What are we really spending on medical care in the US?

[Dr.Who]

Once again: IF the high costs are the fault of the government. . .how do you explain that every other developed country who has some form of government care (whether all government, or a combination of public and private options. . .like most do) have such lower prices, and their prices are not going up?

Who says their costs are really lower. They often "hide" the costs like France does so it appears lower. Governments will try to make it look like they are spending less than they are. But governmnts cant really hide the costs of health care in the private sector as well (and they don't want to)

And we do get better treatment in a variety of ways so that would account for some of our costs.

Theirs are not going up? The UK's costs are going up more than ours. In fact we are listed number 13 for how fast costs are going up.

http://www.businessweek.com/the_thread/economicsunbound/archives/2009/09/where_are_healt.html

One possible reason that some costs in gov run countries (like Canada) would not go up as much as ours is that the gov simply chooses to cut back on services.

But you couild read this about canadian costs rising:
http://retirehappyblog.ca/rising-healthcare-costs-called-a/

 

[ThisTooShallPass]

Once again: IF the high costs are the fault of the government. . .how do you explain that every other developed country who has some form of government care (whether all government, or a combination of public and private options. . .like most do) have such lower prices, and their prices are not going up?

Are we the only developed country who believe all the lies from private industry? Or are we the only country stupid enough to pay huge premium to private industry when we are healthy, and then count on our government to take care of us when our health really fails?

Talk about an unfair situation!

It's precisely because our system is a hybrid that it results in higher costs.

The government here entitles a large portion of the population to health care at an artificially low price. The providers who agree to these prices make up the difference on everyone else by charging them more.

By contrast, foreign governments have more or less a monopoly on health care expenditures, and since they're the only ones making the decisions, they can arbitrarily decide to spend only so much -- throttling supply, lowering net costs, and leading to gross instances of abuse and neglect we hear about all the time.

Our hybrid system can be fixed (in part) if price discrimination were outlawed and the government fixed its Medicare reimbursement schedule. But it won't do that, because this would require a recognition that the money isn't there to entitle tens of millions of Americans to free synthetic hips worth half a million dollars.

 

[PLC1]

Um, no I am not. I am, claiming that we are spending less than countries that don't count it or don't do it as much by some amount that I don't know.

Countries like France pay for a doctor's schooling from a separate budget from health care yet in the united states doctors schooling is included in our health care cost because doctors pay for it themselves and then pass the cost along. So the French system hides the cost of medical school.

Additionally, in many European countries the people rely much more than we do on herbal and natural supplements which is paid for out of pocket and not counted as health care while we more often rely on pharmeceuticals which are counted in our health care cost.

just saying that a straight comparison of health care costs from country to country is not at all easy.

Let's see... France spends $3048 per person, while the US pays $5711.

That's a difference of nearly $2,700 per person, nearly the total cost in Denmark. Somehow, I doubt that herbal supplements and student loans would account for that big of a difference.

 

[Openmind]

It's precisely because our system is a hybrid that it results in higher costs.

The government here entitles a large portion of the population to health care at an artificially low price. The providers who agree to these prices make up the difference on everyone else by charging them more.

By contrast, foreign governments have more or less a monopoly on health care expenditures, and since they're the only ones making the decisions, they can arbitrarily decide to spend only so much -- throttling supply, lowering net costs, and leading to gross instances of abuse and neglect we hear about all the time.

Our hybrid system can be fixed (in part) if price discrimination were outlawed and the government fixed its Medicare reimbursement schedule. But it won't do that, because this would require a recognition that the money isn't there to entitle tens of millions of Americans to free synthetic hips worth half a million dollars.

The hybrid system doesn't work because, as I stated before, the HIGH premiums are paid to private industry who covers ONLY basically healthy populations of relatively young adults, while the others (all those that are either too sick, too old, or too disabled to "qualify" for private health care. . .because it would lower the huge profits!) have to either do without care (unless it is an emergency, and then they can be "stabilized" before being sent home!), or received care from the government program at a cost that they can afford.

Now, if more people were able to opt out of the private health care industry and move to the medicare program, the pool of people would not only be much bigger, but also the average age would be lower, and the "average" risk would be lower.

If all those profits that go to big business health care were instead reinvested into health care by the government (or by non-profit option), there would be a lot more money to cover everyone.

By the way, you are partially right that people who do not have health care insurance at all are being paid for by ALL of us, through rising the price of each service. . .however, if you took away people on medicare, medicaid, and non-insured people from the pool of "clients" for health care, the private industry would NOT be able to continue paying for all the hospitals, all the technology, all the equipment, and the private health care industry's accessibility to health care would also be seriously compromise or sky rocket!

