Healthcare, health policy, cognitive science. , and the path to Universal Healthcare..
“The data shows that many countries with ‘nationalized’ health care systems have little or no waits for elective medical procedures. A 2003 OECD working paper entitled ‘Explaining Waiting Times Variations for Elective Surgery across OECD Countries’ by Luigi Siciliani and Jeremy Hurst provides some survey evidence of actual waiting times in various OECD countries. The results of that survey are presented below.”
Two nice tables here explain a lot…
Thanks to Todd Kunkler at MD Net Guide for his excellent post with links to information about waiting times!
I’ll repeat the links here in individual posts for easier access. If you go to his original post, they are obviously all there for the investigating.
Cheers,
US Slipping in Life Expectancy Rankings – washingtonpost.com: “Murray, from the University of Washington, said improved access to health insurance could increase life expectancy. But, he predicted, the U.S. won’t move up in the world rankings as long as the health care debate is limited to insurance. Policymakers also should focus on ways to reduce cancer, heart disease and lung disease, said Murray. He advocates stepped-up efforts to reduce tobacco use, control blood pressure, reduce cholesterol and regulate blood sugar. ‘Even if we focused only on those four things, we would go along way toward improving health care in the United States,’ Murray said. ‘The starting point is the recognition that the U.S. does not have the best health care system. There are still an awful lot of people who think it does.'”
Summary from National Center for Policy Analysis (as I don’t get the WSJ)
COST CONTROL FOR DUMMIES
[Source: Merrill Matthews, “Cost Control for Dummies,” Wall Street Journal, August 15, 2007.]
http://online.wsj.com/article/SB118714325206398102.html
Whenever the government controls prices, it arbitrarily determines who it will
pay, how much, and for what, explains Matthews.
Someone explain to me why this is seen as “arbitrary”? Are they tossing coins? As long as we can maintain an open debate about healthcare spending priorities, decisions will not be “arbitrary.” Though, I think , the definition of arbitrary for many, is that it didn’t go their way.
Cheers,
France’s model healthcare system – The Boston Globe:
“National health insurance in France stands upon two grand historical bargains — the first with doctors and a second with insurers. Doctors only agreed to participate in compulsory health insurance if the law protected a patient’s choice of practitioner and guaranteed physicians’ control over medical decision-making. Given their current frustrations, America’s doctors might finally be convinced to throw their support behind universal health insurance if it protected their professional judgment and created a sane system of billing and reimbursement. French legislators also overcame insurance industry resistance by permitting the nation’s already existing insurers to administer its new healthcare funds. Private health insurers are also central to the system as supplemental insurers who cover patient expenses that are not paid for by Sécurité Sociale. Indeed, nearly 90 percent of the French population possesses such coverage, making France home to a booming private health insurance market.”
I think that, except for the hard core ideologues, physicians would by and large accept this bargain.
Aggressive Treatments at End of Life Linked to Worse Quality of Death:
“‘The more time patients spent under hospice care, the greater their quality of death,’ Mr. Silverman said. ‘For example, patients who received at least 5 weeks of hospice care were in less physical distress in their last week of life than those who lived less than a week with hospice, and those who received no hospice at all were in the most physical distress at the end of their lives. These results suggest that when patients are actively dying, the use of aggressive treatments should be considered with caution and only pursued with the full understanding of patients or their surrogate decision makers.’ “
Another pet topic of mine, poor end-of-life care. This is especially tragic, as it represents people being egged on to continue aggressive treatments with full knowledge that there will be no substantial benefit. The resources wasted by this are secondary to the human suffering, but they are massive.
Cheers.
Medicare Fraud Settlement Causes Oncologists to Lose Income:
“The cases centered around a major sales promotion effort by two pharmaceutical companies, AstraZeneca and TAP Pharmaceuticals, that encouraged oncologists who received free drug samples to provide the samples to their Medicare-insured prostate cancer patients and bill Medicare the $1,200 charge for the product. Many oncologists earned an extra $100,000 annually in income with this program, and some of the busier ones earned more than $1 “
Sorry this is old news, but I’m tring to dig up information on “rebates’ and the like to physicians from drug and equipment companies. Let me make it clear that this is unique to certain specialties and is not in any way routine practice for the vast majority of physicians.
Cheers.
ACP Online – ObserverWeekly – 14 August 2007: “Study: Expanding preventive services would save 100,000-plus lives Beefing up preventive care measures such as flu shots and cancer screenings would save more than 100,000 U.S. lives each year, a new study found. The Partnership for Prevention study found 45,000 fewer people would die each year if 90% of adults took aspirin daily to prevent heart disease, instead of the 50% taking it currently. Likewise, if 90% of smokers were given cessation advice, medicine and support by a health professional, 42,000 fewer people would die each year, the study found. Other measures that would save lives, if 90% of the target population received them, include: Colorectal cancer screenings for adults age 50 and over would save 14,000 lives. Fewer than 50% of these adults are screened now; Annual flu shots for adults age 50 and over would save 12,000 lives. Fewer than 37% get the shots now; Breast cancer screening every two years for women age 40 and over would save 3,700 lives. About 67% are screened now; and Chlamydia screenings for sexually active young women would prevent 30,000 cases of pelvic inflammatory disease annually. About 40% are screened now. The study also found African Americans, Hispanic Americans and Asian Americans were less likely to use preventive care than whites. That’s partly because many minorities lack continuity of health care or an ongoing relationship with a health professional who can help ensure preventive measures are taken, an expert said. The study was funded by the CDC, the Robert Wood Johnson Foundation and WellPoint Foundation. The Partnership for Prevention report is online here in pdf. “
Another data point for (inadequate) access to treatment and preventative services. In Sally Pipes piece, she comments about 10% of Canadians looking for a PCP. Ha!
Cheers,
Court Rules Out Terminally Ill for Tests – washingtonpost.com:
“Terminally ill patients do not have a constitutional right to be treated with experimental drugs, even if they likely will be dead before the medicine is approved, a federal appeals court said Tuesday. The ruling by the U.S. Court of Appeals for the District of Columbia Circuit overturned last year’s decision by a smaller panel of the same court, which held that terminally ill patients may not be denied access to potentially lifesaving drugs.”
Just thought I’d start gathering data points about access to treatment, as that seems to be brought up quite a lot in these discussions. My position is that these access issues will need to be carefully thought out and thoughtfully debated as we move to a single payer system.
“When the government pays for healthcare, saving money is more important than saving lives. So bureaucrats have an incentive to delay – or deny – the introduction of new, costly drugs.”
The people who write this stuff are a.) not involved in healthcare (at least, not seeing actual patients in any meaningful way) and b.)must have the best G-D insurance in the world. The idea that the US would come out on top in an “anecdote-off” is laughable to all of us actually in healthcare. Our US bureaucrats in our wonderful private insurance industry would make most Soviet era bureaucrats blush.
But the key is this: when the government pays for healthcare, if they don’t cover what we demand, then that is a problem with the citizenry, not the bureaucrats, for not taking command of the situation. When we get to a single payer system, it will be up to us to be vigilant and oversee what is being done by our government. I know that is an odd concept to the Bushies, but that is how government needs to work. And, yet, I can guarantee that the Sally Pipes’ of this world will howl the loudest when money is being spent on Rituxan for someone other than her family member because it would then be “wasteful government spending”!
Cheers,