So Micheal Moore's new movie, Sicko, recently leaked. Since he has stated several times that he encourages illegal downloading and sharing of his movies (as long as it is not for profit), I decided to download it and see what all the fuss is about.
First off, it's a terrific movie! Well made, good production value.. perhaps his best one yet.
It also made me really happy to be Canadian! It was upsetting at times seeing the way the health care system works in the US, and depressing listening to the stories told by its victims. Also, I think I want to move to France now.
Posted by RyanINPnet (Member # 8363) on :
quote:Originally posted by Angiomorphism: It also made me really happy to be Canadian!... Also, I think I want to move to France now.
Good joke.
Posted by Phanto (Member # 5897) on :
While it may not be perfect, I like the idea that you aren't legally stopped from getting health care, as opposed to countries with socialized medicine, where (in Canada, for instance) a dog has better chance at getting needed surgery than a person.
Posted by Zhil (Member # 10504) on :
[spoiler]
I was surprised when they went to Cuba. And then bought pharmaceutical drugs at a fraction of the cost that we pay here in USA. And then brought them back...? Is that legal? I smell profitable drug ring scheme!
I liked the movie, but I noticed that it never once went in-depth into how much tax socialized medicine would cost. It basically said, "Here's a normal middle-class French/Canadian/British, see how good their house is/how many cars they have/their flat-screen TV/etc etc." Yeah, okay, so there's anecdotal evidence that socialized medicine didn't tax ONE family into the ground.. how would it affect OUR taxes? There was very little statistics and study and alot of gut wrenching, sad anecdotes. Now, the anecdotes served the purpose to show how badly HMOs are run, but it would have been nice to see some research on how changing our system to universal health care would CHANGE it. What I mean is, sure it seems to be working for Canada/UK/France, but why?
It was okay, for propaganda; I agree with it, so I'm biased.
I laughed at some of the government services other countries have, though. Government nannies that do your laundry?? Haha, good stuff.
[edit: Oh, and the part where he accused Hillary Clinton of hypocrisy: I didn't know that. Now I do.]
[/spoiler]
Posted by Mintieman (Member # 4620) on :
I agree that the cost of socialised medicine was very very poorly argued in the film. Doesn't mean that there aren't some major economists who have argued that privatisation of health care will inevitably lead to mass market failure (Akerlof, off the top of my head, for one.)
In Australia, we have a socialised system that the vast majority of people are on, coupled with the option to pay for private healthcare. The two systems are not necessarily at odds.
Posted by Flaming Toad on a Stick (Member # 9302) on :
quote:Originally posted by Phanto: (in Canada, for instance) a dog has better chance at getting needed surgery than a person.
What are you getting that from?
Posted by Phanto (Member # 5897) on :
About Canada:
quote: “This is a country in which dogs can get a hip replacement in under a week,” the new president told a newspaper interviewer, “while humans can wait two or three years.”
quote:Originally posted by Flaming Toad on a Stick:
quote:Originally posted by Phanto: (in Canada, for instance) a dog has better chance at getting needed surgery than a person.
What are you getting that from?
I've heard this "fact" thrown around quite a bit, but it's never justified. I wouldn't be surprised if there's some truth to it, though.
Posted by mr_porteiro_head (Member # 4644) on :
quote:I was surprised when they went to Cuba. And then bought pharmaceutical drugs at a fraction of the cost that we pay here in USA. And then brought them back...? Is that legal?
Isn't Cuba on the State Department's list of places where Americans are not allowed to go? I seem to recall Moore catching some flack over that.
Posted by Olivet (Member # 1104) on :
My in-laws' neighbors moved to the US from Canada because they needed health services they were not allowed to get in a timely manner in Canada. It had to do with a catastrophic illness, and they were a mixed Canadian/American couple.
Still, we pay more for health insurance than we did for two car payments put together, and we're healthy and opted for huge deductibles.
I'm interested in seeing the film, though I do not expect anything approaching journalism from it.
Posted by Lyrhawn (Member # 7039) on :
The problem with buying brand name pharmeceuticals outside the US, is that you're still never sure where those drugs are coming from, which is why the Fed tries to stop little old ladies in Detroit from going to Windsor to buy their meds.
And they really have a good point. You can't be sure that those drugs you're getting in Mexico, Canada, or even Cuba are really from the real company, or if they are from a basement pharm lab in Colombia being sent up north in trash bags, and yes, that happens. The drug system isn't 100% safe outside the US. But there is truth to the fact that the US more or less subsidizes cheap drugs for the rest of the world.
And Moore, and everyone else who went with him to Cuba, including injured 9/11 workers who were left in the cold by the government, could be fined up to $200,000, each. They are still working it out.
I think if Moore wasn't going to go indepth about France and Canada, he shouldn't have mentioned them at all, but bringing the problems of the US healthcare system to light is certainly laudable.
Posted by Bob the Lawyer (Member # 3278) on :
Brand name pharmaceuticals sold in Canada are made in Colombian basements? Zounds! I've been taking these things for years!
Posted by Kwea (Member # 2199) on :
Guess what....I went to Mexico and bought the same drugs we get in the US, from a pharmacy that has been in business for over 12 years (in the same location), and they were the same.
I should know...my wife was with me, and she was a pharm tech.
I am as sure as I would have been if I had bought it in the US.
WE pay for ALL the research and development for most of the drug companies, and the rest of the world pays almost nothing of the cost compared to us. THAT is why they are more expensive here then anywhere else in the world.
BTW....in Canada, it would depend on how pad the person's hip was, to be honest. Chronic pain sucks, but it isn't as important (usually) as a heart transplant. If they can't walk, but are otherwise healthy, then it happens sooner than if walking is a problem.
It's called triage, and it works.
And there is always the option of paying for it yourself if you don't want to wait....just like here in the US.
Posted by anti_maven (Member # 9789) on :
OK, I haven't seen Sicko, but I will when I can. Here's my 2p on the subject of healthcare for those that are interested in a Euro-POV. If not, please skip to the next post
<soapbox> My 2p. I've only lived in countries that have socialised medicine - in fact I can't think of many "modern, western countries" (barring the US) that don't.
My personal experience is that you get what you pay for. If you rely on the health service you are likely to have to wait. If you go private you don't wait so long but you pay for the privelege. Some companies offer health insurance as a perk, others contract independantly.
Here in the Basque country, I must say that I am in awe of the medical services. It is quick, reliable and offers a level of excellence and service that should be the envy of many other places. From emergency care, to regular health visits, ongoing care, or paedriatric care we have had nothing but a good experience.
As for the cost - it's high, but I don't feel it in my tax contributions.
Here are some figures:
I calculate an annual tax burden of approximately 7800€* on my 30k annual salary (taxes are a bit higher here due to the local state taxes, but I used national average figures to to the maths).
I picked some online quotes for health insurance, basing myself in Atlanta GA** (and just for individual cover) and I was quoted between $66.79 and $230 per month.
So at best I am only pay +/-800$ per year for me, or at worst $2760.
As I understand it this will not cover emergency room expenses, prescription drugs, check ups or specialist consultations.
So I figure it costs more to be healthy here, but if I get sick I'm covered from top to toe with no extra charges.
OK, so my calculations are extremely crude, and I'm sure that there are more factors that come into play, but I'm happy to know that the low-income family down the street have full and free access to the same services I do for their sick child and at no extra cost.
Additionally, how many times have we read on this forum of post from folks asking for medical advice because they're not covered and can't go to see a doctor or go to the emergency room?
You have to draw your line in the sand somewhere. Personally I think that open access healthcare for all regardless of income is a fundemental part of a caring society - and I'm happy to pay for it with my taxes.
</soapbox>
*oh and I got a 1500€ tax rebate this year too
** Why Atlanta? It's the place I've been to most in the US and it is probably not the most expensive nor the cheapest place to live. And it's home to the One Star Ranch house of ribs - drool!
Posted by Samprimary (Member # 8561) on :
I am so happy to see a movie about how fsking broken the American healthcare system is, since policy wonks need to make this stuff more digestable to the populace. If it takes Michael Moore -- smarming his way through a 90 minute film -- to help more people figure out that our current system is entirely broken, I'm all for it.
I often see people trying to argue for the American system by pointing out the faults of the Canadian system and conflating all of Canada's healthcare flaws as being inherent to socialized medicine.
They are not.
Canada's health care system is considered to be broken in comparison with working socialized systems. And despite the fact that the european nations would consider Canada's socialized health care system to be broken, it still works loads better than the American system.
In fact, the Western hemisphere is a great place to look to if you want to get a really depressing view of our health care priorities. Canada, to the north, is a broken social healthcare system that works better than ours. Cuba, down lower, is an impoverished, ass-backwards little pissant nation under embargo that still manages to provide better healthcare than us.
Beargh! Arghj! That anyone still defends our current system is enough to throw me into an apoplectic fit! Where's Bean Counter when you need him!
Posted by Lyrhawn (Member # 7039) on :
I wasn't going to elaborate on it, but both Bob's flippant, sarcastic response, and Kwea's smug, dismissive response perhaps merits a more in depth response to the question of fake drug trafficking.
It's late, or rather early, at the moment, so I'm going to bed, but I'll be back tomorrow to dispel the notion that what I said wasn't true. I fear others may take Kwea's and Bob's words and assume that the drug distribution systems in other countries to our north and south (and for that matter here at home) are much safer than they actually are.
In the meantime, if you want to look yourself, google some form of "fake drugs in Canda" or "fake drugs in Mexico" and read what comes up.