 

[Openmind]

Who says their costs are really lower. They often "hide" the costs like France does so it appears lower. Governments will try to make it look like they are spending less than they are. But governmnts cant really hide the costs of health care in the private sector as well (and they don't want to)

And we do get better treatment in a variety of ways so that would account for some of our costs.

Theirs are not going up? The UK's costs are going up more than ours. In fact we are listed number 13 for how fast costs are going up.

http://www.businessweek.com/the_thread/economicsunbound/archives/2009/09/where_are_healt.html

One possible reason that some costs in gov run countries (like Canada) would not go up as much as ours is that the gov simply chooses to cut back on services.

But you couild read this about canadian costs rising:
http://retirehappyblog.ca/rising-healthcare-costs-called-a/

Do you really believe that in France, all medical studies are fully paid by the government? You are fooling yourself!

Medical studies are expensive all over the world. . .not as much in Europe, and there are tax subsidies for "qualified" applicants to medical school, but it is still a time consuming, and very expensive venture for every medical student. My niece is currently in medical school in Belgium. Her father was an anesthesiologist (he unfortunately died of cancer a few years ago), my other nephew is also an anesthesiologist who selected (because of the cost of medical school) to go into the military to get his education and training as an anesthesiologist.

You are spreading misleading information. Medical school is NOT free in European country, and the entry exam is VERY difficult. In fact, they have a quota of how many students they will accept in the medical program, and even some qualified applicants are refused each year!

Yet, when they do graduate, they do not make the huge income physicians make in the U.S.. . .

And they do have enough physicians that THEY can afford to man the "Doctors without border" charitable institution, one of the most worthy charity in the world.


We are not getting better treatment!. . .especially for those who can't get ANY treatment at all! I have lived in France (4 years), Belgium (20 years), England (4 years), I have extensively visited both Italy (where my brother lives for part of the year, and where he had a massive heart attack and was hospitalized for 4 weeks) and Portugal, and there is NO WAY I got inferior treatment in any of those countries.


Obviously health care is going up all over the world! The population is getting older, and we live longer. Also, the technology gets more and more intricate and this also costs money! The point is that, in most other developed country, EVERYONE has access to affordable health care, not just those who can easily afford the huge increased due mosty to private industry wanting to keep their profit, their bonuses (and their stocks) up!
And, by the way, there is a much higher level of regulation on any "over the counter" medication and natural supplements! So you are also mistaken about that!

 

[Dr.Who]

Let's see... France spends $3048 per person, while the US pays $5711.

That's a difference of nearly $2,700 per person, nearly the total cost in Denmark. Somehow, I doubt that herbal supplements and student loans would account for that big of a difference.

Maybe not, I don't know how much it cost to educate an entire nation's doctors (and we are not talking loans we are talking outright payment).

But what if we added up doctors education, herbal supplements, cramped waiting rooms, long waiting lists, rejected requests for treatment (like all of our cosmetic surgeries), no such thing as single rooms, plus most important that in America for just about any disease (except for lifestyle issues because we are fat slobs) one is far more likely to be cured here than there, etc. Remember that in America the average person who meets our government definition of poverty lives in better accommodations than the average citizen of Europe what would that say about the average hospital stay here versus there. The difference between 16% (us) and 11% (France), a mere 5%, could be made up quite easily. I for one would gladly pay 5% more to have a room with working equipment and better survival rates for just about any disease. (Though I don't think we are actually paying 5% more.)

Here is an article about France's system. It is in crisis. the costs are rising too fast, the gov has taken to rationing care even more than before, they are closing whole wards, they have added co-pays, and in general are moving more toward a system like ours while some of us are trying to move us more toward a system like the one they are abandoning which has been in the red since 1989. Anyone can keep health care cost down when they operate in the red.

http://online.wsj.com/article/SB124958049241511735.html

 

[Dr.Who]

Do you really believe that in France, all medical studies are fully paid by the government? You are fooling yourself!

Have you already decided without doing the research? Does that make you a person with an open mind?

Here is a quote and a link for you:

"Among the many differences between the U.S. and the French health-care systems is the approach to medical training. While U.S. medical school graduates in 2008 had an average debt of $154,000, French medical students receive their training virtually for free. For example, first-year medical students at the Faculte de Medecine Pierre et Marie Curie in Paris have only one mandatory cost for this year: an enrollment fee of $264."
http://www.kevinmd.com/blog/2009/11/training-doctor-france-differs-united-states.html

Medical studies are expensive all over the world. . .not as much in Europe, and there are tax subsidies for "qualified" applicants to medical school, but it is still a time consuming, and very expensive venture for every medical student.

I am sure that it is expensive in France - just not expensive for the students.
I wonder, since a student only pays $264 perhaps he is not as invested in his education? Might the drop out rate be higher?

