Worst Health Care system in the world

[South Lorenya]

Any religion that insists on only using faith healing.

[Pevisopolis]

I believe USA was ranked 37, or something near that. Next to Slovenia.

For the record, Cuba was higher on the list than we were. Up in the teens or maybe 20s somewhere.

[Classical Liberal]

I believe USA was ranked 37, or something near that. Next to Slovenia.

For the record, Cuba was higher on the list than we were. Up in the teens or maybe 20s somewhere.

Fail on where those statics came from no doubt

[The Tofu Islands]

I believe USA was ranked 37, or something near that. Next to Slovenia.

For the record, Cuba was higher on the list than we were. Up in the teens or maybe 20s somewhere.

Actually, on that list, Cuba is ranked 39.

The US is beaten by, among others, Costa Rica, Dominica, and Chile.

Fail on where those statics came from no doubt

You mean the World Health Organisation?

[Tekania]

Fail on where those statics came from no doubt

You mean the World Health Organisation?

Well, you know, WHO statics on the quality of health care don't work the same way they do by US standards... They measure by standards such as the average life-expectancy of the population, the percentage of the population who have access to preventative care, and such...

US standards are more along the line of how expensive "the maching that goes ping" is, how many times of year the doctors get to upgrade their BMW to a newer model, and how many hundreds of percent they can mark up basic medical supplies for (like $40 ace bandages, and $5 aspirin tablets)... You know, "the important stuff".

[The Majority of this post is sarcasm; and is not intended to represent the views of the post author...]

[United Russian State]

Umm...Cuba by far. <.< How the hell is Europe, even America worse than Cuba.

[The Tofu Islands]

Umm...Cuba by far. <.< How the hell is Europe, even America worse than Cuba.

Cuba beats the US in at least some places, such as infant mortality rate.

Besides, the correct answer is "Other" as it includes all the various dirt-poor countries around the world.

[Zoingo]

Question: Why should health care be done for profit? It would seem that helping people and saving lives should be done by people who's first concern is making sure their charge gets better, not that their charge spends money. The fact is, without health care, people die. That fact alone should make it accessible to anyone, regardless of the size of their pocket book. The troubling fact in America is that many people are left to die because a private insurance company exploits a loophole to deny them care that they cannot afford without insurance. A hospital, who's first concern is making a profit, will not treat someone in that condition, because they cannot turn a profit. If said person ends up in the emergency room to receive treatment they cannot afford, guess who ends up paying for them? You and I, as the hospital jacks it rates to cover those who cannot pay. If the insurance company hadn't denied out patient care, he would have lived, and our bills would be lower. Everybody wins.

When considering health care, it also makes sense to study the rest of the world. Look at France, for example. They have a very effective system that manages to combine both public and private insurance. The main way they do this is through paying for medical school, which allows them to control the number of GP's to specialists, a ratio that is sorely skewed to the specialist side in America. This means that your average American actually waits longer for annual checkups. These checkups are the most effective form of health care a system can provide, because they allow potential problems to be spotted and corrected long before they become life threating and expensive to treat. At the very least, everyone should be given basic access to their doctor for a checkup once a year if they want to have one. The same should be true for dentists.

The question is not healthcare, but health insurance, when talking about healthcare, that is reference to accessibility to doctors, physicians, dentists, radiologists, etc. etc. which the USA arrives at the near top in the number of these specialists, due to the money involved in these professions (like anesthesiologists). This would also include access to pharmaceuticals, MRI's, and other things that go into the system itself, which the USA is known for. Yes, without Healthcare you would most certainly die at some point, but as far as the medical system, the United States has one of the largest number of physicians per capital, as well as has 20 of the top 40 drug companies in the entire world (however, as far as emergency services, the US has a few problems with the time, with non-immediate surgeries, the US ranks quite well). The real problem is paying for it.

Health Insurance is the ability for a person to pay and access these systems, in which the US has a few problems. If you think about socialized medicine countries, it is basically the same thing as regular insurance, only it is paid for by the government, and you pay for it in your taxes as some point. In the United States, it is a blend of it, with 2 government options and over 40 different private insurers, which here underlies the problem. In order to not pay out as many premiums, insurers try to deny you as much coverage as they can, in this case, denying a person coverage due to preexisting conditions. Also, the access to insurance is a problem, as many states have barred the buying of insurance across state lines, which drives up the price of insurance in places with high populations and low numbers of insurance companies. Now, what the current administration could do is do something along the lines of the Credit Card Affordability Act, and bar insurance companies from denying pre-existing conditions, relax regulations on starting insurance companies, allow people to buy insurance across state lines, and extend the government plans that we currently have to those who do not have health insurance. That would cut costs if coupled with malpractice court reform, and would alleviate headaches with the current situation that we have.