Posted by TL (Member # 8124) on :
I've had to get almost all of my medicine from Mexico for the past several years. Luckily I won't have to, now, for the foreseeable future, as I can finally afford insurance. But the drugs I've taken that came from Mexico -- mostly antibiotics such as amoxicillin -- have been fine.
Posted by Dan_Frank (Member # 8488) on :
Samprimary, you seem to have an idealized view of European socialized medicine. Most Europeans I know that have actually had significant ailments to be treated all report similar horror stories as come out of Canada. Since all Moore understands is anecdotes, here's one.
I once had minor surgery, a partial parotidectomy (removal of a tumor in the saliva gland). I had the procedure done at a small center in Flagstaff, Arizona. They have better medical staff in Phoenix, but I didn't want to go the extra many miles. I made an appointment 5 days in advance, headed down, and got it done. I spent a night in the hospital, was off work for a week, and healed without incident.
A friend of mine received an identical procedure in Norway, a country with a heavily socialized medical system. She had to wait an ungodly long time just to be admitted. After the procedure she was hospitalized for a week. When she healed, she discovered to her horror that sometimes, when she salivates, she secretes saliva on the outside of her neck, around the scar.
This is just a minor procedure. But every single step of the way, the socialized system was incompetent compared to the medical center in Flagstaff.
Posted by TL (Member # 8124) on :
A poor person in Flagstaff, though, never would have been able to have the procedure at all. They would have had to just soldier on.
Posted by Kwea (Member # 2199) on :
quote:Originally posted by Lyrhawn: I wasn't going to elaborate on it, but both Bob's flippant, sarcastic response, and Kwea's smug, dismissive response perhaps merits a more in depth response to the question of fake drug trafficking.
It's late, or rather early, at the moment, so I'm going to bed, but I'll be back tomorrow to dispel the notion that what I said wasn't true. I fear others may take Kwea's and Bob's words and assume that the drug distribution systems in other countries to our north and south (and for that matter here at home) are much safer than they actually are.
In the meantime, if you want to look yourself, google some form of "fake drugs in Canda" or "fake drugs in Mexico" and read what comes up.
Smug? I was speaking as someone who has seen, on an off day, over 10,000 people cross over the border (it was a Tuesday) to do the very thing you were saying was so unhealthy.
Do you have the protection of the USDA there? No.
Is the USDA the only regulatory body i the world capable of regulating safe drugs?
Not my a long shot.
There are scams, and bad drugs, even here in the US. Getting drugs in Mexico, as long as you don't go to some fly-by-night outfit, is very safe though, and getting them from Canada is even safer. Most of the doctors there are trained in the US, and in this particular town have been in the same location for at least ten years....some even longer than that.
It was amazing to me the number of people who choose to go south for all sorts of medical treatments, dental treatments, and drugs. I had no idea how widespread the practice was....and some of these people my parents know have been doing it for 25-30 years.
So you can think whatever you like...I have been there, and seen it with my own eyes.
BTW, I am hardly a stranger to the medical field, and my wife is very familiar with the drug industry.
Perhaps rather than smug I am actually informed. I realize there are some risks, but they are no where near as widespread as some people would like you to believe.
The fact that a Z-pack co-pay is $35 here, with insurance, but I was able to buy 4 of them for $5.65 each in Mexico is disgusting, and shows you how broke our system really is, IMO.
Posted by Olivet (Member # 1104) on :
Anti-maven- We live in Atlanta (just north of there) and health insurance is cheaper here than some places. I'm not sure how it works. We are a family of four, but we pay less than half what another family of four we know pays for health insurance. They are in the same industry and also self-employed. They are younger than us, but maybe it's more expensive for them because of their weight. I just don't know.
Another thing is how long you buy insurance from the same company. They offered us a lower rate if we would start over with new policies and pre-existing condition clauses because they have to pay for my optometrist visits since they covered my cataract surgery. It still gets eaten up with the deductibles, though.
With that and my son's condition I expect we'll paying more for health insurance in a few years than we are for our house. What we pay now would be enough to cover everything we need to keep us healthy, but if something really went wrong, we'd be wanting insurance. Our plan is to become super-wealthy before we get old and sick. Heh.
Posted by ClaudiaTherese (Member # 923) on :
1. Canadian healthcare is not "socialized medicine." It is a form of single-payer system (involves both federal and province funds, with decisions about allocation made provincially), but the physicians are not employees of the state -- unlike, say, the UK. The practice of medicine by physicians is through privately organized practices, although hospitals themselves (the buildings) are provided for and run by the provinces.
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2. The plural of anecdote is not data. You will hear "horror stories" coming out of every system, because individual cases differ, and mistakes happen, and YMMV. But this is true for every system, including the US. So if you want to measure systems against systems, you have to look at aggregate data and compare outcomes measurements.
Of note, when national surveys have been done and the results compared, there are proportionally more horror stories coming out of the US, and the US citizens as a whole report the most disatisfaction with their current system. More than Canadians, New Zealanders, Australians, or people in the UK.
----
3. Many people in the US have long wait times as well, including those with insurance. My cardiologist in Wisconsin was booked out more than three months in advance. My wait time was more than three months, even as an established patient -- but this was not a function of payment. It was a function of limited spots available.
The same is true for much of Canadian wait times (and there is no general wait time for emergency services or non-elective surgeries). This is because Canada is short on physicians, as recent conservative governments have been cutting funding to the system. Additionally, the population has expanded tremendously. British Columbia, where I live, has expanded by more than 200,000 people over the last five years, which is just a continuation of a growth trend. This is why I was hired -- I am teaching new medical students as we expand the medical school class size (by more than a third since last year, and we continue to expand).
Neither underfunding nor the population explosion are flaws to the Canadian healthcare system itself -- they are external forces which need to be addressed individually.
Posted by ClaudiaTherese (Member # 923) on :
4. Properly run single-payer systems cost less per capita than trying to take care of uninsured people through ERs. They cost much less per capita than is spent covering everyone in the US, but they even cost less than the burden to everyone in the US -- per capita -- of just covering the people without insurance when push comes to shove.
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5. A correction: in many Canadian provinces, it is illegal to offer separate fee-for-service medical provisions outside the federal and provincial system. This is currently being wrangled out in the courts.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Phanto: About Canada:
quote: “This is a country in which dogs can get a hip replacement in under a week,” the new president told a newspaper interviewer, “while humans can wait two or three years.”
6. You realize, of course, that a hip replacement in a dog is a much, much simpler procedure than in a human. For example, we don't even routinely consider doing hip replacements in dogs who are in heart failure with multiple other chronic medical problems, such as diabetes.
They aren't comparable. But I suppose it does make for a good defensive soundbite when you are being sued for opening an illegal operation. (This quote is from a South African physician who has opened an illegal clinic in BC. He also had trouble getting licensed to work here in Canada. It is being addressed through the court system.)
7. The article has several obvious and egregious errors of fact. I am not familiar with Commentary magazine, but it appears to me to be either a biased source, or have lax fact-checking standards, or some mix of the two.
[ June 20, 2007, 11:52 AM: Message edited by: ClaudiaTherese ]
Posted by twinky (Member # 693) on :
<3 CT Posted by sndrake (Member # 4941) on :
Tomorrow (Thursday, June 21) Moore will be in Chicago for a rally and advance screening of SiCKO. The screening is too late for me, even though we had access to free tickets.
quote:Not Dead Yet Proud to be a Co-Sponsor for "SiCKO" Rally Filmmaker Michael Moore will rally with Health Care for All Illinois and allied groups this Thursday, June 21 at 4:00 p.m. at Daley Bicentennial Plaza. For more information on "SiCKO" and our broken, profit-driven health-care system, visit: www.sickocure.org - a site "dedicated to promoting the only cure for our 'sicko' health system: single-payer national health insurance."
Posted by Mig (Member # 9284) on :
Over the years I've read many stories of people disperate for surgury in Canada who have had to go to the US because they were too far down the waiting list. Some these people would have died if they couldn't have afforded to go to the US for treatment.
Moore is a terrible person. No good person could have allowed himself to be used by one of the worst tyrants of the past century, fidel castro.
It's disenguous to compare Cuba's health care system more favorably to that in the US. I'm Cuban, whenever my family or freinds goes on a vist to Cuba they have to take some medicines that they just can get over there along with other basic health supplies like asprin and things as basic as sanitary napkins.
Idiots like Moore like to point out the number of doctors in Cuba. My uncle was once the President of the Cuban medical association before the revolution, and a prominant doctor in Miami. He's pointed out to me that almost every doctor he's ever seen defect from Cuba after the revolution has been unable to pass the Florida boards. The problem was not their language skills but their poor medical training.
Cuba sends its Doctors around South and Central America and opens it clinics and hosspital to people around the world to bolster its PR, but the average citizen gets a poor treatment with few medicines and little equipment. Here's an interesting link to a story about Cuba's healthcare system: http://www.latinbusinesschronicle.com/app/article.aspx?id=1356
Although the article points ouit that Cuba is near the top on mortality, life expectancy, etc, but the article fails to point out that this was also true before the revolution.
What I don't understand is why liberals who claim to be such strong supporters of human rights, civil rights, etc, like Moore, go out of their way to positively promote one of the most repressive governements in the world?
Posted by Wonder Dog (Member # 5691) on :
CT, you rock! Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Mig: Over the years I've read many stories of people disperate for surgury in Canada who have had to go to the US because they were too far down the waiting list. Some these people would have died if they couldn't have afforded to go to the US for treatment.
8. Many, many more people in the US have died because they cannot afford treatment. [And, note that Canada does not have a wait time for non-elective surgeries or emergency services.]
If you want to compare system to system, then compare system to system.