You are spreading misleading information. Medical school is NOT free in European country,

Well I provided a quote and a link to support my statement and you have not. Which one of us is more likely to be spreading misinformation?

and the entry exam is VERY difficult. In fact, they have a quota of how many students they will accept in the medical program, and even some qualified applicants are refused each year!

Quotas? That's gotta be good (sarcasm).

Yet, when they do graduate, they do not make the huge income physicians make in the U.S.. . .

Of course not they don't have to pay back loans. But I wonder if the total cost is not about the same - well since government can seem to do nothing efficiently it might be more in France.

And they do have enough physicians that THEY can afford to man the "Doctors without border" charitable institution, one of the most worthy charity in the world.

I am glad they have enough doctors to send out of the country. But...

"The petition [crafted by Frances top doctor's] also said successive French governments had saved money by placing draconian limits on the number of training places for doctors and nurses. As a result, especially with the introduction of the 35-hour working week, there was a crippling shortage of trained medical staff, forcing the permanent or temporary closure of many wards."
http://www.independent.co.uk/news/w...vice-is-falling-apart-say-doctors-560704.html

We are not getting better treatment!. . .especially for those who can't get ANY treatment at all!

First, there are no people here who can't get any treatment at all.

Here is a medical journal article that says that for just about any cancer the survival rate in the US is hugely higher than in Europe (including France).
http://www.medscape.com/viewarticle/561737

It lists some of the reasons that we have better surivival rates as: "organization, training, and skills of healthcare professionals; application of evidence-based guidelines; and investment in diagnostic and treatment facilities" And of course better doctors and better facilities would mean that the doctors and facilities are better no matter what disease a person has.

But I can go on because for just about any disease where better doctors and better hospitals makes a difference the US does better. On the other hand in just about any situation where being a fat lazy slop makes a difference the US does worse. But the gov doesn't yet legislate being a fat lazy slob - yet.

And, by the way, there is a much higher level of regulation on any "over the counter" medication and natural supplements! So you are also mistaken about that!

I don't remember making any statements about the regulations on drugs and supplements. I did say that in Europe they buy more natural supplements than we do (because they don't have the access to drugs like we do - their drugs are rationed)

 

[Openmind]

Have you already decided without doing the research? Does that make you a person with an open mind?
Here is a quote and a link for you:
"Among the many differences between the U.S. and the French health-care systems is the approach to medical training. While U.S. medical school graduates in 2008 had an average debt of $154,000, French medical students receive their training virtually for free. For example, first-year medical students at the Faculte de Medecine Pierre et Marie Curie in Paris have only one mandatory cost for this year: an enrollment fee of $264."
http://www.kevinmd.com/blog/2009/11/training-doctor-france-differs-united-states.html
I am sure that it is expensive in France - just not expensive for the students.
I wonder, since a student only pays $264 perhaps he is not as invested in his education? Might the drop out rate be higher?

Yes, EVERY studies (not just medical studies) are heavily subsidized by the government in France. . .another advantage of "social democracy!" So what?

The tuition in France (the first year "tuition" you mentionned is not equivalent to the first year medical school in the US. College students enter DIRECTLY in medical school -- or pre-med if you wish -- at age 18. If they fail the first year, they have a second chance. If they fail again, there is no way they can continue. They are kicked out, and must start back to level 1 for any other career they choose. . .they cannot keep any credits) So the $264 application fee is just that: an application fee to enter into their very first year of college. . .which they selected to be pre-med). The tuitions goes up as they advance, and NO personal expenses (books, rent, food, and obviously the forgoing of other form of income while they are in College) is paid.

French Medical studies last a minimum of 9 years, to 11 years, and even 14 years. . .(this is because, as I mentioned before, the cycle begins on the 1st year of college, not as "graduate" students).

The amount of debt you mentionned for US medical students ($154,000) does include the money they need to borrow to sustain their live (rent, food, transportation) during their medical training.

Basically the advantage of the French system is that it allows ANY person who is intellectually qualified for medical studies to reach their goal of becoming physicians. In the U.S., unfortunately, unless a student is already wealthy, has parents or family willing to pay for them, or is able to qualify for a student loan, even an excellent candidate will never make it! So we basically build in a level of "elitism" in our medical school. . .which is not the case in Europe

Quotas? That's gotta be good (sarcasm).

Quotas based NOT on ability to pay, but intellectual/mental abilities are a better than the kind of "economic quota" that keeps many of our brightest students out of medical school in the U.S.
Quotas are not ideal, but they do work. . .since they provide not only enough physicians to serve all of France, but also a decent number to serve poor people abroad!

Of course not they don't have to pay back loans. But I wonder if the total cost is not about the same - well since government can seem to do nothing efficiently it might be more in France.