[Tunizcha]

*snip*

Despite your flaws in argument, you do bring up a decent point that the United States is not the same as Canada or any other place, health wise. I would bet that our lower life expectancy can be more traced to the american Obesity epidemic and the relatively sedentary lifestyle that a sizable portion of Americans live. Not to say that access to health care is a small matter, of course. I only venture to say that if you were to remove obese and diabetic people from the US population, I would guess that life expectancy would increase. Of course, I have no hard evidence for this, so I just thought I'd toss it out there.

I wouldn't call between 3 and 4% of deaths negligible. That could likely impact our ratings enough to boost the life expectancy rating at least by one slot.

link:

http://www.benbest.com/lifeext/causes.html

Sure, you would increase the life expectancy of a nation if you removed the obese, but the same would happen if you remove heart failures, cancer patients, etc., etc. The fact of the matter is that those people are a part of the nation's health. As for murders, couldn't you argue that those are a result of mental health?

Fail on where those statics came from no doubt

You mean the World Health Organisation?

Well, you know, WHO statics on the quality of health care don't work the same way they do by US standards... They measure by standards such as the average life-expectancy of the population, the percentage of the population who have access to preventative care, and such...

*snip*

(Tekania, ignore this, it's just a defense an argument surely to come up)
As for those who argue that the WHO bases its rankings on different factors than those that matter, I'll give you a little tidbit of just how they calculate them.

DALYs are a gap measure; they measure the gap between a population's actual health and some defined
goal, while healthy life expectancy (HALE) belongs to the family of health expectancies, summarizing the
expected number of years to be lived in what might be termed the equivalent of "full health". As described in
Chapter 3, healthy life expectancy provides the best available single number SMPH for measuring the overall
level of health for populations in a way that is appropriately sensitive to probabilities of survival and death and
to the prevalence and severity of health states among the population. WHO has used healthy life expectancy
as the measure of the average level of health of the populations of Member States in its World Health Report
(WHR) for annually reporting on population health (WHO 2000, WHO 2001). Following feedback from WHO
Member States and to better reflect the inclusion of all states of health in the calculation of healthy life
expectancy, the name of the indicator used to measure healthy life expectancy was changed from disabilityadjusted
life expectancy (DALE) in the WHR 2000 to health-adjusted life expectancy (HALE) in the WHR
2001.
Two different types of methods have been used for calculating health expectancies: Sullivan’s method and
multistate life table methods. All healthy life expectancies calculated to date from burden of disease studies
have used Sullivan’s method. This Involves using the observed prevalence of disability at each age in the
current population (at a given point of time) to divide the hypothetical years of life lived by a period life table
cohort at different ages into years with and without disability. Sullivan’s method requires only a population life
table and prevalence data for the health states of interest.

[Rolling squid]

The question is not healthcare, but health insurance, when talking about healthcare, that is reference to accessibility to doctors, physicians, dentists, radiologists, etc. etc. which the USA arrives at the near top in the number of these specialists, due to the money involved in these professions (like anesthesiologists). This would also include access to pharmaceuticals, MRI's, and other things that go into the system itself, which the USA is known for. Yes, without Healthcare you would most certainly die at some point, but as far as the medical system, the United States has one of the largest number of physicians per capital, as well as has 20 of the top 40 drug companies in the entire world (however, as far as emergency services, the US has a few problems with the time, with non-immediate surgeries, the US ranks quite well). The real problem is paying for it.

Health Insurance is the ability for a person to pay and access these systems, in which the US has a few problems. If you think about socialized medicine countries, it is basically the same thing as regular insurance, only it is paid for by the government, and you pay for it in your taxes as some point. In the United States, it is a blend of it, with 2 government options and over 40 different private insurers, which here underlies the problem. In order to not pay out as many premiums, insurers try to deny you as much coverage as they can, in this case, denying a person coverage due to preexisting conditions. Also, the access to insurance is a problem, as many states have barred the buying of insurance across state lines, which drives up the price of insurance in places with high populations and low numbers of insurance companies. Now, what the current administration could do is do something along the lines of the Credit Card Affordability Act, and bar insurance companies from denying pre-existing conditions, relax regulations on starting insurance companies, allow people to buy insurance across state lines, and extend the government plans that we currently have to those who do not have health insurance. That would cut costs if coupled with malpractice court reform, and would alleviate headaches with the current situation that we have.