On the other hand, if you want to know where a citizen can buy the best health care, then go to the United Arab Emirates, where the royal family employs its own private physicians and has its own hospital. I work with one of their former physicians -- the facilities are exquisite.
Of course, you probably can't afford to access them. But someone can. And if that's your measure of a good system, then so be it. Laud the UAE, where the wait time is all of an hour -- for members of the royal family -- and that is if the physician needs to get dressed first.
[ June 20, 2007, 12:19 PM: Message edited by: ClaudiaTherese ]
Posted by fugu13 (Member # 2859) on :
Which part of the UAE?
Posted by ClaudiaTherese (Member # 923) on :
I believe she worked in Dubai.
She loved her work and found the facilities and people to be absolutely extraordinary. Other members of her family wanted to return to Canada, but she misses the work she was able to do there quite keenly.
---
Edited to add: And [in the interests of accuracy], according to my source, that royal family was working hard to improve medical facilities in all areas. The difference in access between the wealthiest and the poorest was still quite severe, but it was being addressed.
quote:The Government of Dubai, in the United Arab Emirates, is developing Dubai Healthcare City (DHCC) with the goal of creating a regional center of excellence for medical services, medical education, and life science research and development in the Middle East.
As a locus of political and economic stability and innovation, Dubai is in a position to serve the region's needs for high-quality health care, and to be a model for institution-building in the region. The leadership of DHCC is committed to the principle of accessibility for all, to professional and academic development, and to international recognition for quality of care as well as patient privacy, rights, and satisfaction.
...
The total site comprises of two phases, including disease treatment, prevention and wellness facilities. The first phase, located behind Wafi City, Dubai, is approximately 4.1 million square feet in size. The second phase, dedicated to wellness facilities, will be announced soon. DHCC's services and facilities will be available to the UAE, the whole of the Middle East, and surrounding regions. Under the auspices of the Center for Healthcare Planning and Quality (CPQ), Harvard Medical International and DHCC will oversee a quality assurance system that will guide continuous improvement throughout the entire site.
[ June 20, 2007, 12:15 PM: Message edited by: ClaudiaTherese ]
Posted by fugu13 (Member # 2859) on :
Yeah, Dubai does an overall remarkably good job in many sectors.
Posted by ClaudiaTherese (Member # 923) on :
It does. I was delighted to learn more about an area of the world that I knew so little about.
Still, though, if you are the right person, you have a private physician [and that is not available to most citizens there]. I suppose that happens for the wealthiest or most powerful in the US, too, but from what she said, I believe the facilities available to the wealthiest and most powerful in Dubai outstrip that available in the US. Everything, down to the operating tables, was completely brand-new and state of the art. It broke her heart to leave.
Posted by Bob the Lawyer (Member # 3278) on :
*le sigh*
Lyr, what you're thinking of are certain mail-order pharmaceutical companies based in Canada that take advantage of a little (but horrible) loophole in our laws that allow them to ship uninspected product to other countries so long as none of them are actually sold on Canadian soil. I wrote a lengthy post about this the last time the topic came up, but now that I think about it that must have been 3ish years ago. To my knowledge the laws have not changed.
Saying that people are crossing the border and buying bad drugs in person in a store is utter nonsense. Except insofar as there are mistakes made on both sides of the border.
Posted by solo (Member # 3148) on :
quote:<3 CT
and
quote:CT, you rock!
Posted by Nighthawk (Member # 4176) on :
I think I've mentioned this before, but when you have to go to the hospital in Cuba, one of the things they suggest you bring is "one lightbulb." Comforting, no?
And I have family down there, and have to send medicine to them on a reasonably regular basis because of the the prices they face down there. Perhaps if you're an American tourist you can get decent prices and treatment, but if you're just another peasant it's a whole other story.
Forgive me if I have low opinions of the healthcare system there.
Posted by Mrs.M (Member # 2943) on :
I am very, very satisfied with the quality of healthcare my entire family has received, both here in Virginia, in Georgia and in New York. Andrew and I currently pay for our own insurance and we do pay a lot, but we have fantastic coverage. We've also had major medical issues that we were able to get through without additional financial burdens.
The US is one of the best countries for preemie care, if not the best. Every preemie is covered by Medicaid. Even if the parents have insurance, Medicaid will pay if their insurance tops out (which it frequently does - micropreemies are sometimes referred to as "million dollar babies"). NICUs in the US exhaust every resource to save these babies and their rate of success is inspiring.
Mircopreemies don't have it so good in many other countries. In Portugal, for example, they won't give any medical care to a baby born at 24 weeks or under. To give you some perspective, two 24-weekers and two 23.5-weekers went home with their parents while Aerin was in the NICU. There was a case in England where the parents actually had to take the doctors to court to get them to treat their micropreemie daughter. The doctors called her a bed-waster and said there was no chance for survival. She's currently thriving at home with her parents.
Also, there are many ways for low-income families to get coverage in the US. In Virginia, for example, we have FAMIS, which provides insurance coverage to children and pregnant women whose family incomes are 200% or less than the poverty line. There's WIC, which safeguards "the health of low-income women, infants, and children up to age 5 who are at nutrition risk by providing nutritious foods to supplement diets, information on healthy eating, and referrals to health care." The March of Dimes provides research grants to fight prematurity and has gotten amazing results.
I have personally worked to increase funding and awareness of the above programs. There are many, many others like them in every state. It's very frustrating for those of us who work on these programs to constantly hear how hopeless and terrible the US healthcare system is. Yes, it has its flaws, and some of them are huge and glaring, but there is a lot that we're doing right.
BTW, I wonder if Mr. Moore mentioned the $4.00 perscriptions available at WalMart in his movie. Something tells me he did not.
Posted by Jhai (Member # 5633) on :
Sigh.
I violently dislike all Michael Moore films, mainly because, as CT points out, anecdotes do not equal data. And pulling up random statistics to support your position is not equal to a balanced study done by experts in the field.
If you're interested in this topic, read some unbiased research on it, rather than supporting propaganda by watching Moore's movie.
Posted by Sterling (Member # 8096) on :
There are an awful lot of people in the U.S. who have to pay out-of-pocket to see a doctor, if they can afford to see a doctor at all.
It's also true that we pay the highest rates in the world for our drugs, and an enormous amount of that cost is not research, but advertising. Take it from someone with a closet full of drug company tchotchkes and anecdotes about drug-company sponsored lunches and dinners.
Other countries may certainly have their problems. But the U.S. system is dying on the vine. Tons of new doctors are avoiding the fields where people are most needed, such as obstetrics and family medicine, in favor of specialist fields with lower malpractice insurance rates and higher financial returns.
You can get good care almost anywhere if you have the money to pay for it; that's largely irrelevant. It does nothing for low-level epedemics like influenza, nothing for the productivity of workforces that don't have insurance, nothing for the overall health and well-being of the population.
Posted by Angiomorphism (Member # 8184) on :
I agree Jhai, it is much better to inform yourself about any controversial topic. But many people will not put in the work required, and in those cases, a film like Moore's (while extremely biased) will propel some people to actually get informed and act accordingly.
When it comes to political issues like the war in Iraq, I tend to dispise Moore's opinions and biases, but he hit the issue of health care right on the head. It seems absurd to me that socialized health care is so deamonized in the US, to the point where misinformation is spread about countries where the system actually works (and I know Canada and the UK have their own problems - see wait times and the UK's hygeine problems, but there are no wait times for necessary or emmergency surgery, and no one has ever had to watch their partner die because a company would not let them receive appropriate care).
Also, Mrs. M, how would you explain the fact that the US has the highest infant mortality rate of all the developped countries?
Posted by Lyrhawn (Member # 7039) on :
quote:Originally posted by Bob the Lawyer: *le sigh*
Lyr, what you're thinking of are certain mail-order pharmaceutical companies based in Canada that take advantage of a little (but horrible) loophole in our laws that allow them to ship uninspected product to other countries so long as none of them are actually sold on Canadian soil. I wrote a lengthy post about this the last time the topic came up, but now that I think about it that must have been 3ish years ago. To my knowledge the laws have not changed.
Saying that people are crossing the border and buying bad drugs in person in a store is utter nonsense. Except insofar as there are mistakes made on both sides of the border.
It's not nonsense, it happens. The fake drug industry is going to be a $70 billion dollar business in the next few years. The FBI and other law enforcement agencies have broken up labs in and around major cities in Canada, the US and Mexico who were making fake drugs, that look precisely like the real thing, and then got them into pharmacies where they were sold to real people over the counter, not in a mailbox.
You and Kwea can think whatever you like, and chances are the system probably is 85%-90% safe, and those are pretty good odds, but blithely dismissing what I'm saying is just stupid, to say nothing of wrong and irresonsible. I'm not going to post the big mega info post that I was going to, because now I just don't think it's worth my time or effort, but like I said before, do a quick google search for fake drugs. It's a huge business that is gaining steam every year, and people are dying from it all over the world.
Law enforcement officials say no number of inspections or border checks are going to keep the drugs out, they can only hope that when fake drugs are consumed by an individual, the bad effects are quickly reported so they can jump on it quickly.
But hey, you guys just go on thinking whatever you want. You're experts apparently.
Posted by Mrs.M (Member # 2943) on :
quote:Also, Mrs. M, how would you explain the fact that the US has the highest infant mortality rate of all the developped countries?
It doesn't.
Those are spurious and misleading statistics and it really upsets me that policies are made based on them. Each country has different criteria for what constitutes stillbirth and what constitutes a miscarriage. In the US, every baby born (that dies at birth) past the age of viability (24 weeks) is counted as a stillbirth and included in our infant mortality statistics. In many other developed nations, any baby born before term (38 weeks) is counted as a miscarriage and therefore NOT included in that country's infant mortality rate.