What makes you think they don't have to pay back loans? The tuition in Medical school is not the ONLY expenses included in those loans. . .and French student have to live by their own means during the 9 to 14 years of medical school. This doesn't come for free, and some must obtain loans as well. .maybe not as big, but proportionally just as costly. . .especially since they do NOT expect to make upward of $300,000 a year as soon as they get out of school!

I am glad they have enough doctors to send out of the country. But...

"The petition [crafted by Frances top doctor's] also said successive French governments had saved money by placing draconian limits on the number of training places for doctors and nurses. As a result, especially with the introduction of the 35-hour working week, there was a crippling shortage of trained medical staff, forcing the permanent or temporary closure of many wards."
http://www.independent.co.uk/news/w...vice-is-falling-apart-say-doctors-560704.html
I wouldn't worry too much about that! There are still a lot more hospital per capita in France than any where in the US! And French hospitals do not kick people out after two days!

.

We are not getting better treatment!. . .especially for those who can't get ANY treatment at all!

First, there are no people here who can't get any treatment at all.

EVERYONE in case of dire emergency can get STABILIZED. . .then sent home with no required follow up. . .until the next emergency!
Is that the kind of "treatment" you would like for yourself and your family?
I certainly don't!

Here is a medical journal article that says that for just about any cancer the survival rate in the US is hugely higher than in Europe (including France).
http://www.medscape.com/viewarticle/561737

It lists some of the reasons that we have better surivival rates as: "organization, training, and skills of healthcare professionals; application of evidence-based guidelines; and investment in diagnostic and treatment facilities" And of course better doctors and better facilities would mean that the doctors and facilities are better no matter what disease a person has.

But I can go on because for just about any disease where better doctors and better hospitals makes a difference the US does better. On the other hand in just about any situation where being a fat lazy slop makes a difference the US does worse. But the gov doesn't yet legislate being a fat lazy slob - yet.

Yes, the general cancer survival rate AFTER % YEARS is better in the US. . .and it is due mostly to the very early detection, and the fact that all "cancers" are reported, even if they are very slow, not life threatening forms of cancers.

Most people develop cancer at some point in their life, usually very late in their life cycle. These slow growing cancers may never be diagnosed, or may never cause worries bout "terminal" illnesses.

So, the way "cancer detection" is done also enters in the "survival" rate of people who are diagnosed with cancer. And, infant mortality is higher in the US, and life expectancy is lower.

Having experienced the health care system in several countries, and having been lucky enough of NEVER be without health care insurance, I can tell you that I have not experienced a difference in care between France, Belgium, England, Pennsylvania, California, Colorado, and South Carolina.
But then, I'm one of the lucky one. . .I've ALWAYS had private health care in the US!
Most of my clients for whom I had to fight to get medical care. . . haven't been so lucky!

I don't remember making any statements about the regulations on drugs and supplements. I did say that in Europe they buy more natural supplements than we do (because they don't have the access to drugs like we do - their drugs are rationed)

Their drugs are not rationned. . .they just have greater regulations and less drugs are sold "over the counter." But ANYONE needing drugs gets it at a much lower price than here! And French people (Europeans in general) are not as fascinated by "homeopathic"' medication than we are! Thank God!

 

[PLC1]

Maybe not, I don't know how much it cost to educate an entire nation's doctors (and we are not talking loans we are talking outright payment).

But what if we added up doctors education, herbal supplements, cramped waiting rooms, long waiting lists, rejected requests for treatment (like all of our cosmetic surgeries), no such thing as single rooms, plus most important that in America for just about any disease (except for lifestyle issues because we are fat slobs) one is far more likely to be cured here than there, etc. Remember that in America the average person who meets our government definition of poverty lives in better accommodations than the average citizen of Europe what would that say about the average hospital stay here versus there. The difference between 16% (us) and 11% (France), a mere 5%, could be made up quite easily. I for one would gladly pay 5% more to have a room with working equipment and better survival rates for just about any disease. (Though I don't think we are actually paying 5% more.)

Here is an article about France's system. It is in crisis. the costs are rising too fast, the gov has taken to rationing care even more than before, they are closing whole wards, they have added co-pays, and in general are moving more toward a system like ours while some of us are trying to move us more toward a system like the one they are abandoning which has been in the red since 1989. Anyone can keep health care cost down when they operate in the red.

http://online.wsj.com/article/SB124958049241511735.html

We are not paying 5% more. We are paying 5% of our GDP more. It is not a matter of adding 5% to our medical bills.

The current GDP is in the neighborhood of 14 trillion. 5% of that is 700 billion dollars. That is the difference in cost.


As for you assessment of our getting better treatment for that 700 B, the WHO does not agree.

Neither does Openmind, who appears to have some first hand experience.

Isn't 700B about half of the current deficit, and approximately the entire cost of the US military? That is how much we're spending over and above what we need to spend on health care. How is that sustainable?