So aside from arguing over semantics, we both agree that less people should be denied health care, via denying their claims. The problem with your suggestion of relaxing regulation on the creation insurance companies of is that it creates the possibility of unsustainable companies. You want insurance companies to be very solvent. That being said, I like the ideas of relaxing the state lines policy, and making it illegal to deny a preexisting condition claim, or for that matter denying a claim for being experimental.

The problem with the American health care system as it currently stands is the lack of General practitioners, which make it hard for your average citizen to see their GP. This lack of preventative care is what dooms the American system. The answer lies in subsidizing medical school for those who want to become GP's, creating more and making it easier for people to get to see their doctor. That is the least we should do. I personally would like to see a single payer system that borrows elements from the French, Canadian and British systems.

[Buffett and Colbert]

According to WHO, Myanmar has the worst.

Damn your "fast" fingers...

[Neu Leonstein]

The problem with your suggestion of relaxing regulation on the creation insurance companies of is that it creates the possibility of unsustainable companies. You want insurance companies to be very solvent. That being said, I like the ideas of relaxing the state lines policy, and making it illegal to deny a preexisting condition claim, or for that matter denying a claim for being experimental.

Do you see that you're contradicting yourself here? The more safe an insurance can play it, the more solvent it is as far as expected pay-outs go. By making it illegal to deny people who one can be virtually certain to cost a lot of money, you'd not be doing the sustainability of the system (or the premia people pay) any favours.

Posner has it right - what needs to change is the way health insurance in the US is usually linked to one's job, due to tax incentives and the like. That's why many people don't bother beyond their job, and when they lose it they find that suddenly they're old, potentially unhealthy and have a hard time getting a different insurance.

[Tech-gnosis]

Do you see that you're contradicting yourself here? The more safe an insurance can play it, the more solvent it is as far as expected pay-outs go. By making it illegal to deny people who one can be virtually certain to cost a lot of money, you'd not be doing the sustainability of the system (or the premia people pay) any favours.

To keep the costs down for a system that makes it illegal to deny coverage for those with pre-existing conditions getting insurance should be mandatory. That way the risk is spread and everyone is covered.

Posner has it right - what needs to change is the way health insurance in the US is usually linked to one's job, due to tax incentives and the like. That's why many people don't bother beyond their job, and when they lose it they find that suddenly they're old, potentially unhealthy and have a hard time getting a different insurance.

Many people don't bother with insurance beyond their work because its expensive and because they'll have to pay extra for pre-existing conditions and the like. Also, in a free market how would the elderly generally not be priced out of the market?

[Rolling squid]

Do you see that you're contradicting yourself here? The more safe an insurance can play it, the more solvent it is as far as expected pay-outs go. By making it illegal to deny people who one can be virtually certain to cost a lot of money, you'd not be doing the sustainability of the system (or the premia people pay) any favours.

Posner has it right - what needs to change is the way health insurance in the US is usually linked to one's job, due to tax incentives and the like. That's why many people don't bother beyond their job, and when they lose it they find that suddenly they're old, potentially unhealthy and have a hard time getting a different insurance.

I'm not contradicting myself at all. The large current insurance companies are rolling in the profit, they can afford to pay many more claims than they do currently. However, insurance companies require large amounts of start-up capital to begin, capital that is hard to come by. Relaxing regulations on creation of insurance companies will open the doors to companies that promise low rates and high coverage, however, when it comes time to pay out, they will not have the necessary capital and go out of business, leaving customers SOL. These companies will also ruin the market for insurance; their low rates will drive actual companies out of business.

[Dyakovo]

Sicko is propagandistic trash,<SNIP>.

I was with you up to there, and then you had to go back to your standby of doing your imitation of AP, only substituting Ayn Rand for Stalin...

[Yootopia]

I dunno, probably some shithole like Haiti or something.

[Bluth Corporation]

Do you see that you're contradicting yourself here? The more safe an insurance can play it, the more solvent it is as far as expected pay-outs go. By making it illegal to deny people who one can be virtually certain to cost a lot of money, you'd not be doing the sustainability of the system (or the premia people pay) any favours.

To keep the costs down for a system that makes it illegal to deny coverage for those with pre-existing conditions getting insurance should be mandatory. That way the risk is spread and everyone is covered.

Why should I have to purchase something I don't want, just because it makes it better for those who do want it?

[Neu Leonstein]

To keep the costs down for a system that makes it illegal to deny coverage for those with pre-existing conditions getting insurance should be mandatory. That way the risk is spread and everyone is covered.