Here is a Canadian study that confirms this:
quote:Large differences in infant mortality are reported among and within industrialised countries. We hypothesised that these differences are at least partly the result of intercountry differences in registration of infants near the borderline of viability (<750 g birthweight) and/or their classification as stillbirths vs. live births.
quote:International comparisons and rankings of infant mortality should be interpreted with caution.
-Kramer MS, Platt RW, Yang H, Haglund B, Cnattingius S, Bergsjo P., Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Canada
Posted by Kwea (Member # 2199) on :
quote:Originally posted by Lyrhawn: [QUOTE]Originally posted by Bob the Lawyer: [qb] *le sigh*
But hey, you guys just go on thinking whatever you want. You're experts apparently.
Far, far closer than you are, that's for sure.
I worked in the Army for USAMRIID, and personally drafted protocols for drug testing, as well as participating in them myself. I helped formulate a model system for drug testing with human subjects that was presented to Congress, and is administered with congressional oversight.
It is also the basis for model programs across the world.
The program was already in place before I got there, but they were considering dismantling it. Because of the revamping myself and 3 other soldiers instituted, it has more members now than ever before, and has saved countless lives.
What were your qualifications again? A web search?
Lyr, you are a smart person, but on this you are way off base. I wasn't trying to be smug, but I DO know what I am talking about. I didn't call you names, or question your integrity....I just disagree with you.
Keep in mind I didn't say it was perfect, or completely safe....but given the number of people doing this very thing, if there was even a 4% chance of a scam we would be seeing hundreds of thousands of deaths/injuries a year.
The government has a vested interest in making sure that we buy here in the US. It isn't that they are lying...but they are playing Chicken Little a bit.
There have been at least 4 people here in the US who have gone to jail in the past 2 years for passing fake drugs. It happens everywhere....and the possibility make me wonder as well.
But people have also tested the drugs bought in Mexico....and most of them are legit. Ask the drug companies why the drugs they ADMIT to selling are so much cheaper in Canada or Mexico. Not the false one, the ones they sell themselves.
We foot the bill for R&D for most of the world.
BTW...I haven't seen Sicko, nor do I plan to, because I don't trust Moore. This issue is far larger than he is though.
Posted by Bob the Lawyer (Member # 3278) on :
Lyr, I think it's pretty lame that you'd say my sarcasm was enough to stop you from writing a post enlightening people to the dangers of prescription drugs. Well, Ok, Kwea helped a little. I also find it funny that in your second post this is also a problem within the US. Why not say that originally? (You may want to ignore that. I sometimes find you hyper patriotic and it irks me. This could very well be completely my problem).
Be that as it may.
I think you're actually talking about the same thing I am. From the results of my searches on google it seems that a lot of drugs that wind up on pharmacy shelves are bought from online Canadian distributors. Which is, in fact, the very same problem I posted. There are, of course, also problems with dilutions, simply swiping the pills and replacing them with other ones, but in many ways those are less of a problem because they probably don't operate with the same volume as mail orders.
I could be wrong. What does your research say?
As an aside, I apologise for the snark. We don't like each other and if we're ever going to communicate effectively on an issue it behoves me to treat you with more respect so we don't get bogged down with comments on the others' personality. I will try and be more respectful in the future. (I may have said this before. I probably have. I'm still trying!)
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Mrs.M:
quote:Also, Mrs. M, how would you explain the fact that the US has the highest infant mortality rate of all the developped countries?
It doesn't.
Those are spurious and misleading statistics and it really upsets me that policies are made based on them. Each country has different criteria for what constitutes stillbirth and what constitutes a miscarriage. In the US, every baby born (that dies at birth) past the age of viability (24 weeks) is counted as a stillbirth and included in our infant mortality statistics. In many other developed nations, any baby born before term (38 weeks) is counted as a miscarriage and therefore NOT included in that country's infant mortality rate.
Here is a Canadian study that confirms this:
quote:Large differences in infant mortality are reported among and within industrialised countries. We hypothesised that these differences are at least partly the result of intercountry differences in registration of infants near the borderline of viability (<750 g birthweight) and/or their classification as stillbirths vs. live births.
quote:International comparisons and rankings of infant mortality should be interpreted with caution.
-Kramer MS, Platt RW, Yang H, Haglund B, Cnattingius S, Bergsjo P., Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Canada
That study proposes a mechanism by which some potential confounding can be minimized. Even if absolutely correct, the US mortality rate for Black infants (given the study's proposed corrected numbers) is still nearly double that of Swedish infants, and half again as much as that of Israeli Jewish and US White babies -- despite the fact that, as you have noted before, Black females should do better than other babies.
It explains away some of the disparity, but only about 1/2 of it, if that. When you take into account the fact that this group should be doing better than the others, the disparity is revealed to be yet wider.
Posted by Mrs.M (Member # 2943) on :
CT, that may be true, but I don't think there are very many black Swedish babies (if any) and there are relatively few black Israeli babies, when compared to the US. What are the numbers of Sweden's minority populations (does Sweden even have a minority population?)? Don't you have to compare populations to like populations? I don't know very much about statistics, but it seems to me that you do.
I don't know how much the US healthcare system is to blame for the disparity (though it definitely plays a part). Certainly black mothers, in parts of the country, do not have access to the level of prenatal care that white mothers do. However, there are cultural factors that must be considered. I recently attended a March of Dimes summit as a mission family rep (the rest of the participants were medical professionals and public health officials) and one of the issues was taking our folic acid campaign to black markets because black women aren't being reached through traditional markets (we're going to focus on community centers, churches, and barber/beauty shops). We also have a Spanish-language campaign, but the Hispanic/Latino population is difficult to market to.
ART (Assisted Reproductive Technology) and Advanced Maternal Age aren't being taken into account in these stats. ART and AMA mothers are at a much higher risk for complications and stillbirths and this does not reflect a problem with the US heathcare system.
Andrew brought up a good point at supper. No one seems to be advocating any kind of reasonable, tenable solutions to our healthcare problems. It seems like the loudest critics only want us to switch over to socialized medicine, which is not going to happen. I wish they would focus on their energies on something that could actually help.
Posted by Kwea (Member # 2199) on :
The problem is the level of accountability.......our representatives are so deep in the pockets of the medical.insurance companies that significant change is hard to come by.
Posted by Megan (Member # 5290) on :
Mortality rate seems to suggest the respective number of black babies in Sweden, Israel, and the U.S. was taken into consideration. I could be mistaken, but that's what it suggests to me.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Mrs.M: CT, that may be true, but I don't think there are very many black Swedish babies (if any) and there are relatively few black Israeli babies, when compared to the US. What are the numbers of Sweden's minority populations (does Sweden even have a minority population?)? Don't you have to compare populations to like populations? I don't know very much about statistics, but it seems to me that you do.
You do, if you can. If you cannot, you try to anticipate how it would affect the data and minimize confounding.
That is exactly what the study you cited was trying to do; "here we have this data from different populations, so let's try to make the analysis as comparable as possible, and where we can't, then at least acknowledge which ways it is likely to be biased." No populations are going to be perfectly equivalent, or they would be the same population. It is always a matter of doing better rather than worse analyses, not of trying to make it perfect.
So, we know that Black preemies seem to do a lot better than White babies preemies, regardless of socioeconomic status. It seems to be a matter of physiology. Thus one would expect that Black babies should have lower mortality rates -- in this case, the difference in the populations should bias in the opposite direction from what we find in the data. Thus, normalizing to the rates we should expect, the disparity is even wider than it seems.
quote:ART (Assisted Reproductive Technology) and Advanced Maternal Age aren't being taken into account in these stats. ART and AMA mothers are at a much higher risk for complications and stillbirths and this does not reflect a problem with the US heathcare system.
. True. Again, though, it does not tend to be Black babies that are the ones conceived via ART or with AMA. Again, this is yet another bias that should be skewing the US data we see in the opposite direction -- thus, the gap is yet again even wider than it appears.
quote:Andrew brought up a good point at supper. No one seems to be advocating any kind of reasonable, tenable solutions to our healthcare problems. It seems like the loudest critics only want us to switch over to socialized medicine, which is not going to happen.
The loudest critics I hear are advocating that we switch to a single payer system, like Canada. (?) (That isn't "socialized medicine." Medical practitioners are in private practice, not employees of the government.)
Of note, the Canadian change over to a single payer system was extraordinarily fraught with problems. Although the majority of Canadian physicians support the current system (as per national surveys), when it was initially implemented in the province of Saskatchewan, the physicians of the province went on strike. The prime minister flew in replacements from other provinces. But now that the changeover has been made, the majority of the population (lay and physician both, [also per the national surveys]) is glad the change was made.
So why am I advocating a change that -- at least in one other country -- nearly shut down that local system? Because I see worse ahead if the changeover is not made, and I think we, too, would be glad we made the change after. Mostly, though, it's because I see a worse breakdown if we stay put.
---
Edited to add: It seems that you and Andrew may not see a change to a single payer system as tenable. I see not making the change as even less tenable. This may be why what you hear doesn't seem to speak to your concerns -- I think our fundamental concerns differ. (Maybe because of perspective, maybe because of other fundamentally different concerns tied to these, maybe because of areas of knowledge. Regardless, it is a respectful disagreement, and I appreciate that enormously.)
Posted by Lyrhawn (Member # 7039) on :
quote:Originally posted by Bob the Lawyer: Lyr, I think it's pretty lame that you'd say my sarcasm was enough to stop you from writing a post enlightening people to the dangers of prescription drugs. Well, Ok, Kwea helped a little. I also find it funny that in your second post this is also a problem within the US. Why not say that originally? (You may want to ignore that. I sometimes find you hyper patriotic and it irks me. This could very well be completely my problem).