 

[Openmind]

Maybe not, I don't know how much it cost to educate an entire nation's doctors (and we are not talking loans we are talking outright payment).

But what if we added up doctors education, herbal supplements, cramped waiting rooms, long waiting lists, rejected requests for treatment (like all of our cosmetic surgeries), no such thing as single rooms, plus most important that in America for just about any disease (except for lifestyle issues because we are fat slobs) one is far more likely to be cured here than there, etc. Remember that in America the average person who meets our government definition of poverty lives in better accommodations than the average citizen of Europe what would that say about the average hospital stay here versus there. The difference between 16% (us) and 11% (France), a mere 5%, could be made up quite easily. I for one would gladly pay 5% more to have a room with working equipment and better survival rates for just about any disease. (Though I don't think we are actually paying 5% more.)

Here is an article about France's system. It is in crisis. the costs are rising too fast, the gov has taken to rationing care even more than before, they are closing whole wards, they have added co-pays, and in general are moving more toward a system like ours while some of us are trying to move us more toward a system like the one they are abandoning which has been in the red since 1989. Anyone can keep health care cost down when they operate in the red.

http://online.wsj.com/article/SB124958049241511735.html

Have you ever personally experience a hospital stay in France, or in England, or in Belgium or in Italy?

MAYBE some hospital in the "old world" are not as "marble and stainless steel" as they are here, but they have ALL the equipments, they keep patients a lot longer if they wish (even for a simple birth!), AND the risk of contracting a deadly infection unrelated to the original reason for one's hospitalization is MUCH lower in French hospitals!

link: United States: The Centers for Disease Control and Prevention (CDC) estimates that roughly 1.7 million hospital-associated infections, from all types of bacteria combined, cause or contribute to 99,000 deaths each year.[1] Other estimates indicate that 10%, or 2 million, patients a year become infected, with the annual cost ranging from $4.5 billion to $11 billion. In the USA the most frequent type of infection hospitalwide is urinary tract infection (36%), followed by surgical site infection (20%), bloodstream infection (BSI), and pneumonia (both 11%).[1]

France: estimates ranged from 6.7% in 1990 to 7.4% (patients may have several infections).[4] At national level, prevalence among patients in health care facilities was 6.7% in 1996,[5] 5.9% in 2001[6] and 5.0% in 2006.[7] The rates for nosocomial infections were 7.6% in 1996, 6.4% in 2001 and 5.4% in 2006.

In 2006, the most common infection sites were urinary tract infections (30,3 %), pneumopathy (14,7 %), infections of surgery site (14,2 %). infections of the skin and mucous membrane (10,2 %), other respiratory infections (6,8%) and bacterial infections / blood poisoning (6,4 %).[8] The rates among adult patients in intensive care were 13,5% in 2004, 14,6% in 2005, 14,1% in 2006 and 14.4% in 2007.[9])

It has also been estimated that nosocomial infections make patients stay in the hospital 4-5 additional days. Around 2004-2005, about 9,000 people died each year with a nosocomial infection, of which about 4,200 would have survived without this infection.[10]



By the way, homeopathy in France falls under the law, and ONLY physicians with additional studies in homeopathy can practice it legally!

Link: France
Regulatory status of homeopathy in France

Homeopathic practice

In France the practice of homeopathy is only allowed to medical doctors. The Ordre National des Médécins (National Medical Council) in their report of 27 February 1997 (Lebatard-Sartre report) recognised homeopathy as a medical therapeutic method and recommended the creation of a Diplôme Inter-Universitaire (DIU) of homeopathy.

Currently, General Practitioners (GPs) who have taken additional training in homeopathy are allowed to use the qualification "orientation homéopathie".

 

[Dr.Who]

Yes, EVERY studies (not just medical studies) are heavily subsidized by the government in France. . .another advantage of "social democracy!" So what?

I thought the implication was obvious. If tuition is heavily subsidized in France (I say almost all of it) then the cost of medical care in France should include the cost of tuition. Their 11% of GDP is a gross understatement of the real cost.

The tuition in France (the first year "tuition" you mentionned is not equivalent to the first year medical school in the US. College students enter DIRECTLY in medical school -- or pre-med if you wish -- at age 18. If they fail the first year, they have a second chance. If they fail again, there is no way they can continue. They are kicked out, and must start back to level 1 for any other career they choose. . .they cannot keep any credits) So the $264 application fee is just that: an application fee to enter into their very first year of college. . .which they selected to be pre-med). The tuitions goes up as they advance, and NO personal expenses (books, rent, food, and obviously the forgoing of other form of income while they are in College) is paid.

Ok so they pay more than just tuition. But my sources have indicated that the money they pay to the university, i.e. tuition consiste almst entirely of the small application fee. Regardless of whether they pay 1% of the tuition or 2% or even 3%, the remainder paid by the gov is still money that is not counted in the cost of health care in France when comparisons are made. I have provided a source and you are your own source.