Which amounts to a giant subsidy, really. And I seriously doubt that, looking at it from the point of view of society, requiring everyone to pay premia (and the majority of the uninsured today are healthy, young people apparently) would reduce costs. It's just redistribution.

Many people don't bother with insurance beyond their work because its expensive and because they'll have to pay extra for pre-existing conditions and the like. Also, in a free market how would the elderly generally not be priced out of the market?

By signing up for life-long insurances which you can't get kicked out of, outside of your place of work. Many people don't do that at the moment, because they get subsidised insurance through their employer, and hope they can make it until they're eligible for Medicare, in which case they are covered for the worst. But that's a risky way of doing things, and one which costs the US a lot of money.

I'm not contradicting myself at all. The large current insurance companies are rolling in the profit, they can afford to pay many more claims than they do currently.

All insurances can afford to pay more claims than they do, hence why they make profits. But take that away from them and you'll see there won't be any insurances. And besides, are you going to make a law that makes it mandatory to insure people who have pre-existing conditions up to the point at which it would no longer be profitable? You don't know the numbers that would confirm whether or not this policy would overstretch the industry or have other consequences, I don't that anyone does.

However, insurance companies require large amounts of start-up capital to begin, capital that is hard to come by. Relaxing regulations on creation of insurance companies will open the doors to companies that promise low rates and high coverage, however, when it comes time to pay out, they will not have the necessary capital and go out of business, leaving customers SOL. These companies will also ruin the market for insurance; their low rates will drive actual companies out of business.

Capital isn't that hard to come by, if you can demonstrate to investors that you've got a good business. In other words, that your receipts far exceed your expected pay-outs. They do that by designing a portfolio of policyholders, using probability theory and the like. If they actually can't demonstrate it to investors, they won't have the capital and there won't be anything to worry about.

At any rate, your argument boils down to: by letting competition into the market the big established companies won't have it as easy and that's bad. Suffice to say that I disagree and think you've misunderstood the whole point behind competition.

[Tech-gnosis]

Which amounts to a giant subsidy, really. And I seriously doubt that, looking at it from the point of view of society, requiring everyone to pay premia (and the majority of the uninsured today are healthy, young people apparently) would reduce costs. It's just redistribution.

Having everybody pay for insurance would reduce the reduce the cost of premiums, not necessarily costs in aggregate. Any how I don't have any problem with redistribution.

By signing up for life-long insurances which you can't get kicked out of, outside of your place of work. Many people don't do that at the moment, because they get subsidised insurance through their employer, and hope they can make it until they're eligible for Medicare, in which case they are covered for the worst. But that's a risky way of doing things, and one which costs the US a lot of money.

I'm not aware of any life-long insurances which you can't get kicked out. In any case, said insurance would have to take the high level of healthcare inflation into consideration and would be more expensive than plans that could kick their customers. It also leaves consumers pretty fucked if the company goes under or they have problems with the insurance company since if any health problems arose they will be in a poorer bargaining position.

[Rolling squid]

All insurances can afford to pay more claims than they do, hence why they make profits. But take that away from them and you'll see there won't be any insurances. And besides, are you going to make a law that makes it mandatory to insure people who have pre-existing conditions up to the point at which it would no longer be profitable? You don't know the numbers that would confirm whether or not this policy would overstretch the industry or have other consequences, I don't that anyone does.

What I was saying is that companies are making enough that they can pay out most of the claims they deny, and still turn a profit. And if they can't, then the they obviously were inneficent, and should be replaced anyways.

At any rate, your argument boils down to: by letting competition into the market the big established companies won't have it as easy and that's bad. Suffice to say that I disagree and think you've misunderstood the whole point behind competition.

You really don't want insurance to be highly competitive, as insurance companies going out of business tends to shaft their customers. Ideal, all forms of insurance would be provided by a single publicly accountable firm. This would remover the inherent wrongness about modern insurance, where companies sell people protection for misfortune, but include as many exemptions as possible. There are just some things that shouldn't be for profit.

[Rhodmhire]

Any religion that insists on only using faith healing.

Christian Science. And I've heard Scientology, but I have no idea what the Church of Scientology's views are on medical treatment, only that people are some immortal beings who've lost their old ways or something.

[Neu Leonstein]

Having everybody pay for insurance would reduce the reduce the cost of premiums, not necessarily costs in aggregate. Any how I don't have any problem with redistribution.

It does appear to be a particularly cynical case though: "here, buy this product you don't want and presumably don't need, so that the costs of production fall and the price is lower for others". It's like redistribution and corporate welfare all rolled into one.