Be that as it may.
I think you're actually talking about the same thing I am. From the results of my searches on google it seems that a lot of drugs that wind up on pharmacy shelves are bought from online Canadian distributors. Which is, in fact, the very same problem I posted. There are, of course, also problems with dilutions, simply swiping the pills and replacing them with other ones, but in many ways those are less of a problem because they probably don't operate with the same volume as mail orders.
I could be wrong. What does your research say?
As an aside, I apologise for the snark. We don't like each other and if we're ever going to communicate effectively on an issue it behoves me to treat you with more respect so we don't get bogged down with comments on the others' personality. I will try and be more respectful in the future. (I may have said this before. I probably have. I'm still trying!)
First off, I wasn't aware that we didn't like each other. I don't hold any overall negative opinion of you at all, and wasn't aware that you held one of me. So, I guess I'm sorry for whatever it is that I've done in the past to piss you off so much? But there's no hostility on this side of the fence.
Second of all, hyperpatriotic, me? I like to think I'm just a fair normal amount of patriotic. But hey, everyone is allowed to have their own opinion. Sorry about not mentioning the US in the initial post, I can assure you it had absolutely zero to do with my level of patriotism.
Third, thank you for taking the time to at least address my claims with a search. The reason I decided not to post a big mega post that might take me a half hour to construct was not because you were sarcastic, it was because I felt there was no use in wasting my time when you and Kwea clearly, CLEARLY felt my position was baseless, and especially in Kwea's words, that a little internet search was totally invalid compared to the mass of knowledge he has. So really, and I don't ask this flippantly, why would I really waste the time and effort?
I'm not trying to be petty, I'm just not going to waste my time. I've put forth the seeds of information that I think should at least be looked at and considered, despite what Kwea thinks, so you can all go out and find it if you want, I'm obviously not stopping you, and I don't hold any ill will towards either of you, I just think it's always a good idea to consider risks and consequences, no matter how slight they may be.
Posted by Belle (Member # 2314) on :
My husband delivers babies on a regular basis - the latest was just last week. The population he serves (he's a firefighter/paramedic working in inner-city Birmingham) tends to be urban poor. Many if not most of the babies he delivers are to mothers who report receiving zero prenatal care. Zero.
Prenatal care is available to these mothers, free of charge at local health department clinics located on bus routes so public transportation is available. He tells them this, and hands out informational brochures about the programs to anyone he sees on an ob-related call, but he cannot force them to go to the department to get the prenatal care.
We have an issue in this country - no denying it. But whose fault is it? If the programs are out there, and they are - Mrs. M is right - but people are not motivated to take advantage of what is offered, how far do we go? We cannot force young women to go to health clinics and get prenatal care for their unborn children.
We can have programs, do our best to get the word out (Mrs. M's group has the right idea reaching out to community settings) and try to make it more convenient, especially for those who don't have reliable transportation, but how far can we take it? I would suspect that the overrepresentation of minority children in infant mortality statistics is related to the overrepresentation of minority mothers living in poverty. Poverty is the enemy, not race or ethnicity. So how do you fix it, if as we've stated there are programs available but many people will not take advantage of them?
Posted by Dan_Frank (Member # 8488) on :
CT, I'm not specifically familiar with the study Mrs. M mentioned, so I have no interest in discussing the apparent ... murder? Negligent care? I'm not sure what you're insinuating here... of black infants.
However, the information about the disparity of recorded infant mortality rates is very real and confirmed by many sources. The US follows the WHO's definition of a a live birth; any infant which shows a sign of life, such as a breath or a heartbeat, outside the mother's womb. Even if they die within minutes of coming out.
Very few industrialized nations are nearly so generous in their definition of a living baby. Aside from length and weight and how early the birth is (all of which, outside our utterly horrible medical system, typically disqualify infants as being alive), in many countries, most newborns which died within 24 hours of birth were counted as stillbirths.
It's a fairly common phenomenon in and outside of medicine. A place (or person) that holds itself to a higher standard is more likely to fail to meet their standard. That doesn't actually mean their less competent than the alternatives. Usually, it means the opposite.
Posted by Kwea (Member # 2199) on :
Lyr, what makes you think I haven't in the past? I have, and am aware of a lot of potential problems. However, I also have formal knowledge of this that you don't, and that very few people in the US do. I have been a part of drug trials, on both sides of a stethoscope, and have a first hand grasp of the drug approval process. I know the weight the drug companies bring to bear, and I have a decent idea how much money drug companies contribute to our politicians.
I said you are smart, and that you have some good points. I also said that the level of fear in your posts was inaccurate. I admitted that there ARE groups that take advantage of the fact that it is not as regulated, and that scams do happen. I also pointed out that it is a problem within the borders of the US as well.
You challenged my knowledge base based on an internet search basically, but now you are offended because I was off base?
Whatever.
I don't think you are petty, and I have considered your points. I understand the risks and consequences, but my risk assessment is different than yours. Considering why it is different might be more constructive than continuing to pick at us.
My point has been pretty much overlooked by you actually.....we shouldn't have to go do another country to buy these drugs. It is disgusting that it is at times a better choice than buying them here.
Considering I have personal and professional experience that you don't, I am fine with that.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Dan_Frank: CT, I'm not specifically familiar with the study Mrs. M mentioned, so I have no interest in discussing the apparent ... murder? Negligent care? I'm not sure what you're insinuating here... of black infants.
Please. That's silly, as well as insulting, and it marks you as entering the discussion in bad faith. That's one mark -- you don't get two, at least not to discuss anything in depth with me.
I have a low tolerance of noise v. sound.
There is a difference in mortality rates. There are a host of potential explanations in the literature. If all you can come up with is murder or deliberate negligence, then the least insulting explanation I can come up with is that you must be hampered in mental creativity.
quote:However, the information about the disparity of recorded infant mortality rates is very real and confirmed by many sources. ... It's a fairly common phenomenon in and outside of medicine. A place (or person) that holds itself to a higher standard is more likely to fail to meet their standard. That doesn't actually mean their less competent than the alternatives. Usually, it means the opposite.
Right. So you should reread the study.
Again, it addresses mitigating some of the disparity by changing analysis, but -- by its own numbers -- confirms that a large disparity still exists.
Posted by ClaudiaTherese (Member # 923) on :
Belle, I completely agree with you that individual actions are a possible explanation for at least some of the disparity, although I have reason to think it is more complicated than that. However, the details of why is a complicated discussion probably worth a separate thread. (one I'd be willing to participate in, by the way)
Here I was addressing the interpretation of a particular study raised in a post, and the data given therein (and its interpretation in terms of the numbers themselves, regardless of reasons driving those numbers) was all I was speaking to directly. I say this explicitly not in order to pull back or shut down discussion, but to make clear why I wasn't responding to you, too. It's relevant and interesting, but it is more of a tangent than I want to take on int his thread, as infant mortality rates aren't the central issue I was discussing in the main flow of the thread, and -- though details came up -- I'm not willing to address more than just the details raised, unless the general conversation follows that line as well.
I am doing too much typing as it is. *grin
[ June 21, 2007, 02:24 PM: Message edited by: ClaudiaTherese ]
Posted by Lisa (Member # 8384) on :
quote:Originally posted by Angiomorphism: So Micheal Moore's new movie, Sicko, recently leaked. Since he has stated several times that he encourages illegal downloading and sharing of his movies (as long as it is not for profit), I decided to download it and see what all the fuss is about.
Since he's not the sole owner of the film, downloading it is just as illegal (and immoral, if you consider it immoral in general) as downloading any other film.
Posted by Angiomorphism (Member # 8184) on :
I don't think there is any mention of it being legal in there... in fact I think I explicitly mentioned it was illegal. And you hit the nail right on the head: I do not consider it immoral, especially considering that it is his intellectual property, and he doesn't mind, and in fact, encourages people to get the word out - it just means more money in his pockets.
EDIT: but getting into piracy really isn't the point of this thread.. you must be a lobbyist from the health care companies trying to derail this important topic! (I think Moore would agree)
Posted by Lyrhawn (Member # 7039) on :
quote:Originally posted by Kwea: Lyr, what makes you think I haven't in the past? I have, and am aware of a lot of potential problems. However, I also have formal knowledge of this that you don't, and that very few people in the US do. I have been a part of drug trials, on both sides of a stethoscope, and have a first hand grasp of the drug approval process. I know the weight the drug companies bring to bear, and I have a decent idea how much money drug companies contribute to our politicians.
I said you are smart, and that you have some good points. I also said that the level of fear in your posts was inaccurate. I admitted that there ARE groups that take advantage of the fact that it is not as regulated, and that scams do happen. I also pointed out that it is a problem within the borders of the US as well.
You challenged my knowledge base based on an internet search basically, but now you are offended because I was off base?
Whatever.
I don't think you are petty, and I have considered your points. I understand the risks and consequences, but my risk assessment is different than yours. Considering why it is different might be more constructive than continuing to pick at us.
My point has been pretty much overlooked by you actually.....we shouldn't have to go do another country to buy these drugs. It is disgusting that it is at times a better choice than buying them here.
Considering I have personal and professional experience that you don't, I am fine with that.
I'm not questioning your knowledge, at least, I'm not now. ::sheepish look:: I didn't know your credentials beforehand, and I was unfairly (to you) pissy in the midst of the last few posts we've made so I kind of ignored it.