The amount of debt you mentionned for US medical students ($154,000) does include the money they need to borrow to sustain their live (rent, food, transportation) during their medical training.

Ok then, well all the money that American doctors must borrow will be included in their salaries and is thus counted in our estimate of how much health care costs in the US. In France not all of it is counted.

Basically the advantage of the French system is that it allows ANY person who is intellectually qualified for medical studies to reach their goal of becoming physicians. In the U.S., unfortunately, unless a student is already wealthy, has parents or family willing to pay for them, or is able to qualify for a student loan, even an excellent candidate will never make it! So we basically build in a level of "elitism" in our medical school. . .which is not the case in Europe

You may think that to be an advantage but the top doctors in France who wrote the petition to the gov disagree with you.

Quotas based NOT on ability to pay, but intellectual/mental abilities are a better than the kind of "economic quota" that keeps many of our brightest students out of medical school in the U.S.

Quotas represent government coercion. In the US we have a system whereby bright but poor students earn scholarships either from the gov or from private foundations.

Quotas are not ideal, but they do work. . .since they provide not only enough physicians to serve all of France, but also a decent number to serve poor people abroad!

You are saying that they have enough physicians but the facts that I presented come straight from the horses mouth and the facts say that France has a "crippling shortage of medical staff" Either you or the best doctors in France are wrong about this.

What makes you think they don't have to pay back loans? The tuition in Medical school is not the ONLY expenses included in those loans. . .and French student have to live by their own means during the 9 to 14 years of medical school. This doesn't come for free, and some must obtain loans as well. .maybe not as big, but proportionally just as costly. . .especially since they do NOT expect to make upward of $300,000 a year as soon as they get out of school!
I stand corrected may have to pay back loans - just not for tuition which is the largest cost of medical school. The cost of those loans would be included in each doctors calculations as he or she decided to become a doctor or not and they are thus counted.

.

We are not getting better treatment!. . .especially for those who can't get ANY treatment at all!

There are NO people who are not getting any treatment at all unless they make the choice to avoid getting treatment - maybe a homeless man is is afraid of hospitals. But we can't compel him to get treatment.

EVERYONE in case of dire emergency can get STABILIZED. . .then sent home with no required follow up. . .until the next emergency!

That is not correct. for follow up people have choices: use insurance, pay for it, or use public aid to see regular physicians outside of the ER, or even appeal to charity (and I will add now that I know of no charity organized around the idea of paying for people's medical care. Why? Because no one lacks care.

Feel free to show us an example of a person who does not have medical care in this thread. The thread has been up since Sept. 2009 and no one has given a legitimate example yet.

https://www.houseofpolitics.com/forum/showthread.php?t=8518&highlight=47+million

Is that the kind of "treatment" you would like for yourself and your family?
I certainly don't!

No I do not want to rely on public aid. It is a gov program and only offers adequate care rather than the exceptional care I want. I suppose that is why I studied hard in school, got post graduate degrees, worked hard to climb the ladder, and worked hard to never be without insurance. But everyone did not have the same opportunities that I had - many went to really bad public schools instead of a good public school like me. I blame failing public schools and say that this is the first thing that needs to be fixed.

Yes, the general cancer survival rate AFTER % YEARS is better in the US. . .and it is due mostly to the very early detection, and the fact that all "cancers" are reported, even if they are very slow, not life threatening forms of cancers.

yes, cancer survival is better in the US. As is a better outcome for just about any disease a person might get compared to other countries. The ways in which other countries offer better cures can be counted on one hand.

Their drugs are not rationned. . .they just have greater regulations and less drugs are sold "over the counter." But ANYONE needing drugs gets it at a much lower price than here! And French people (Europeans in general) are not as fascinated by "homeopathic"' medication than we are! Thank God!

I don't know why anyone would want to by "medicine" with no active ingredient either but that is their choice. But I was referring to other supplements that actually work. In Europe this is a bigger market than here in part because they do not have access to as much drugs as we do.

Is it not rationed in France? Rationing is by definition an authoritative limitation on access to a good. Maybe France does not ration medicines. Maybe the ruling government just restricts drugs, through greater regulation (your words) , by deciding who will get what when and why more than we do. Ooops, that's rationing.

 

[Dr.Who]

We are not paying 5% more. We are paying 5% of our GDP more. It is not a matter of adding 5% to our medical bills.

The current GDP is in the neighborhood of 14 trillion. 5% of that is 700 billion dollars. That is the difference in cost.

You are right. I should have said my share of the 5% difference in GDP (which I really believe is a smaller difference)

I don' know exactly how a 5% higher part of GDP translates into what percent higher for me but If Openmind is right it means a couple of thousand dollars more per year. Again, if that is the difference between living and dying or being in a cramped ward with doctors who are not as good and equipment that is not as good I will pay it.