I'm not aware of any life-long insurances which you can't get kicked out.

Well, there are certain things you can do that will see you lose coverage. Like lying about your health etc. But I'm pretty sure there are insurances that actually insure you for life, provided that you sign up early enough. If you don't, that's ultimately your own decision and your own problem, but the current system leaves people with incentives to make bad decisions.

In any case, said insurance would have to take the high level of healthcare inflation into consideration and would be more expensive than plans that could kick their customers. It also leaves consumers pretty fucked if the company goes under or they have problems with the insurance company since if any health problems arose they will be in a poorer bargaining position.

It's not perfect, but surely it's better than the current system. And indeed the part that I criticise about it at the moment won't be fixed by Obama either - if anything the indication is that he'll try and subsidise employer-provided insurances even further. That leaves people with more eggs in one basket, and it is not only a burden for the employer, but also leaves the employee rather more fucked than my idea if they lose their job and are in a bad position income-wise to go and get a different insurance.

What I was saying is that companies are making enough that they can pay out most of the claims they deny, and still turn a profit. And if they can't, then the they obviously were inneficent, and should be replaced anyways.

But if that is true, what is your solution? A law which says how many claims they can deny, or one that says how much profit they can make? Neither seems like the kind of policy that will improve this market in the States.

You really don't want insurance to be highly competitive, as insurance companies going out of business tends to shaft their customers. Ideal, all forms of insurance would be provided by a single publicly accountable firm. This would remover the inherent wrongness about modern insurance, where companies sell people protection for misfortune, but include as many exemptions as possible.

No monopolist is ever publicly accountable. Either it is private, in which case everyone gets shafted, or it is a government entity, in which case everyone but the politicians who claim the good parts and blame the bad ones on the opposition gets shafted. The US government in particular is not very good at making public entities work well - the whole states v federal and the extreme partisan nature of US politics seem to see to that.

And at any rate, I seem to recall a certain large insurance company which let down the US taxpayer (and many of its customers) big time recently, and two semi-state institutions designed to play with probabilities to improve access to loans for poor people as well. A public insurer will necessarily err on the side of expanding provision. That leaves it with the problem that it will either be a massive, ongoing drain on the budget, or that some way of controlling costs must be found. The former doesn't seem like a smart idea given the state of US finances, the latter means diluted services for everyone. So then everyone gets to go to the GP, but it will only be the very rich who can treat their million-dollar diseases. And while insurance companies try to avoid paying out wherever they can, at least some percentage of such claims are granted at the moment.

There are just some things that shouldn't be for profit.

Yes. But insurance is probably not one of them. You can argue that by its nature it lends itself to beneficial government involvement, but that's fundamentally different from actual government provision.

[Tech-gnosis]

It does appear to be a particularly cynical case though: "here, buy this product you don't want and presumably don't need, so that the costs of production fall and the price is lower for others". It's like redistribution and corporate welfare all rolled into one.

One could say the same about law enforcement, particularly as a subsidy for high crime low income urban neighborhoods.

Well, there are certain things you can do that will see you lose coverage. Like lying about your health etc. But I'm pretty sure there are insurances that actually insure you for life, provided that you sign up early enough. If you don't, that's ultimately your own decision and your own problem, but the current system leaves people with incentives to make bad decisions.

I'm not sure those policies are feasible for most people, but I don't disagree about the current system.

[

[Rolling squid]

But if that is true, what is your solution? A law which says how many claims they can deny, or one that says how much profit they can make? Neither seems like the kind of policy that will improve this market in the States.

Laws that prevent insurance companies from denying claims based on preexisting conditions, claiming a treatment is experimental, and dropping people for daring to file claims.

No monopolist is ever publicly accountable. Either it is private, in which case everyone gets shafted, or it is a government entity, in which case everyone but the politicians who claim the good parts and blame the bad ones on the opposition gets shafted. The US government in particular is not very good at making public entities work well - the whole states v federal and the extreme partisan nature of US politics seem to see to that.

Probably true, America's federalist system tends to fuck up socialist initiatives. Still, I trust governments more than private corporations. Governments are self-regulating, and publicly accountable. Corporation, not so much.

Yes. But insurance is probably not one of them. You can argue that by its nature it lends itself to beneficial government involvement, but that's fundamentally different from actual government provision.

I do think there needs to be a government option, if only to guarantee that everyone gets basic preventative care and life saving care. No one should die because of lack of money, and universal preventative care saves money in the long run.

[Bluth Corporation]

Would you expect a company that provides homeowners' insurance to insure a house that's already on fire?