Anyways, I accept that you have superior knowledge, and it's good to know the danger isn't nearly so pronounced. And I'm not offended, not personally anyways. I often don't mind being wrong or corrected (though sometimes I do, hey, we all have egos). I think the reason I was so snippy before (which I apologize for btw), is because I thought I was chiming in with a cautionary note, and I felt like I was being totally smacked down for it. Overreaction maybe, but every argument needs a devil's advocate.
Your overarching point is something I totally agree with, and given your expertise, you could probably answer the only question I'd have on the feasibility of doing such a thing (giving us cheaper drugs):
We subsidize the production of these drugs, which can cost billions to research, right? If the price were to suddenly bottom out in the US, I have to imagine the big Pharma companies would lose millions if not billions of dollars over the life of the drug, especially given they have a limited amount of time to recoup their losses before generics may be made for a fraction of the cost and sold at a fraction of the price. Correct?
If we drop the price in the US, how will they be able to afford to spend billions on research, absorbt the loss on failed drugs, recoup their research funds and still turn a profit? Or do we just raise the price everywhere else and lower ours to a global happy medium?
I don't accept that prices should be as expensive as they are, and I'm curious to see how we'd fairly, to both the people and the companies, set a price that everyone can live with.
Posted by Dan_Frank (Member # 8488) on :
quote:Please. That's silly, as well as insulting, and it marks you as entering the discussion in bad faith. That's one mark -- you don't get two, at least not to discuss anything in depth with me.
I don't know you from Eve, ma'am, and I'm quite certain I have no interest in being subjected to "marks" for the privilege of carrying on a conversation with you. So, if you decide you're done talking to me, I suppose I'll just soldier on as best I can.
Obviously you aren't insinutating literal murder. But from the tone I interpreted from your posts (which could of course be totally off the mark), you were insinuating that our health care system is killing more black babies through negligence/apathy/etc.
The least insulting interpretation I can think of is that a higher percentage of blacks live in poverty. So your point was more about our health care system with regards to the poor, and less about racism. But like I said, I don't know you, and a charge of racism isn't uncommon in discussions about this subject. There tends to be a lot of histrionics and hyperbole.
quote:Right. So you should reread the study.
I can't reread it if I've never read it. None of my information on this topic is based on that study. It's a Canadian study, right? Is there any particularly stunning credential this study has, that might convince me not to write it off? I wouldn't put much faith in a study of Israeli politics that was published by Hamas, and I don't have a lot of patience for critiques of our health care as done by the average Canadian.
That was a good example of the aforementioned hyperbole.
Hey Kwea, I'll freely admit I don't have a thimble of the expertise on the drug topic as you. So this question is just a shot in the dark, but I'm going to ask anyway.
Most companies, in general, try to hit the sweet spot of pricing with a maximum balance of purchasers and price, to get the best possible profit. That doesn't mean it's not still profitable to sell cheaper to other markets. Airlines have done this for years; charging different people what they think they can get that person to spend, for essentially the same product.
Isn't the issue of cheaper out-of-country drugs at least in part a result of this policy? They charge different markets what they think they can get away with. So long as every market is still bringing in a profit, they win.
I like a lot of what Lyrhawn just said too.
Posted by dkw (Member # 3264) on :
Since you don't know her and she won't toot her own horn, I'll fill you in that CT is a pediatrician. I also know that she's worked at a University hospital and been involved in research studies. And has a degree in medical ethics. I'm pretty confident that when she says that studies show poorer outcomes for black babies in the US she isn't insinuating anything about anyone's intent, merely pointing out that, contrary to what was earlier asserted, that we do not have the best outcomes in infant mortality rates for all population groups in this country.
Posted by fugu13 (Member # 2859) on :
Is her PhD in medical ethics or philosophy of science? I have vague recollections of the latter, but the former makes sense too.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Dan_Frank: I can't reread it if I've never read it. None of my information on this topic is based on that study.
Interesting that you still felt equipped to comment on it [the topic].
quote:It's a Canadian study, right? Is there any particularly stunning credential this study has, that might convince me not to write it off?
The same as for assessing any study. It is well-designed, published in a top-of-the-line peer-reviewed journal (Paediatric and Perinatal Epidemiology), and was performed through an internationally recognized academic and medical institution. The authors work with the Robert Wood Johnson Foundation and the Harvard School of Public Health as well.
Provincialism does not become you.
quote:I wouldn't put much faith in a study of Israeli politics that was published by Hamas
Odd comparison. Marks for creativity, after all. *amused
quote:and I don't have a lot of patience for critiques of our health care as done by the average Canadian.
Ah, yes, well, these are Canadians with epidemiological, medical, and statistical training. And your qualifications to assess medical epidemiology are ... ?
I'll follow up on the kind words of dkw and fugu13 above [and toot my own horn after all, as it is now relevant to the discussion]. I am a US-trained physician with a degree in medical ethics who spent 2 further years in an NIH-funded research fellowship as a National Service Research Award Fellow studying healthcare outcomes in international pediatric populations, particularly with respect to substance abuse, poverty, and risk-taking behavior. I did some cross-training in Canada and currently teach medical students in British Columbia how to critically assess medical literature as well as how to practice medicine.
I am American, not Canadian. But I care enough about making the US system the best it can be to look wherever I can for good, solid, scientific information to use in improving it. To do otherwise seems to treat that topic as one not worth the utmost care and importance, and I find that egregious.
[ June 22, 2007, 12:19 PM: Message edited by: ClaudiaTherese ]
Posted by ClaudiaTherese (Member # 923) on :
quote:I'm pretty confident that when she says that studies show poorer outcomes for black babies in the US she isn't insinuating anything about anyone's intent, merely pointing out that, contrary to what was earlier asserted, that we do not have the best outcomes in infant mortality rates for all population groups in this country.
And most assuredly what dkw said. (Thanks! )
As I clarified in my post to Belle above, I was not commenting on whether individual choices and/or the influences of poverty in other ways played a role, or to the extent it played a role. I think it does, but that is tangential to my posts -- I was commenting on the interpretation of the data in this article, as I went back and looked at the numbers myself. I think that there are many sources online which are taking the implications of the study to be greater than intended by the authors of the study, as from the article itself, they acknowledge that what they see is a mitigation of the disparity, although they acknowledge that a great disparity does still exist.
You see, Dan_Frank, these Canadian authors published an article that was arguing against the US numbers being as bad as is generally presented. Yes, the same Canadians you were disparaging.
Posted by orlox (Member # 2392) on :
[ June 22, 2007, 05:02 PM: Message edited by: orlox ]
Posted by sndrake (Member # 4941) on :
Diane and I went to the Chicago rally yesterday - speakers included Studs Terkel, Michael Moore, and Quentin Young (National Coordinator of the Physicians for a National Health Program).
Then we went and watched SiCKO at a theater a mile away. Free tickets for members of sponsoring organizations. Posted by JLM (Member # 7800) on :
We have an nice little universal healthcare experiment going on in Massachusetts. Lets wait a few years (at least 5) and see how well it works before we even think about wading into the waters at a national level.
Posted by sndrake (Member # 4941) on :
Video of the rally at our local Fox channel, includes a brief shot of Diane wearing her "Not Dead Yet" tshirt. (I'm there, too, but my head's cut off in the clip.)
Posted by mackillian (Member # 586) on :
I'm not sure of the Massachusetts healthcare experiment is exactly universal healthcare. Residents are now legally required to purchase heath insurance, like the requirement that insurance must be purchased for cars.
edit: sndrake—diane's shirt made me giggle, especially knowing her sense of humor
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by JLM: We have an nice little universal healthcare experiment going on in Massachusetts. Lets wait a few years (at least 5) and see how well it works before we even think about wading into the waters at a national level.
Alternatively, you could look at the outcomes of the 50 state-wide programs providing universal access to children that have been in place for the last 10 years, as per Title XXI of the Social Security Act.
Posted by Icec0o1 (Member # 8157) on :
quote:WE pay for ALL the research and development for most of the drug companies, and the rest of the world pays almost nothing of the cost compared to us. THAT is why they are more expensive here then anywhere else in the world.
That's what the drug companies brainwash the American public to think and it's complete BULL. It does not take billions of dollars to create a drug. Most of the enormous amounts of money the drug companies make go towards TV and other advertisement, gifts and lunches to doctors who prescribe the drugs, lawyers, and of course a thick lining of the corporation's pockets.
Drugs aren't expensive because of R&D, it's because they're a necessity and drug companies can charge anything they want for them.
Posted by Angiomorphism (Member # 8184) on :
Case and point, Genetech's Avastin and Herceptin, two revolutionary cancer drugs, priced through the roof, just because they can be:
_________________________________________
Until now, drug makers have typically defended high prices by noting the cost of developing new medicines. But executives at Genentech and its majority owner, Roche, are now using a separate argument — citing the inherent value of life-sustaining therapies.
If society wants the benefits, they say, it must be ready to spend more for treatments like Avastin and another of the company's cancer drugs, Herceptin, which sells for $40,000 a year.
"As we look at Avastin and Herceptin pricing, right now the health economics hold up, and therefore I don't see any reason to be touching them," said William M. Burns, the chief executive of Roche's pharmaceutical division and a member of Genentech's board. "The pressure on society to use strong and good products is there." ____________________________________________
quote:I'm there, too, but my head's cut off in the clip.
Wow. You guys are SERIOUS about that "no disability makes me less of a human" rhetoric. Posted by Samprimary (Member # 8561) on :
quote:Originally posted by Dan_Frank: [QB] Samprimary, you seem to have an idealized view of European socialized medicine.
I wish I could idealize, but about the best I'm saying for their systems is that 'they work better than the American system.'