As for you assessment of our getting better treatment for that 700 B, the WHO does not agree.

If you read the WHO report they actually do agree. The report has a final score and a set of scores that are used to arrive at that final score. Several of those subscores that are used to arrive at the final score are basically B.S. and are not of any importance ( is that a surprise from bureaucrats?) The one score that means the most is the one that measure how well people got better - and on that one the WHO rates the U.S. very very high.

Neither does Openmind, who appears to have some first hand experience.

Isn't 700B about half of the current deficit, and approximately the entire cost of the US military? That is how much we're spending over and above what we need to spend on health care. How is that sustainable?

I agree that we are spending too much on health care. But moving to a more nationalized system will only drive up costs while restoring competition will reduce them.
And her experience is purely anecdotal. She should provide some links and sources.

 

[Openmind]

I thought the implication was obvious. If tuition is heavily subsidized in France (I say almost all of it) then the cost of medical care in France should include the cost of tuition. Their 11% of GDP is a gross understatement of the real cost.

Ok so they pay more than just tuition. But my sources have indicated that the money they pay to the university, i.e. tuition consiste almst entirely of the small application fee. Regardless of whether they pay 1% of the tuition or 2% or even 3%, the remainder paid by the gov is still money that is not counted in the cost of health care in France when comparisons are made. I have provided a source and you are your own source.


Ok then, well all the money that American doctors must borrow will be included in their salaries and is thus counted in our estimate of how much health care costs in the US. In France not all of it is counted.

You may think that to be an advantage but the top doctors in France who wrote the petition to the gov disagree with you.




Quotas represent government coercion. In the US we have a system whereby bright but poor students earn scholarships either from the gov or from private foundations.


You are saying that they have enough physicians but the facts that I presented come straight from the horses mouth and the facts say that France has a "crippling shortage of medical staff" Either you or the best doctors in France are wrong about this.

What makes you think they don't have to pay back loans? The tuition in Medical school is not the ONLY expenses included in those loans. . .and French student have to live by their own means during the 9 to 14 years of medical school. This doesn't come for free, and some must obtain loans as well. .maybe not as big, but proportionally just as costly. . .especially since they do NOT expect to make upward of $300,000 a year as soon as they get out of school!
I stand corrected may have to pay back loans - just not for tuition which is the largest cost of medical school. The cost of those loans would be included in each doctors calculations as he or she decided to become a doctor or not and they are thus counted.

.

There are NO people who are not getting any treatment at all unless they make the choice to avoid getting treatment - maybe a homeless man is is afraid of hospitals. But we can't compel him to get treatment.


That is not correct. for follow up people have choices: use insurance, pay for it, or use public aid to see regular physicians outside of the ER, or even appeal to charity (and I will add now that I know of no charity organized around the idea of paying for people's medical care. Why? Because no one lacks care.

Feel free to show us an example of a person who does not have medical care in this thread. The thread has been up since Sept. 2009 and no one has given a legitimate example yet.

https://www.houseofpolitics.com/forum/showthread.php?t=8518&highlight=47+million



No I do not want to rely on public aid. It is a gov program and only offers adequate care rather than the exceptional care I want. I suppose that is why I studied hard in school, got post graduate degrees, worked hard to climb the ladder, and worked hard to never be without insurance. But everyone did not have the same opportunities that I had - many went to really bad public schools instead of a good public school like me. I blame failing public schools and say that this is the first thing that needs to be fixed.



yes, cancer survival is better in the US. As is a better outcome for just about any disease a person might get compared to other countries. The ways in which other countries offer better cures can be counted on one hand.


I don't know why anyone would want to by "medicine" with no active ingredient either but that is their choice. But I was referring to other supplements that actually work. In Europe this is a bigger market than here in part because they do not have access to as much drugs as we do.

Is it not rationed in France? Rationing is by definition an authoritative limitation on access to a good. Maybe France does not ration medicines. Maybe the ruling government just restricts drugs, through greater regulation (your words) , by deciding who will get what when and why more than we do. Ooops, that's rationing.

Do you speak French? Do you read French? If you do, I'll be happy to provide you with my source re: tuition in France!

And, by the way, with an additional $2,700 per year, per capita, paid by the US for health care, I would say that the subsidies that the French government provides for ALL educational fields (not just medical) seem like a drop of water compare to what we pay in additional health care!

Would you care to do the calculation, per year, per capita? ( US population X difference in cost of health care per capita X 40 years career of medical doctors) I think it would be something like: (311,813,034 X $2,700 X 40 = upward of $33 TRILLIONS
For comparison, France had 170,000 student in last year of medical school in 2009. So, let's say that each of those student cost the French government $60,000 that year. (170,000 X $60,000 = $10.2 Billions)

Now, which system seems to be the most economically efficient?

