

That would be a record high number of such deaths, and is double the 60,000 patients who died in 2017/18.

For example, the Royal Free hospital in London said it had had 3,615 such deaths, while there were 2,888 at the Morecambe Bay trust in Cumbria and 2,039 at Leeds teaching hospitals trust.

Hospital bosses said the deaths highlighted the dangers of patients having to endure long waits for care and reflected a “decade of underinvestment” that had left the NHS with too few staff and beds.

Healthwatch England, a patient advocacy group that scrutinises NHS performance, said the number of people dying while waiting for care was “a national tragedy”.

https://www.standard.co.uk/news/uk/n...s-6655230.html

One in six doctors have seen patients die because of rationing in NHS resources, according to a new survey.

More than half said they had seen patients suffer due to treatment rationing and two thirds said that they had been told not to prescribe certain drugs by their NHS trust, even though the results could be fatal.

Emergency rooms in the UK are woefully inadequate:

https://www.forbes.com/sites/katheri...r-report-says/

England’s Emergency Crisis Led To 14,000 Deaths Last Year, Report Says

Almost 270 people are likely to have died every week last year as they faced lengthy waits for emergency healthcare in England, an industry body has estimated.

The staggering research reflects the continued toll of a sector that’s been in crisis for at least two years. Last year, a similar analysis found excessive waits for emergency care could have caused around 280 deaths per week.

https://www.wsws.org/en/articles/201.../heal-m03.html

UK: Rising mortality rates and rationing across the National Health Service

Cuts and rationing of treatments are thought to be linked to thousands of preventable deaths across England and Wales, according to a joint study by Researchers from the London School of Hygiene & Tropical Medicine and Oxford University and Blackburn with Darwen Borough Council.

The report examined statistics from January 2006 up to December 2015 and found that during that period increases in mortality clearly coincided with financial cuts to the NHS and social care. The report found there were 30,000 excess deaths in 2015 in England and Wales and that these were likely associated with NHS and social care cuts.

The study found that the overall mortality rate increased during the period 2014 to 2015 and the huge increase in preventable deaths during 2015 was the highest since 2008. “The rise in deaths from 2014 to 529,655 in 2015 was the biggest in percentage terms in almost 50 years and the mortality rate was the highest since 2008.” The report notes that those most dependent on social care, mostly elderly people, had the highest numbers of excess mortality rates.

Perhaps you two could be a little more honest about this and spare us the moralizing.

[frank ryan]

Haha. We are 15 pages in and you (and Frank) are still committed to the bit.

"Oh no, 30-50K people in the US are dying every year because they don't have socialized medicine! Whah!"

Meanwhile, in the UK:

https://www.theguardian.com/society/...s-waiting-list



https://www.standard.co.uk/news/uk/n...s-6655230.html



Emergency rooms in the UK are woefully inadequate:

https://www.forbes.com/sites/katheri...r-report-says/



https://www.wsws.org/en/articles/201.../heal-m03.html



Perhaps you two could be a little more honest about this and spare us the moralizing.

I am being honest. How about not making assumptions all the time and telling me what I mean. It's always negative and often misrepresented.

[Bo Diddley]

Haha. We are 15 pages in and you (and Frank) are still committed to the bit.

"Oh no, 30-50K people in the US are dying every year because they don't have socialized medicine! Whah!"

Meanwhile, in the UK:

https://www.theguardian.com/society/...s-waiting-list

Figures obtained by Labour show an estimated 120,695 people died in England while awaiting treatment

https://www.standard.co.uk/news/uk/n...s-6655230.html

Emergency rooms in the UK are woefully inadequate:

https://www.forbes.com/sites/katheri...r-report-says/

https://www.wsws.org/en/articles/201.../heal-m03.html

Perhaps you two could be a little more honest about this and spare us the moralizing.

The NHS is in rough shape. I have connections to people over there and know of the struggles they face, so in no way am I trying to defend it.

But this comparison isn't apples to apples. You're comparing people who died while waiting for care with people estimated to have died because they lacked access to care. Those are fundamentally different metrics, so the conclusion doesn't follow.

This too is agenda driven. Figures by Labour...

[Jeff Lebowski]

The NHS is in rough shape. I have connections to people over there and know of the struggles they face, so in no way am I trying to defend it.

But this comparison isn't apples to apples. You're comparing people who died while waiting for care with people estimated to have died because they lacked access to care. Those are fundamentally different metrics, so the conclusion doesn't follow.

Huh?

"people who died while waiting for care" vs people who "died because they lacked access to care"

On what planet is that a meaningful difference?

Of course they are in different systems, the entire point is that socialized medicine is not superior to the US system in preventing deaths due to access. In fact, it is worse.

This too is agenda driven. Figures by Labour...

You can't trust those lefties when it comes to fairly characterizing the NHS, eh?

[Jeff Lebowski]

I am being honest. How about not making assumptions all the time and telling me what I mean. It's always negative and often misrepresented.

Be honest, Frank. You and tooblue are kicking yourself for mocking me a few posts up for questioning a source because now you cannot do that in response to all these numbers.