This is like idealizing a car by saying that it isn't a rusted hulk sitting on blocks. Glowing praise, indeed.
And if one doesn't turn a limited anecdotal perspective into a scientific study of which system is better, the socialized systems win, hands down. There is not even a comparison. The American system is a failure.
We have fewer doctors per capita. We go to the hospital less frequently. We waste many orders of magnitude more of our healthcare costs on inefficient bureaucracy and paperwork. We are less satisfied with the healthcare we receive. We have about the lowest life expectancy of any modern nation, and we have higher infant mortality rates than some developing countries. It's obscene.
And, of course, every single other country in the industrialized world insures every single one of its citizens. We spend hundreds of billions of dollars more on health care -- over two and a half times the industrialized world's median -- and still leave over 50 million people without insurance of any sort.
And if you'll excuse my sudden bluntness, I'm going to jump on the idea of having limited tolerance for noise. Don't waste time with useless anecdotal criticism, and don't try to run an Argument by Question.
Posted by Samprimary (Member # 8561) on :
I watched Sicko.
THE BAD:
- Heavy anecdotal pressuring - Emotional appeals - Michael Moore is still smarmy - So are his sound and retro video clips
THE GOOD:
- Essentially right - Makes sure to establish that it's actually covering the story of America's 'insured' patients - Picks on all the right baddies, including incriminating evidence about Nixon's collaborations - Sickening - Actually goes a fair bit into the damning statistics about american health care - Hillary Clinton gets some overglorification. You THINK. Then there's a startling plot twist! - Pillories the false crap that is used to defensively demonize socialized healthcare - Actually turns some of that on its head in a creative way: in the same field, we've socialized nearly every other public service and it works ... better?
I mean, he's attacking the American healthcare system. How easy does it get? He had it made with this one.
As a person who won't sit through his other movies, I think everyone needs to suck it up and watch this one.
Posted by Icarus (Member # 3162) on :
What's the point in watching if you already agree? (Or, frankly, if you're educated on the topic at all?) It won't help you discuss the issue, if it's true to Michael Moore form, because it will be so full of half-truths that anybody knowledgeable on the other side will skewer you if you try. It's not really educational. So you get a fun rah-rah! for your side, but is that worth the nine bucks?
I can see hoping that the uneducated and the apathetic on the other side see it, because it may change their views and motivate them. I don't feel that way personally, though. For one thing, if they're on the other side and unmotivated, they won't be interested in this movie. For another, it feels vaguely intellectually dishonest of me to wish for easy conversions from propaganda.
ADDED: I wish Michael Moore movies weren't on the scene. As someone who agree with him on some major issues, I don't think they help at all. I think he damages discourse.
Posted by Dagonee (Member # 5818) on :
quote:It does not take billions of dollars to create a drug.
No, it takes about $800 million, counting everything necessary to get approval to offer the drug on the market.
I used to work for a pharmaceutical company. It was about seven years ago, so my first hand info is definitely out of date, but I can promise you that R&D is in fact a huge part of the budget, even more than sales and marketing.
And, sales and marketing efforts wouldn't have to be so aggressive and thus so expensive if drug companies weren't pressured to have to make back all the R&D cost so quickly because of expiring patents and cheap generics.
Don't forget about the R&D on all the drugs that didn't make it to the market.
Oh, and compliance costs a lot of money. We actually employed more people in our regulatory department than we did our marketing department. Regulatory's job was to ensure drug safety and compliance with all FDA regulations. Those regulations are exact and very detailed and we got audited twice while I worked there, big drug companies get audited even more often. Those are good things, though for the American consumer. The FDA inspectors came in and checked things like whether we were keeping proper records on our samples (in case of recall), were the drugs stored at the proper temperature, was all packaging labeling correct, etc.
America does have the safest drug supply in the world, but that safety costs money. We also had an indigent program where we supplied drugs to people who couldn't afford it. Most if not all pharmaceutical companies have similar programs. Since we marketed a drug to kids with cystic fibrosis, we were also very active in the local CF charity events, and donated quite a lot of money not to mention pretty much every employee volunteered time in such activities.
Lest you think I'm a Big Pharma Kool-Aid drinker, however, I do feel obligated to point out that much of what was spent in the sales and marketing department was excessive. We did not need to hold sales meetings in exotic locales when brining our reps to Birmingham Alabama would have served just fine and been a lot cheaper. Yes, there is a lot of waste. However, I don't think pharmaceutical companies deserve quite the bad rap they always get. There's a lot going on the average public doesn't know about. Saying that R&D costs money is not an excuse to charge vast amounts for a drug because R&D really DOES cost money. So does regulatory, so do indigent care programs.
Posted by Bob the Lawyer (Member # 3278) on :
Belle, out of curiousity, roughly how large was the company you worked for? (~number of employees. tens, hundreds, thousands, tens of thousands?)
Posted by Belle (Member # 2314) on :
Hundreds. We were very small. While I worked there they only marketed one prescription drug and several other non-prescription. They have since been purchased by a large company and absorbed into the larger one.
Posted by Kwea (Member # 2199) on :
quote:Originally posted by Icec0o1:
quote:WE pay for ALL the research and development for most of the drug companies, and the rest of the world pays almost nothing of the cost compared to us. THAT is why they are more expensive here then anywhere else in the world.
That's what the drug companies brainwash the American public to think and it's complete BULL. It does not take billions of dollars to create a drug. Most of the enormous amounts of money the drug companies make go towards TV and other advertisement, gifts and lunches to doctors who prescribe the drugs, lawyers, and of course a thick lining of the corporation's pockets.
Drugs aren't expensive because of R&D, it's because they're a necessity and drug companies can charge anything they want for them.
Bullshit.
How much does a single study cost, on average? I know, because I was a part of 12 of them....but I bet you have no idea.
How many studies are required, on average, before a drug is approved? What are the legal repercussions if a drug is unsafe, even if it passes every single clinical study the USDA requires before being released. What type of liability does the drug company have in those cases?
How many lawsuits does an average drug company deal with per day?
What percent of all drugs under development actually make it to the shelf? What is the average cost of each one that doesn't make it, and how long does it take before the company finds out it isn't effective?
What type of liability does the company assume during the testing process?
What is the average time frame before a drug becomes available?
Before you make any such claims again, you should be able to answer...and document each answer...each of those. And that is just to get the BASICS down, the basics of the claim you have already made.
Ours system is broke, no doubt. A lot of money DOES go to some of what you mentioned. But a HUGE part of it goes to R&D.
Ignorance isn't the cure.
[ June 23, 2007, 08:19 PM: Message edited by: Kwea ]
Posted by Bob the Lawyer (Member # 3278) on :
Kwea, if you know half as much as you say you do you know that most of those questions don't have answers. What's an "average" drug company? The size of the company and the nature of the work they're conducting has an enormous impact on costs.
Not to mention that lawyer costs are in a different category. The fact that drug companies have to employ many, many more lawyers than research scientists may well be a problem, but it's a different problem from research costs.
I also wonder how applicable your time with USAMRIID is. Their drug targets are, by and large, completely different from what Big PharmaTM goes after (which is another huge problem with the system).
For that matter, I think you're suffering from the same problem, Belle. Small start up companies generally look at diseases that Big PharmaTM does not, and generally goes about their research "by the fine touch of a chemist's hand." Nobody who has the money not to that does that. The game is so different between companies with a few hundred people than one with thousands that it's not really fair to compare.
Posted by Kwea (Member # 2199) on :
quote:Originally posted by Bob the Lawyer: Kwea, if you know half as much as you say you do you know that most of those questions don't have answers. What's an "average" drug company? The size of the company and the nature of the work they're conducting has an enormous impact on costs.
Not to mention that lawyer costs are in a different category. The fact that drug companies have to employ many, many more lawyers than research scientists may well be a problem, but it's a different problem from research costs.
I also wonder how applicable your time with USAMRIID is. Their drug targets are, by and large, completely different from what Big PharmaTM goes after (which is another huge problem with the system).
For that matter, I think you're suffering from the same problem, Belle. Small start up companies generally look at diseases that Big PharmaTM does not, and generally goes about their research "by the fine touch of a chemist's hand." Nobody who has the money not to that does that. The game is so different between companies with a few hundred people than one with thousands that it's not really fair to compare.
There are answers, but some of them are not clearly defined. That in itself was a correct answer to some of those questions.
USAMRIID is the place that created (after some very dangerous and sometimes immoral experiments in the past) one of the best informed-consent programs for human testing of drug protocols in the world, a model that is held up as a gold standard for human testing of final stage protocols all over the world.
I realize that not all of the costs are the same, but I have a better-than-average knowledge of the system used and it's costs than most. I am NOT an expert....12 years ago was when I had the majority of my experience, and a lot of that was a the lower end of those protocols. The LEAST expensive protocol I worked o was well in excess of 2.3 million dollars, though...just to give a baseline for comparison. That was for the final stage alone...there were 6 other stages before that, and 3 other groups after mine, to address complications that were a part of our study.
I am not aware of the final costs, but it was AT LEAST half a billion if I had to guess.....not including production, of course. That was also using our world-class labs and personell.
The Army has LOWER costs than the drug companies on average, and their base findings are more dependable on average because their base population for MRVS's are healthier, with fewer confounding complications than most test populations.
Bob, the only reason I addressed the points of lawyers is that that IS an associated cost for companies that test on humans, even with informed consent. It is also a HUGE part of the risk assessment of a drug protocol, which bears on the over all cost of R&D in general.
I personally worked on new anti-Malarial drugs, Chick/VEE, Hantana, and RVF protocols. Most of the work USAMRIID does is NOT related to biological counters, although there are some of those going on all the time as well.