 

[PLC1]

I don' know exactly how a 5% higher part of GDP translates into what percent higher for me but If Openmind is right it means a couple of thousand dollars more per year. Again, if that is the difference between living and dying or being in a cramped ward with doctors who are not as good and equipment that is not as good I will pay it.



If you read the WHO report they actually do agree. The report has a final score and a set of scores that are used to arrive at that final score. Several of those subscores that are used to arrive at the final score are basically B.S. and are not of any importance ( is that a surprise from bureaucrats?) The one score that means the most is the one that measure how well people got better - and on that one the WHO rates the U.S. very very high.



I agree that we are spending too much on health care. But moving to a more nationalized system will only drive up costs while restoring competition will reduce them.

Yet, every nation that has a "more nationalized system" i.e., universal health care, pays a lot less than we do. If such a system drives up costs, how is it that we pay significantly more than any other nation on Earth? Every one!

And your assessment of the French system as inadequate, cramped, etc. is simply an assumption. We pay more, so we must be getting more, correct?
It doesn't always work that way.

 

[Dr.Who]

Have you ever personally experience a hospital stay in France, or in England, or in Belgium or in Italy?

No, I have not. If I had my report would be anecdotal. Not worthless but highly subjective.

MAYBE some hospital in the "old world" are not as "marble and stainless steel" as they are here, but they have ALL the equipments, they keep patients a lot longer if they wish (even for a simple birth!), AND the risk of contracting a deadly infection unrelated to the original reason for one's hospitalization is MUCH lower in French hospitals!

Are you rebutting my statement that our equipment works better? That was actually a quote from a medical journal. And I did not say that France does not have all the equipment I quoted that our better rates of recover are due in part to better equipment.

link: United States: The Centers for Disease Control and Prevention (CDC) estimates that roughly 1.7 million hospital-associated infections, from all types of bacteria combined, cause or contribute to 99,000 deaths each year.[1] Other estimates indicate that 10%, or 2 million, patients a year become infected, with the annual cost ranging from $4.5 billion to $11 billion. In the USA the most frequent type of infection hospitalwide is urinary tract infection (36%), followed by surgical site infection (20%), bloodstream infection (BSI), and pneumonia (both 11%).[1]

France: estimates ranged from 6.7% in 1990 to 7.4% (patients may have several infections).[4] At national level, prevalence among patients in health care facilities was 6.7% in 1996,[5] 5.9% in 2001[6] and 5.0% in 2006.[7] The rates for nosocomial infections were 7.6% in 1996, 6.4% in 2001 and 5.4% in 2006.

In 2006, the most common infection sites were urinary tract infections (30,3 %), pneumopathy (14,7 %), infections of surgery site (14,2 %). infections of the skin and mucous membrane (10,2 %), other respiratory infections (6,8%) and bacterial infections / blood poisoning (6,4 %).[8] The rates among adult patients in intensive care were 13,5% in 2004, 14,6% in 2005, 14,1% in 2006 and 14.4% in 2007.[9])

It has also been estimated that nosocomial infections make patients stay in the hospital 4-5 additional days. Around 2004-2005, about 9,000 people died each year with a nosocomial infection, of which about 4,200 would have survived without this infection.[10]

Are you attempting to show that we do not have better recovery rates because we have a higher rate of contracting infections in he hospital? Contracting an infection is not the same as recovering from an infection. What would count as a rebuttal is if we died at a higher rate as a result of these infections. Just getting the infections could be the result of many things. And since the infection rate in France varies so widely from year to year we should expect that these infections are not the fault of doctors (unless we want to say that the quality of doctors goes up and down from year to year).

P.S. making some words blue and calling it a link is not actually a link. But don't worry I was able to google the text. The article does not state anywhere that the U.S. does not cure disease better than France. It gives some inconsistant information about infections caught in hospitals.

By the way, homeopathy in France falls under the law, and ONLY physicians with additional studies in homeopathy can practice it legally!

Link: France
Regulatory status of homeopathy in France

Homeopathic practice

In France the practice of homeopathy is only allowed to medical doctors. The Ordre National des Médécins (National Medical Council) in their report of 27 February 1997 (Lebatard-Sartre report) recognised homeopathy as a medical therapeutic method and recommended the creation of a Diplôme Inter-Universitaire (DIU) of homeopathy.

Currently, General Practitioners (GPs) who have taken additional training in homeopathy are allowed to use the qualification "orientation homéopathie".

They actually offer professional training and only let doctors practice homeopathy which is no better than quackery. (homeopathy uses "medicine" that has virtually no active ingredient and is only found to be effective in Meta-analysis which is the statistical equivalent of quackery).