You can find stats on the "average" cost of a lot of the points I brought up earlier, but you are correct in assuming that the size of the companies involved plays a part in the over all cost of medical research. The problem is that the risks are so high that all it takes to bankrupt even a fairly large company is one or two drugs that don't pan out....or even worse, accidentally ccause harm to people taking it. Most drugs tested never pan out, but that doesn't mean it didn't take millions of dollars to find that out.
Lyr.....don't worry about it. I am fairly knowledgeable about these issues, but hardly an expert. I did my homework, to be sure, but every person should always make up their own mind about serious issues like these. I just happen to have some personal...and professional... experiences that helped me make up my own mind.
Dan...that is part of the problem. Medical knowledge does belong to those who discover and develop it. They should be able to price it according to a market value, but there also has to be some sort of balance between that and the common good. It isn't black and white....but the grays are pretty dark these days, IMO.
Point blank...we spend more money for less results than almost any other country, and that has to change, one way or another.
[ June 24, 2007, 01:52 AM: Message edited by: Kwea ]
Posted by Xaposert (Member # 1612) on :
quote:What's the point in watching if you already agree? (Or, frankly, if you're educated on the topic at all?) It won't help you discuss the issue, if it's true to Michael Moore form, because it will be so full of half-truths that anybody knowledgeable on the other side will skewer you if you try. It's not really educational. So you get a fun rah-rah! for your side, but is that worth the nine bucks?
Is it ever be worthwhile for an educated person to read or watch a persuasive essay, article, book, or film? All of these will deliberately slant the truth towards whatever the work is persuading us to agree with, and will show only a set of facts that the author believes shows his conclusion to be true, but does that make the work worthless and not really educational?
Posted by Bob the Lawyer (Member # 3278) on :
Ah, I had thought you were referring to lawyers handling suits after the drug was released and resolving patent issues, neither of which should really be factored into R&D (although patent lawyers often are, I believe).
The reason I questioned your experience is because the design philosophy of the army and Big PharmTM are completely opposed. The army works on new vaccines. Large American companies, as a general rule, do not. Heck, just looking for novel cures is a big difference. The money is in treatments for conditions that already have treatments on the market. Sure chemical libraries cost a lot of money, but you already know where to look.
I disagree with your risk assessment. Or rather, I agree but think what I just mentioned above is how companies have worked around it. Once you're using chemical libraries based on existing comounds and using preclinical simulations software (which, to be fair, didn't exist 12 years ago), your risk plummets and your development cycle shrinks by a few years. (5-7 years standard as opposed to 10ish). At this point, how much of a risk are you taking? A big one, but not nearly the risk that most people think.
Most drugs don't pan out. Most drugs don't cost millions of dollars to find that out. Anything before preclinical is pretty cheap, and preclinical is getting cheaper and cheaper. The ~3 drugs that make it to clinical trials are where the expense lies.
Pardon this if it rambles and meanders. I just got off a 12 hour shift Posted by Kwea (Member # 2199) on :
No....I agree to a point, although as you said a lot of things depend on a number of variables.
Hell...I know about this stuff more than most, but as I said I am hardly an expert. My experience was in administering those drugs and recording data for the study, not in drawing up compounds for testing myself. However, my day day to day job was in the safety office so I got a fairly well-rounded view of the whole process.
I am a fine jewelry manager these days, and I know more about that than I do about safety OR drug development.
But to say that R&D isn't a major cost, if not THE major cost, is complete bunk.
Gotta love thread shift. Posted by Chanie (Member # 9544) on :
I am wondering whether the average American with decent health insurance gets better/worse/same health care as a Canadian. Is the wait time less? Are there tests/treatments better? Does it depend on whether it is a routine problem (say ear infection) or a serious problem (maybe a heart attack)? I have seen statistics such as life expectancy and cost/person for an entire country's health care system. But a lot of detail can be lost in those aggregates.
Why *are* the drug prices so radically different? I got my prescription when I was in Spain for less than I pay with insurance, and 10% of what I would have paid without insurance. Are other countries subsidizing those drugs? I would imagine they are, and if Americans started allowing mass imports, they would stop allowing them out of the country. Allowing drugs from Canada doesn't seem like a viable solution to me.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Chanie: But a lot of detail can be lost in those aggregates.
Aggregates are made up of details -- large numbers of details. Where details really get lost is when you focus on individual cases, since that way you lose everyone eles's details.
That being said, I'd be happy to try to answer your question, but I'm not sure I can make sense of it yet. What do you mean by "average American" and "a Canadian"? American with the most common brand of insurance, or American with the median income, or American most like you (sometimes people do mean this), or what? And by "a Canadian," do you mean "most Canadians" or an "average Canadian" (see previous)?
Canadians don't actually all get the same experience of healthcare. There are federal funds [as well as provincial], but they are allocated provincially, so there are differences between provinces. Also, if you are way out in a relatively unpopulated area, your healthcare experience is driven as much by travel issues as it is by insurance.
Posted by Chanie (Member # 9544) on :
Ah, sorry. I meant, for Mrs. M.'s example of premie care on the previous page. One could say that a certain country spent less of premie care and got the same life expectancy. But are more of the premies disabled? I was trying to say that perhaps if you randomly chose a set of premies that had similar birth circumstances and compared them after say a year, you may be able to get a better idea of the quality.
I guess for American, I would go with "most common plan on the most common insurance." Pretty much everyone that I discuss this with has health insurance. Their argument is that if we went to a system like Canada, those who currently have health care would get better service. But people like them (say assistant professors) would have inferior care than what they currently have.
I guess what I'm asking it how the median American with insurance compares with the median Canadian. I know it's not a rigorous measure, but what I have not really been able to find is an objective measure. For example, does the median Canadian wait longer/shorter if they have an ear infection and want to see a doctor? What if they have back pain? This is the sorta question that while not comprehensive, at least gives an intuitive way to compare health care systems.
I thank you for any help you can be answering these questions.
Posted by Bob the Lawyer (Member # 3278) on :
quote: But to say that R&D isn't a major cost, if not THE major cost, is complete bunk.
Well, R&D and marketing combined are a drop in the bucket in comparison to production costs.
quote:No....I agree to a point, although as you said a lot of things depend on a number of variables.
Hey, that's something, I'm not even sure I know what my point was! Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Chanie: I was trying to say that perhaps if you randomly chose a set of premies that had similar birth circumstances and compared them after say a year, you may be able to get a better idea of the quality.
This is indeed what is done in many of the comparison studies already referenced. A sample population is drawn randomly, double-checked to make sure it is representative, and then generalized to the whole population.
Sometimes there are aggregate numbers used for the whole population, but often these are not available, so samples are used.
quote:I guess for American, I would go with "most common plan on the most common insurance."
I'm pretty sure that no individual plan covers more than Kaiser Permanente, which has a total of 8.5 million plan members. So there are more people with no insurance plan (~46 million) than there are with any given private plan. (And I think Kaiser offers multiple plans, so even the 8.5 million is probably smaller.)
We could use "no plan," though, since it is technically the most common individual plan by how I understand what you are asking for.
quote:Pretty much everyone that I discuss this with has health insurance. Their argument is that if we went to a system like Canada, those who currently have health care would get better service. But people like them (say assistant professors) would have inferior care than what they currently have.
I don't think the data supports this, but I am not sure why many people believe many of the things they do.
quote:I guess what I'm asking it how the median American with insurance compares with the median Canadian.
"Median" always has to refer to some particular scale, and until I am sure what scale you are using, I don't think I can make sense of the term you are using. It is too vague to mean anything specific, and you have to be specific if you are going to compare numbers.
quote:For example, does the median Canadian wait longer/shorter if they have an ear infection and want to see a doctor? What if they have back pain? This is the sorta question that while not comprehensive, at least gives an intuitive way to compare health care systems.
Again, it's hard to be specific without defining the terms carefully. But I expect that for most primary care types of problems (which are most problems people see a physician about), Candians probably wait less on average to be seen by a physician. This is because Canadians with a healthcare insurance from any of the provinces can walk into any primary care doctor's office -- anywhere in Canada -- and have that visit covered by their insurance.
In contrast, many (if not most) Americans with private insurance have HMO plans, which means they are only covered (for most common problems) if they see one of a very limited number of physicians employed by their HMO. Otherwise, they have to pay out of pocket.
But that is just a hazarded guess based on how the systems work -- we'd have to define terms more carefully to look at actual numbers.
quote:I thank you for any help you can be answering these questions.
Delighted! They are interesting questions.
----
Edited to add: You could also look at the numbers of people on Medicaid, Medicare, and/or other State or Federal programs and look at wait times, if you included these as "insurance plans." (You seemed to be going for private plans, not public, though.) Many premature infants are covered on non-private plans, for example.
[ June 24, 2007, 04:08 PM: Message edited by: ClaudiaTherese ]
Posted by jlt (Member # 10088) on :
Just commenting on my own experience... My friend who moved here from England (her family moved because of business) who has a chronic joint problem (she's in the hospital almost once a week, with big needles to drain stuff)said that the system in England was slow at first but that once you had a doctor and regular appointments things were fine. I asked her if it was more expensive here- she said very much so. Also, I wanted to bring up that bureaucracy is rarely efficient, for example, the state run hospitals where I live are much worse than the private ones. Personally, I like the idea of both private and public healthcare co existing (if it was possible). I think that if someone really needs treatment for an injury or illness, or something lifesaving, then (in almost all cases-there's so many what ifs)they should be able to get it without having to worry about the cost. But I really don't know enough about the issue to make a strong judgement.
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